Abstract
OBJECTIVE: To evaluate whether "Script Killing" immersive teaching improves job competency among resident physicians rotating through the emergency department across departments. METHODS: We conducted a cohort-allocated controlled educational study at Zhengzhou People's Hospital (November 2024 to March 2025). Thirty-six rotating residents were allocated by cohort to an intervention group (n = 18; "Script Killing" immersive role-play, also referred to as a murder-mystery game-based scenario teaching) or a control group (n = 18; traditional teaching). Outcomes included written theoretical assessment, objective structured clinical examination (OSCE), teaching satisfaction, recognition of the teaching process, clinical decision-making indicators (e.g., triage accuracy and reasonableness of emergency management plans), and 3-month knowledge retention. RESULTS: After 3 months, the intervention group scored higher than controls in theoretical knowledge (86.82 ± 2.85 vs. 72.45 ± 3.25) and OSCE performance (92.47 ± 3.22 vs. 75.18 ± 4.08) (both p < 0.001). Triage accuracy was higher in the intervention group (94.44% vs. 66.67%, p = 0.034). The reasonableness of management plans was numerically higher but did not reach statistical significance (88.89% vs. 61.11%, p = 0.054). At 3-month follow-up, the intervention group showed better knowledge retention, with smaller declines in theoretical and OSCE scores from baseline (p < 0.001). CONCLUSION: "Script Killing" immersive teaching was associated with improved examination performance, OSCE skills, and key decision-making behaviors, with higher learner satisfaction and improved knowledge retention among cross-department rotating residents in the emergency department.