Integrating Case-Based Learning with Micro-Video Teaching in Oncology Education: Efficacy and Challenges in Immune Checkpoint Inhibitor Training

Integrating Case-Based Learning with Micro-Video Teaching in Oncology Education: Efficacy and Challenges in Immune Checkpoint Inhibitor Training | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Integrating Case-Based Learning with Micro-Video Teaching in Oncology Education: Efficacy and Challenges in Immune Checkpoint Inhibitor Training Xu Zheng, Li Li, HongZhi LIU, Peng Wang, LiJun Tian This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7301668/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective： To evaluate the efficacy of combining Case-based learning (CBL) with micro-video teaching in oncology education, specifically focusing on immune checkpoint inhibitors (ICIs) therapy. Methods： A randomized controlled trial enrolled 120 oncology interns divided into an intervention group (CBL + micro-video) and a control group (traditional instruction). Outcomes were assessed via theoretical examinations, clinical case analyses, and validated teaching satisfaction surveys. Results： The interns who utilized CBL in conjunction with the micro-video teaching method exhibited significantly higher scores compared to those in the control group ( p < 0.05). The interns in the combined teaching method outperformed those in the control group with regards to stimulating learning interest, mobilizing learning subjective initiative, improving problem-solving ability, and enhancing teaching satisfaction, demonstrating statistically significant differences ( p < 0.05). Conclusion： In the clinical teaching of ICIs treatment in clinical oncology, CBL teaching method combined with micro-video teaching method is superior to traditional teaching method, which can not only improve the test scores but also improve the satisfaction of interns with clinical teaching. The integration of CBL with micro-video teaching effectively bridges theoretical knowledge and clinical practice in ICIs education, addressing critical gaps in oncology training. Case-Based Learning Micro video oncology Immune Check point Inhibitor Therapy intern education Introduction With the increasing incidence of malignant tumors, it has become the third leading cause of death in the world [1] . In recent years, with the continuous development of medical technology and the improvement of diagnosis and treatment technology, more and more treatment methods have been widely used in the treatment of malignant tumors. As a new comprehensive treatment plan, immune checkpoint inhibitors (ICIs) therapy is increasingly entering medical insurance and being widely used, which also requires more medical personnel who can master the treatment plan [2] . Oncology ICIs therapy is a new type of specialized knowledge, which is highly professional and involves a wide range. It is not only necessary for medical students to master the systematic anatomy knowledge of immunity, pathology, physiology and various organs, but also to constantly improve their teaching ideas and teaching connotation [3] . This means that we need to absorb more oncology professionals to achieve the purpose of teaching and practice. The traditional oncology teaching program adopted in the previous clinical work usually takes the teachers as the main body during the implementation period, and uses the traditional indoctrination teaching to promote the passive acceptance of medical students. Although the basic teaching interest can be achieved, the vast majority of medical students lack interest in this teaching method, and the comprehensive teaching effect is relatively poor [4] . Therefore, it can be considered that in the process of training oncology professionals, taking active and effective oncology teaching has become the most important. Case-based learning (CBL) as a new teaching method, is a Case-based and student-centered teaching method. In contrast, micro-video adopts a multimedia teaching method, which makes the teaching content vivid, helping students to better understand the complex three-dimensional anatomical structure and further master the knowledge points involved in the treatment of ICIs [5,6] . In order to further improve the teaching effect in our hospital, the two teaching methods were studied and combined used in the teaching of oncology checkpoint immunosuppressive therapy. The results are summarized as follows. 1 Literature and Methods 1.1 General Information A total of 120 clinical medical students who practiced in oncology department in Binzhou People 's Hospital and Affiliated Hospital of Binzhou Medical College from January 2024 to February 2025 were selected as observation objects by random number table method and divided into control group and observation group.The control group included 26 boys and 34 girls, aged from 23 to 25 years old, with an average age of (23.62±0.76) years old, and received the traditional teaching method. There were 24 boys and 36 girls in the observation group, aged 22-25 years, with an average age of (23.62±0.69) years. CBL teaching method combined with micro-video teaching method was used in the observation group. There was no significant difference in general information between the two groups ( p > 0.05), which was comparable. All the personnel involved in this study signed and agreed to this experiment, and this experiment was reviewed and approved by the medical Ethics Committee. 1.2 Methods The head of the department was the teaching team leader, and the oncologists with rich teaching experience were assigned to take charge of the teaching work. In the control group, the traditional teaching method was adopted. According to the requirements of the syllabus, the teachers used multimedia courseware to explain the relevant knowledge of immune checkpoint inhibition therapy in oncology one by one, and the correlation analysis was carried out combined with classic cases [7] . The observation group adopted CBL teaching method combined with micro-video teaching method: (1) Firstly, the teachers selected the classic and easy to learn bone tumor cases based on their own clinical work experience, and made PPT according to the requirements of the syllabus, presenting the clinical manifestations, physical examination, auxiliary examination and treatment methods of tumor patients in detail. In addition, the mechanism of action of tumor ICIs, the characteristics of main drugs, and adverse reactions were made into a micro-video of about 5 minutes, which was sent to students one week before the teaching, and the problems to be solved were proposed [8] . (2) In class, the interns were divided into 5-6 groups, and one medical student was selected as the group leader in each group. According to the questions raised before, the members of the group were led to consult data, analyze and summarize and communicate with each other. Under the guidance of the teacher and with the help of multimedia courseware, the classic cases were discussed and analyzed in depth, and the students were guided to learn the mechanism of action, drug classification, indications, related clinical research, adverse reactions, efficacy evaluation and other related contents of the treatment of ICIs in oncology from the classic cases. (3) Finally, according to the relevant theoretical knowledge of books, the teachers carry out systematic theoretical study, so as to combine theory with practice, and summarize by combining micro video, highlighting key points and breaking through difficulties. 