Abstract
OBJECTIVE: To investigate the efficacy of situational simulation teaching (SST) in enhancing clinical thinking competencies among residents. METHODS: A randomized controlled trial was conducted with second-year residents (n = 121) during their rotation (May-August 2025). Participants were allocated to either an intervention group (n = 57, receiving SST) or a control group (n = 64, conventional training). Pre- and post-intervention assessments evaluated clinical thinking performance. Faculty assessments using the entrust able professional activities (EPAs) and Mini-clinical evaluation exercise (Mini-CEX) were completed within 2 weeks post-training, supplemented by resident satisfaction surveys. RESULTS: Both groups demonstrated significant post-intervention improvement in overall clinical thinking scores (all P < 0.05), except for the "Ethics and Professionalism" domain in controls (P = 0.12).The intervention group outperformed the control group in total clinical thinking scores and all sub-dimensions (P < 0.05), with higher EPAs scores, EPA pass rates, and Mini-CEX total scores (all P < 0.05). Resident satisfaction (content, resources, interaction, and teaching methods) was also significantly higher in the intervention group (P < 0.05). CONCLUSION: SST significantly enhances clinical thinking development in residency programs.