Abstract
BACKGROUND: Undergraduate medical education in China faces significant gaps in integrating theory with practice, with 32.7% of graduates requiring remedial procedural training. OBJECTIVE: To implement and evaluate a competency-based reform targeting problem-solving and practical skills. METHODS: In a single-center RCT (Anhui, China; 2023-2024), 180 medical undergraduates were randomized to control (traditional pedagogy, n = 90) or intervention groups (reformed curriculum: 40% practice-oriented content, integrated PBL/TBL/CBT). Assessments used OSCE-aligned tools (clinical checklists: Cronbach's α = 0.89; case analysis rubrics: κ = 0.85). RESULTS: Intervention group showed significant improvements: theoretical scores (78.7 ± 3.9 vs 68.3 ± 4.8; t = -17.78, P < 0.01, d = 2.39); clinical skill excellence (80.4% vs 60.2%; χ² = 25.93, P < 0.001, OR = 2.67); PBL adaptability (70.1% vs 42.3%; χ² = 9.0, P < 0.05). CONCLUSION: This reform bridges theory-practice gaps and enhances clinical decision-making, requiring institutional support for scalability.