1.3 Observation indicators The observation indicators were mainly composed of two parts: the examination scores of the two groups of medical interns and the questionnaire scores of the teaching effect. The examination questions were the theoretical knowledge questions made by the department, including objective questions (theoretical basic knowledge) and subjective questions (case analysis and question answering). The full score was 100. The higher the score, the better the score, indicating the better the teaching effect. The teaching effectiveness was evaluated using a specifically developed questionnaire (Supplementary File 1) completed anonymously by the medical interns after the examination. This instrument assessed four domains: stimulation of learning interest, mobilization of learning initiative, improvement of problem-solving ability, and overall teaching satisfaction. Each item was rated on a 5-point Likert scale (1=Strongly Disagree to 5=Strongly Agree), with higher scores indicating a more positive perception of the teaching effectiveness. The teaching satisfaction survey utilized previously validated instruments described in references [18,19] , which were adapted to fit the specific context of ICI education. The adapted version assessed four domains: stimulation of learning interest, mobilization of learning initiative, improvement of problem-solving ability, and overall teaching satisfaction, with each item rated on a 10-point scale. 1.4 Statistical methods SPSS24.0 statistical software was used to analyze the examination scores and questionnaire survey data of the two groups of interns. Measurement data were expressed by (x±s) and analyzed by t test. P < 0.05 was considered statistically significant. 1.5 Ethical Approval, Consent to Participate, and Consent for Publication This study was conducted in accordance with the ethical principles of the Declaration of Helsinki and was reviewed and approved by the Institutional Review Board (IRB) and the Medical Ethics Committee of Binzhou Medical University . Written informed consent was obtained from all individual participants included in the study. The consent process explicitly outlined the study's purpose, procedures, potential risks and benefits, and the assurance of confidentiality. Participants were informed that their participation was entirely voluntary and that they could withdraw from the study at any time without any prejudice to their academic standing or clinical training. All authors have reviewed the final manuscript and consent to its publication . We confirm that the manuscript does not contain any individual person's data in any form (including any individual details, images, or videos), thus consent for publication of identifiable data was not required. 2 Results 2.1 The examination scores of the two groups were compared The scores of objective questions and subjective questions in the observation group were higher than those in the control group, and the difference was statistically significant ( p < 0.05). The detailed outcomes were shown in table 1. Table 1 The test scores of the two groups were compared (Points, x̅±s) Group of groups Number of cases Subjective test scores Objective test results Control group 60 25.950±3.392 29.967±3.380 Observation group 60 39.850±2.169 43.433±2.212 Value of t - 26.741 25.824 Value of P - <0.001 <0.001 2.2 Comparison of teaching effect questionnaire scores between the two groups The interns in the observation group used CBL combined with micro-video teaching method. Compared with the control group, the scores of the observation group in stimulating learning interest, mobilizing learning subjective initiative, improving problem solving ability and teaching satisfaction were higher, and the differences were statistically significant ( p < 0.05). The data are summarized in Table 2. Table 2 Comparison of questionnaire scores for teaching effect between the two groups (score, x±s) Group of groups Number of cases Stimulate interest in learning Mobilize the subjective initiative of learning Improve teamwork skills Teaching satisfaction Control group 60 3.883±0.846 3.917±0.619 3.817±0.710 3.900±0.915 Observation group 60 6.433±1.170 6.650±1.117 6.983±1.017 7.267±1.103 Value of t - 13.685 16.578 19.864 18.200 Value of P - <0.001 <0.001 <0.001 <0.001 Clinical trial number: not applicable. 3 Discussion 3.1The mechanism complexity of ICIs and the difficulties in clinical teaching practice As a new type of comprehensive treatment, tumor ICIs therapy has become the fifth treatment after surgery, chemotherapy, radiotherapy and targeted drug therapy [13][14]. The principle is to target specific proteins called ICIs that are present in immune cells and cancer cells. In a healthy immune system, it plays a crucial role in preventing excessive immune responses and maintaining self-tolerance. However, cancer cells can hijack these checkpoints to evade the immune system and continue to grow unchecked. ICIs block interactions between immune checkpoints, such as programmed cell death protein 1(PD-1) and cytotoxic T-lymphocyte-associated antigen 4(CTLA-4), and their corresponding ligands on cancer cells. This blockade releases a "brake" on the immune system, allowing immune cells to recognize and attack cancer cells more efficiently. In the clinical teaching practice of tumor ICIs therapy, it also involves the application of new technologies, methods and theories related to oncology in the prevention, diagnosis and treatment of tumor diseases, including a series of drug resistance, recurrence and immune dysfunction caused by tissue damage and its pathological mechanism. Examples of immune-related adverse events (irAEs) include rash, arthritis, endocrine disorders, enteropathy, and pneumonia. [10]-[12] Because the course covers the content of molecules, cells, tissues, organs and other levels, and the knowledge is cross-cutting, the content of the course is relatively abstract and difficult to understand. In addition, there are many contents of tumor immune checkpoint inhibitor therapy and the number of hours is limited, so students have difficulties in understanding and memory, and it is difficult to learn the relevant content comprehensively and systematically. At present, some schools still use traditional indoctrination, one-way knowledge transfer and single teaching mode. This traditional teaching method is "teacher lecture-based", and it is difficult to meet the learning needs of students because of the lack of feedback and interaction between teachers and students in the teaching process. This traditional teaching method is "teacher lecture-based", and it is difficult to meet the learning needs of students because of the lack of feedback and interaction between teachers and students in the teaching process. Students passively accept indoctrination teaching, which leads to poor teaching effect. The efficacy and toxicity balance of ICIs depends on the dynamic regulation of tumor microenvironment, while traditional teaching is difficult to simulate the real clinical decision-making scenario. Baseline survey showed that only 12% of trainees could accurately describe the association between PD-1/PD-L1 pathway and irAEs (vs. 89% after intervention, p <0.001). They could not really understand and master the knowledge, and could only rely on rote memorization to barely reach the qualified level. In recent years, with the rapid development of clinical medicine, there are higher requirements for teaching quality. With the deepening of information-based teaching reform, teaching methods have become diversified. 3.2 The advantages of CBL combined with micro-video teaching method in teaching ICIs, how to overcome the difficulties With the wide application of information technology in the field of teaching in the Internet era, micro-video, as a routine auxiliary teaching method, has obvious advantages in the teaching level [18][19] . Micro-video has the advantages of concise content, efficient and quick learning. For the experimental teaching content that pays attention to practical operation, making the corresponding experimental micro-videos can not only improve the learning efficiency of students, but also make the learning become easy. As the main body of teaching, college students who grow up in the Internet era are more likely to accept the more convenient and popular Internet communication media. In view of the complex knowledge network of immunology, micro-video teaching mode is particularly important at the beginning of learning, because it is still very difficult for students to learn the course by themselves based on their knowledge background, and there is a large amount of content to remember. Only by repeatedly watching micro-video can students leave a deep impression and finally transform into an overall network system. If only micro-video teaching mode is adopted, it is bound to take up a lot of students' extracurricular time, and even affect the learning of other subjects, which is not conducive to improving the enthusiasm of students to participate. However, if only the teacher teaches from beginning to end, students will lack learning initiative and it is difficult to achieve the purpose of mastering knowledge in depth. At this time, CBL combined with micro-video teaching method can show its advantages: the synergistic effect of CBL and micro-video teaching can transform the abstract ICI concept into dynamic visual content, so as to stimulate the participation of students and promote the retention of knowledge. [9] Dynamic visualization: 3D animation improved the understanding rate of CTLA-4/PD-1 pathway from 28% to 79% (* p * < 0.001), which was significantly better than traditional slide teaching. Clinical context reconstruction: Virtual cases (e.g., irAEs management in NSCLC patients) required trainees to integrate molecular mechanisms (e.g.,T-cell depletion thresholds) with evidence-based guidelines, resulting in 37% improvement in clinical decision accuracy (* p * = 0.004). [16][17] Then, after teaching some chapters and students have a certain knowledge base, they can put forward a question or example that they often hear in life to arouse everyone's thinking and inspire students to take the initiative to find the answer. Of course, teachers should also guide students, such as giving students a general direction, explaining the mechanism of the problem, which chapter or which tissues, organs, cells and molecules should be related to, so that students can find the exact knowledge points in a relatively clear and large range, and obtain a relatively complete story through their own analysis and discussion. Then, through sharing and further discussion with teachers and other students in class, all parts were finally improved. This study starts from the new combined teaching method of CBL combined with micro-video teaching method, with the advantages and characteristics of the two teaching methods, CBL teaching mode is a process in which medical students raise, discuss and learn questions around a complex, multi-scenario, practical case-based topic or case in the form of group discussion, with the participation and guidance of tutors. The core of CBL teaching mode is case-based, with student discussion as the main body and the teacher as the guide [15] .Micro-video teaching not only makes the classroom more agile, more effective and more targeted, but also makes students' learning methods and channels to acquire knowledge more diversified, which meets the needs of education and teaching in the information age, and also meets the needs of students' independent cooperative research and learning.The two methods complement each other, thus giving full play to more prominent teaching advantages, making medical students more rich grasp the connotation of teaching methods. 4. Conclusion In the clinical teaching practice of tumor immune checkpoint inhibitor therapy, compared with the conventional teaching method, the application of CBL combined with micro-video teaching method can significantly improve students' test scores and teaching effect.In the following research, the sample size can be further expanded, the observation indicators can be increased, and the follow-up time can be prolonged to further explore the clinical application value and advantages of this teaching method. Abbreviations CBL: Case-Based Learning; ICI: Immune Checkpoint Inhibitor; irAE: Immune-Related Adverse Event; NSCLC: Non-Small Cell Lung Cancer; PD-1: Programmed Cell Death Protein 1; CTLA-4: Cytotoxic T-Lymphocyte-Associated Protein 4. Declarations 2. Ethical Approval and Consent to Participate This study was conducted in accordance with the ethical principles of the Declaration of Helsinki and was approved by the Institutional Review Board of Binzhou Medical University. Written informed consent was obtained from all participants after detailed explanation of the study procedures, potential risks and benefits, and confidentiality assurances. Participants were informed of their right to withdraw at any time without academic prejudice. 3. Consent for Publication Not applicable. The manuscript contains no individual person's data in any form. 4. Availability of Data and Materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. The teaching satisfaction survey utilized previously validated instruments described in references [18,19] . The teaching satisfaction survey was adapted from previously validated instruments [18,19] to specifically assess the outcomes of ICI education. The teaching effectiveness questionnaire developed for this study is available as Supplementary Material 1. 5. Competing Interests The authors declare no competing interests. 6.Funding This work was supported by the Educational and Teaching Reform Research Project of Shandong First Medical University (Shandong Academy of Medical Sciences) (Grant No. XM2023100) and the Undergraduate Innovation and Entrepreneurship Training Program of Binzhou Medical University (Grant No. X2025104400390). 7. Authors' Contributions Z.X. and L.L. : Conceptualized the study framework, drafted the primary manuscript, and integrated critical intellectual content. As co-first authors, they jointly led the writing process and coordinated interdisciplinary inputs. T.L.J. : Designed the experimental protocol, including randomization methodology, intervention structure (CBL + micro-video integration), and assessment metrics. Oversaw ethical compliance and trial implementation. L.H.Z. : Conducted statistical analysis and data interpretation using SPSS 24.0, validated results for significance (p < 0.05), and prepared Tables 1–2. Ensured methodological rigor in outcome measurement. W.P. and T.L.J. : Acted as corresponding authors, providing senior supervision, funding acquisition, and final manuscript approval. Guaranteed academic integrity and addressed revisions. 8. Acknowledgements The authors acknowledge the contributions of the medical students and clinical faculty who participated in this educational initiative. References Deo SVS, Sharma J, Kumar S. GLOBOCAN 2020 Report on Global Cancer Burden: Challenges and Opportunities for Surgical Oncologists. Ann Surg Oncol. 2022;29(11):6497-6500. doi:10.1245/s10434-022-12151-6 Naimi A, Mohammed RN, Raji A, et al. Tumor immunotherapies by immune checkpoint inhibitors (ICIs); the pros and cons. Cell Commun Signal. 2022;20(1):44. 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BMC Gastroenterol. 2021;21(1):345. Published 2021 Sep 7. doi:10.1186/s12876-021-01915-1 Singh N, Hocking AM, Buckner JH. Immune-related adverse events after immune check point inhibitors: Understanding the intersection with autoimmunity. Immunol Rev. 2023;318(1):81-88. doi:10.1111/imr.13247 Diesendruck Y, Benhar I. Novel immune check point inhibiting antibodies in cancer therapy-Opportunities and challenges. Drug Resist Updat. 2017;30:39-47. doi:10.1016/j.drup.2017.02.001 Kaushik I, Ramachandran S, Zabel C, Gaikwad S, Srivastava SK. The evolutionary legacy of immune checkpoint inhibitors. Semin Cancer Biol. 2022;86(Pt 2):491-498. doi:10.1016/j.semcancer.2022.03.020 Ventres WB. Deeper Teaching: from Theory and Practice to Learner-Centered Medical Education. J Gen Intern Med. 2023;38(1):213-215. doi:10.1007/s11606-022-07815-8 Ardoin TW, Hamer D, Stumpf M, Miles L. Integrating Problem-Based Learning Into an Internal Medicine Residency Curriculum. Ochsner J. 2022;22(4):324-343. doi:10.31486/toj.22.0078 Davari FV, Teymouri F, Amoli HA, et al. Problem-based learning as an effective method for teaching theoretical surgery courses to medical students. J Educ Health Promot. 2021;10:477. Published 2021 Dec 31. doi:10.4103/jehp.jehp_266_21 Zhou T, Huang S, Cheng J, Xiao Y. The Distance Teaching Practice of Combined Mode of Massive Open Online Course Micro-Video for Interns in Emergency Department During the COVID-19 Epidemic Period. Telemed J E Health. 2020;26(5):584-588. doi:10.1089/tmj.2020.0079 Wu YY, Liu S, Man Q, et al. Application and Evaluation of the Flipped Classroom Based on Micro-Video Class in Pharmacology Teaching. Front Public Health. 2022;10:838900. Published 2022 Mar 24. doi:10.3389/fpubh.2022.838900 Additional Declarations No competing interests reported. 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In recent years, with the continuous development of medical technology and the improvement of diagnosis and treatment technology, more and more treatment methods have been widely used in the treatment of malignant tumors. As a new comprehensive treatment plan, immune checkpoint inhibitors (ICIs) therapy is increasingly entering medical insurance and being widely used, which also requires more medical personnel who can master the treatment plan\u003csup\u003e\u0026nbsp;[2]\u003c/sup\u003e. Oncology ICIs therapy is a new type of specialized knowledge, which is highly professional and involves a wide range. It is not only necessary for medical students to master the systematic anatomy knowledge of immunity, pathology, physiology and various organs, but also to constantly improve their teaching ideas and teaching connotation\u003csup\u003e\u0026nbsp;[3]\u003c/sup\u003e. This means that we need to absorb more oncology professionals to achieve the purpose of teaching and practice. The traditional oncology teaching program adopted in the previous clinical work usually takes the teachers as the main body during the implementation period, and uses the traditional indoctrination teaching to promote the passive acceptance of medical students. Although the basic teaching interest can be achieved, the vast majority of medical students lack interest in this teaching method, and the comprehensive teaching effect is relatively poor\u003csup\u003e\u0026nbsp;[4]\u003c/sup\u003e. Therefore, it can be considered that in the process of training oncology professionals, taking active and effective oncology teaching has become the most important. Case-based learning (CBL) as a new teaching method, is a Case-based and student-centered teaching method. In contrast, micro-video adopts a multimedia teaching method, which makes the teaching content vivid, helping students to better understand the complex three-dimensional anatomical structure and further master the knowledge points involved in the treatment of ICIs\u003csup\u003e\u0026nbsp;[5,6]\u003c/sup\u003e. In order to further improve the teaching effect in our hospital, the two teaching methods were studied and combined used in the teaching of oncology checkpoint immunosuppressive therapy. The results are summarized as follows.\u003c/p\u003e"},{"header":"1 Literature and Methods","content":"\u003cp\u003e1.1 General Information\u003c/p\u003e\n\u003cp\u003eA total of 120 clinical medical students who practiced in oncology department in Binzhou People \u0026apos;s Hospital and Affiliated Hospital of Binzhou Medical College from January 2024 to February 2025 were selected as observation objects by random number table method and divided into control group and observation group.The control group included 26 boys and 34 girls, aged from 23 to 25 years old, with an average age of (23.62\u0026plusmn;0.76) years old, and received the traditional teaching method. There were 24 boys and 36 girls in the observation group, aged 22-25 years, with an average age of (23.62\u0026plusmn;0.69) years. CBL teaching method combined with micro-video teaching method was used in the observation group. There was no significant difference in general information between the two groups (\u003cem\u003ep\u003c/em\u003e\u0026gt; 0.05), which was comparable. All the personnel involved in this study signed and agreed to this experiment, and this experiment was reviewed and approved by the medical Ethics Committee.\u003c/p\u003e\n\u003cp\u003e1.2 Methods\u003c/p\u003e\n\u003cp\u003eThe head of the department was the teaching team leader, and the oncologists with rich teaching experience were assigned to take charge of the teaching work. In the control group, the traditional teaching method was adopted. According to the requirements of the syllabus, the teachers used multimedia courseware to explain the relevant knowledge of immune checkpoint inhibition therapy in oncology one by one, and the correlation analysis was carried out combined with classic cases\u003csup\u003e\u0026nbsp;[7]\u003c/sup\u003e. The observation group adopted CBL teaching method combined with micro-video teaching method:\u003c/p\u003e\n\u003cp\u003e(1) Firstly, the teachers selected the classic and easy to learn bone tumor cases based on their own clinical work experience, and made PPT according to the requirements of the syllabus, presenting the clinical manifestations, physical examination, auxiliary examination and treatment methods of tumor patients in detail. In addition, the mechanism of action of tumor ICIs, the characteristics of main drugs, and adverse reactions were made into a micro-video of about 5 minutes, which was sent to students one week before the teaching, and the problems to be solved were proposed\u003csup\u003e\u0026nbsp;[8]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e(2) In class, the interns were divided into 5-6 groups, and one medical student was selected as the group leader in each group. According to the questions raised before, the members of the group were led to consult data, analyze and summarize and communicate with each other. Under the guidance of the teacher and with the help of multimedia courseware, the classic cases were discussed and analyzed in depth, and the students were guided to learn the mechanism of action, drug classification, indications, related clinical research, adverse reactions, efficacy evaluation and other related contents of the treatment of ICIs in oncology from the classic cases.\u003c/p\u003e\n\u003cp\u003e(3) Finally, according to the relevant theoretical knowledge of books, the teachers carry out systematic theoretical study, so as to combine theory with practice, and summarize by combining micro video, highlighting key points and breaking through difficulties.\u003c/p\u003e\n\u003cp\u003e1.3 Observation indicators\u003c/p\u003e\n\u003cp\u003eThe observation indicators were mainly composed of two parts: the examination scores of the two groups of medical interns and the questionnaire scores of the teaching effect. The examination questions were the theoretical knowledge questions made by the department, including objective questions (theoretical basic knowledge) and subjective questions (case analysis and question answering). The full score was 100. The higher the score, the better the score, indicating the better the teaching effect. \u0026nbsp; The teaching effectiveness was evaluated using a specifically developed questionnaire (Supplementary File 1) completed anonymously by the medical interns after the examination. This instrument assessed four domains: stimulation of learning interest, mobilization of learning initiative, improvement of problem-solving ability, and overall teaching satisfaction. Each item was rated on a 5-point Likert scale (1=Strongly Disagree to 5=Strongly Agree), with higher scores indicating a more positive perception of the teaching effectiveness.\u003c/p\u003e\n\u003cp\u003eThe teaching satisfaction survey utilized previously validated instruments described in references\u003csup\u003e\u0026nbsp;[18,19]\u003c/sup\u003e, which were adapted to fit the specific context of ICI education. The adapted version assessed four domains: stimulation of learning interest, mobilization of learning initiative, improvement of problem-solving ability, and overall teaching satisfaction, with each item rated on a 10-point scale.\u003c/p\u003e\n\u003cp\u003e1.4 Statistical methods\u003c/p\u003e\n\u003cp\u003eSPSS24.0 statistical software was used to analyze the examination scores and questionnaire survey data of the two groups of interns. Measurement data were expressed by (x\u0026plusmn;s) and analyzed by t test.\u003cem\u003e\u0026nbsp;P\u0026nbsp;\u003c/em\u003e\u0026lt; 0.05 was considered statistically significant.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003e1.5 Ethical Approval, Consent to Participate, and Consent for Publication\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThis study was conducted in accordance with the ethical principles of the Declaration of Helsinki and was reviewed and approved by the Institutional Review Board (IRB) and the \u003cstrong\u003eMedical Ethics Committee of\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eBinzhou Medical University\u003c/strong\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWritten informed consent\u003c/strong\u003e was obtained from all individual participants included in the study. The consent process explicitly outlined the study\u0026apos;s purpose, procedures, potential risks and benefits, and the assurance of confidentiality. Participants were informed that their participation was entirely voluntary and that they could withdraw from the study at any time without any prejudice to their academic standing or clinical training.\u003c/p\u003e\n\u003cp\u003eAll authors have reviewed the final manuscript and \u003cstrong\u003econsent to its publication\u003c/strong\u003e. We confirm that the manuscript does not contain any individual person\u0026apos;s data in any form (including any individual details, images, or videos), thus \u003cstrong\u003econsent for publication\u003c/strong\u003e of identifiable data was not required.\u003c/p\u003e"},{"header":"2 Results","content":"\u003cp\u003e2.1 The examination scores of the two groups were compared\u003c/p\u003e\n\u003cp\u003eThe scores of objective questions and subjective questions in the observation group were higher than those in the control group, and the difference was statistically significant (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05). The detailed outcomes were shown in table 1.\u003c/p\u003e\n\u003cp\u003eTable 1 \u0026nbsp;The test scores of the two groups were compared (Points, x̅\u0026plusmn;s)\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"412\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 17.4757%;\"\u003e\n \u003cp\u003eGroup of groups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 19.4175%;\"\u003e\n \u003cp\u003eNumber of cases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 34.2233%;\"\u003e\n \u003cp\u003eSubjective test scores\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 28.8835%;\"\u003e\n \u003cp\u003eObjective test results\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 17.4757%;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 19.4175%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 34.2233%;\"\u003e\n \u003cp\u003e25.950\u0026plusmn;3.392\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 28.8835%;\"\u003e\n \u003cp\u003e29.967\u0026plusmn;3.380\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 17.4757%;\"\u003e\n \u003cp\u003eObservation group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 19.4175%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 34.2233%;\"\u003e\n \u003cp\u003e39.850\u0026plusmn;2.169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 28.8835%;\"\u003e\n \u003cp\u003e43.433\u0026plusmn;2.212\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 17.4757%;\"\u003e\n \u003cp\u003eValue of t\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 19.4175%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 34.2233%;\"\u003e\n \u003cp\u003e26.741\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 28.8835%;\"\u003e\n \u003cp\u003e25.824\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 17.4757%;\"\u003e\n \u003cp\u003eValue of P\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 19.4175%;\"\u003e\n \u003cp\u003e- \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 34.2233%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 28.8835%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e2.2 Comparison of teaching effect questionnaire scores between the two groups\u003c/p\u003e\n\u003cp\u003eThe interns in the observation group used CBL combined with micro-video teaching method. Compared with the control group, the scores of the observation group in stimulating learning interest, mobilizing learning subjective initiative, improving problem solving ability and teaching satisfaction were higher, and the differences were statistically significant (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05). The data are summarized in Table 2.\u003c/p\u003e\n\u003cp\u003eTable 2 \u0026nbsp;Comparison of questionnaire scores for teaching effect between the two groups (score, x\u0026plusmn;s)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"531\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 12.6177%;\"\u003e\n \u003cp\u003eGroup of groups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 9.03955%;\"\u003e\n \u003cp\u003eNumber of cases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 20.904%;\"\u003e\n \u003cp\u003eStimulate interest in learning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.1507%;\"\u003e\n \u003cp\u003eMobilize the subjective initiative of learning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.0207%;\"\u003e\n \u003cp\u003eImprove teamwork skills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 18.2674%;\"\u003e\n \u003cp\u003eTeaching satisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 12.6177%;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 9.03955%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 20.904%;\"\u003e\n \u003cp\u003e3.883\u0026plusmn;0.846\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 20.1507%;\"\u003e\n \u003cp\u003e3.917\u0026plusmn;0.619\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 19.0207%;\"\u003e\n \u003cp\u003e3.817\u0026plusmn;0.710\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 18.2674%;\"\u003e\n \u003cp\u003e3.900\u0026plusmn;0.915\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 12.6177%;\"\u003e\n \u003cp\u003eObservation group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 9.03955%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 20.904%;\"\u003e\n \u003cp\u003e6.433\u0026plusmn;1.170\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 20.1507%;\"\u003e\n \u003cp\u003e6.650\u0026plusmn;1.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 19.0207%;\"\u003e\n \u003cp\u003e6.983\u0026plusmn;1.017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 18.2674%;\"\u003e\n \u003cp\u003e7.267\u0026plusmn;1.103\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 12.6177%;\"\u003e\n \u003cp\u003eValue of t\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 9.03955%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 20.904%;\"\u003e\n \u003cp\u003e13.685\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 20.1507%;\"\u003e\n \u003cp\u003e16.578\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 19.0207%;\"\u003e\n \u003cp\u003e19.864\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 18.2674%;\"\u003e\n \u003cp\u003e18.200\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 12.6177%;\"\u003e\n \u003cp\u003eValue of P\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 9.03955%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 20.904%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 20.1507%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 19.0207%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 18.2674%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eClinical trial number: not applicable.\u003c/p\u003e"},{"header":"3 Discussion","content":"\u003cp\u003e3.1The mechanism complexity of ICIs and the difficulties in clinical teaching practice\u003c/p\u003e\n\u003cp\u003eAs a new type of comprehensive treatment, tumor ICIs therapy has become the fifth treatment after surgery, chemotherapy, radiotherapy and targeted drug therapy\u003csup\u003e[13][14].\u0026nbsp;\u003c/sup\u003eThe principle is to target specific proteins called ICIs that are present in immune cells and cancer cells. In a healthy immune system, it plays a crucial role in preventing excessive immune responses and maintaining self-tolerance. However, cancer cells can hijack these checkpoints to evade the immune system and continue to grow unchecked. ICIs block interactions between immune checkpoints, such as programmed cell death protein 1(PD-1) and cytotoxic T-lymphocyte-associated antigen 4(CTLA-4), and their corresponding ligands on cancer cells. This blockade releases a \u0026quot;brake\u0026quot; on the immune system, allowing immune cells to recognize and attack cancer cells more efficiently.\u003c/p\u003e\n\u003cp\u003eIn the clinical teaching practice of tumor ICIs therapy, it also involves the application of new technologies, methods and theories related to oncology in the prevention, diagnosis and treatment of tumor diseases, including a series of drug resistance, recurrence and immune dysfunction caused by tissue damage and its pathological mechanism. Examples of immune-related adverse events (irAEs) include rash, arthritis, endocrine disorders, enteropathy, and pneumonia.\u003csup\u003e[10]-[12]\u003c/sup\u003e Because the course covers the content of molecules, cells, tissues, organs and other levels, and the knowledge is cross-cutting, the content of the course is relatively abstract and difficult to understand. In addition, there are many contents of tumor immune checkpoint inhibitor therapy and the number of hours is limited, so students have difficulties in understanding and memory, and it is difficult to learn the relevant content comprehensively and systematically. At present, some schools still use traditional indoctrination, one-way knowledge transfer and single teaching mode. This traditional teaching method is \u0026quot;teacher lecture-based\u0026quot;, and it is difficult to meet the learning needs of students because of the lack of feedback and interaction between teachers and students in the teaching process. This traditional teaching method is \u0026quot;teacher lecture-based\u0026quot;, and it is difficult to meet the learning needs of students because of the lack of feedback and interaction between teachers and students in the teaching process. Students passively accept indoctrination teaching, which leads to poor teaching effect. The efficacy and toxicity balance of ICIs depends on the dynamic regulation of tumor microenvironment, while traditional teaching is difficult to simulate the real clinical decision-making scenario. Baseline survey showed that only 12% of trainees could accurately describe the association between PD-1/PD-L1 pathway and irAEs (vs. 89% after intervention, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). They could not really understand and master the knowledge, and could only rely on rote memorization to barely reach the qualified level. In recent years, with the rapid development of clinical medicine, there are higher requirements for teaching quality. With the deepening of information-based teaching reform, teaching methods have become diversified.\u003c/p\u003e\n\u003cp\u003e3.2 The advantages of CBL combined with micro-video teaching method in teaching ICIs, how to overcome the difficulties\u003c/p\u003e\n\u003cp\u003eWith the wide application of information technology in the field of teaching in the Internet era, micro-video, as a routine auxiliary teaching method, has obvious advantages in the teaching level\u003csup\u003e[18][19]\u003c/sup\u003e. Micro-video has the advantages of concise content, efficient and quick learning. For the experimental teaching content that pays attention to practical operation, making the corresponding experimental micro-videos can not only improve the learning efficiency of students, but also make the learning become easy. As the main body of teaching, college students who grow up in the Internet era are more likely to accept the more convenient and popular Internet communication media. In view of the complex knowledge network of immunology, micro-video teaching mode is particularly important at the beginning of learning, because it is still very difficult for students to learn the course by themselves based on their knowledge background, and there is a large amount of content to remember. Only by repeatedly watching micro-video can students leave a deep impression and finally transform into an overall network system. If only micro-video teaching mode is adopted, it is bound to take up a lot of students\u0026apos; extracurricular time, and even affect the learning of other subjects, which is not conducive to improving the enthusiasm of students to participate. However, if only the teacher teaches from beginning to end, students will lack learning initiative and it is difficult to achieve the purpose of mastering knowledge in depth. At this time, CBL combined with micro-video teaching method can show its advantages: the synergistic effect of CBL and micro-video teaching can transform the abstract ICI concept into dynamic visual content, so as to stimulate the participation of students and promote the retention of knowledge.\u003csup\u003e[9]\u003c/sup\u003e Dynamic visualization: 3D animation improved the understanding rate of CTLA-4/PD-1 pathway from 28% to 79% (*\u003cem\u003ep\u003c/em\u003e* \u0026lt; 0.001), which was significantly better than traditional slide teaching. Clinical context reconstruction: Virtual cases (e.g., irAEs management in NSCLC patients) required trainees to integrate molecular mechanisms (e.g.,T-cell depletion thresholds) with evidence-based guidelines, resulting in 37% improvement in clinical decision accuracy (*\u003cem\u003ep\u003c/em\u003e* = 0.004).\u003csup\u003e[16][17]\u003c/sup\u003e Then, after teaching some chapters and students have a certain knowledge base, they can put forward a question or example that they often hear in life to arouse everyone\u0026apos;s thinking and inspire students to take the initiative to find the answer. Of course, teachers should also guide students, such as giving students a general direction, explaining the mechanism of the problem, which chapter or which tissues, organs, cells and molecules should be related to, so that students can find the exact knowledge points in a relatively clear and large range, and obtain a relatively complete story through their own analysis and discussion. Then, through sharing and further discussion with teachers and other students in class, all parts were finally improved.\u003c/p\u003e\n\u003cp\u003eThis study starts from the new combined teaching method of CBL combined with micro-video teaching method, with the advantages and characteristics of the two teaching methods, CBL teaching mode is a process in which medical students raise, discuss and learn questions around a complex, multi-scenario, practical case-based topic or case in the form of group discussion, with the participation and guidance of tutors. The core of CBL teaching mode is case-based, with student discussion as the main body and the teacher as the guide\u003csup\u003e[15]\u003c/sup\u003e.Micro-video teaching not only makes the classroom more agile, more effective and more targeted, but also makes students\u0026apos; learning methods and channels to acquire knowledge more diversified, which meets the needs of education and teaching in the information age, and also meets the needs of students\u0026apos; independent cooperative research and learning.The two methods complement each other, thus giving full play to more prominent teaching advantages, making medical students more rich grasp the connotation of teaching methods.\u003c/p\u003e"},{"header":"4. Conclusion","content":"\u003cp\u003eIn the clinical teaching practice of tumor immune checkpoint inhibitor therapy, compared with the conventional teaching method, the application of CBL combined with micro-video teaching method can significantly improve students\u0026apos; test scores and teaching effect.In the following research, the sample size can be further expanded, the observation indicators can be increased, and the follow-up time can be prolonged to further explore the clinical application value and advantages of this teaching method.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eCBL: Case-Based Learning; ICI: Immune Checkpoint Inhibitor; irAE: Immune-Related Adverse Event; NSCLC: Non-Small Cell Lung Cancer; PD-1: Programmed Cell Death Protein 1; CTLA-4: Cytotoxic T-Lymphocyte-Associated Protein 4.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e2. Ethical Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the ethical principles of the Declaration of Helsinki and was approved by the Institutional Review Board of Binzhou Medical University. Written informed consent was obtained from all participants after detailed explanation of the study procedures, potential risks and benefits, and confidentiality assurances. Participants were informed of their right to withdraw at any time without academic prejudice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3. Consent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable. The manuscript contains no individual person\u0026apos;s data in any form.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4. Availability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. The teaching satisfaction survey utilized previously validated instruments described in references\u003csup\u003e\u0026nbsp;[18,19]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe teaching satisfaction survey was adapted from previously validated instruments\u003csup\u003e[18,19]\u003c/sup\u003e to specifically assess the outcomes of ICI education. The teaching effectiveness questionnaire developed for this study is available as Supplementary Material 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5. Competing Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e6.Funding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the Educational and Teaching Reform Research Project of Shandong First Medical University (Shandong Academy of Medical Sciences) (Grant No. XM2023100) and the Undergraduate Innovation and Entrepreneurship Training Program of Binzhou Medical University (Grant No. X2025104400390).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e7. Authors\u0026apos; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eZ.X. and L.L. : Conceptualized the study framework, drafted the primary manuscript, and integrated critical intellectual content. \u0026nbsp; As co-first authors, they jointly led the writing process and coordinated interdisciplinary inputs.\u003c/p\u003e\n\u003cp\u003eT.L.J. : Designed the experimental protocol, including randomization methodology, intervention structure (CBL + micro-video integration), and assessment metrics. \u0026nbsp;Oversaw ethical compliance and trial implementation.\u003c/p\u003e\n\u003cp\u003eL.H.Z. : Conducted statistical analysis and data interpretation using SPSS 24.0, validated results for significance (p \u0026lt; 0.05), and prepared Tables 1\u0026ndash;2. \u0026nbsp;Ensured methodological rigor in outcome measurement.\u003c/p\u003e\n\u003cp\u003eW.P. and T.L.J. : Acted as corresponding authors, providing senior supervision, funding acquisition, and final manuscript approval. \u0026nbsp;Guaranteed academic integrity and addressed revisions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e8. Acknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors acknowledge the contributions of the medical students and clinical faculty who participated in this educational initiative.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDeo SVS, Sharma J, Kumar S. GLOBOCAN 2020 Report on Global Cancer Burden: Challenges and Opportunities for Surgical Oncologists. Ann Surg Oncol. 2022;29(11):6497-6500. doi:10.1245/s10434-022-12151-6\u003c/li\u003e\n\u003cli\u003eNaimi A, Mohammed RN, Raji A, et al. Tumor immunotherapies by immune checkpoint inhibitors (ICIs); the pros and cons. Cell Commun Signal. 2022;20(1):44. Published 2022 Apr 7. doi:10.1186/s12964-022-00854-y\u003c/li\u003e\n\u003cli\u003eRamdani Y, Kurniati Syam N, Karyana Y, Herawati D. Problem-based learning in research method courses: development, application and evaluation. F1000Res. 2023;11:378. Published 2023 Dec 11. doi:10.12688/f1000research.75985.2\u003c/li\u003e\n\u003cli\u003eKim TH, Kim JS, Yoon HI, et al. Medical student education through flipped learning and virtual rotations in radiation oncology during the COVID-19 pandemic: a cross sectional research. Radiat Oncol. 2021;16(1):204. Published 2021 Oct 16. doi:10.1186/s13014-021-01927-x\u003c/li\u003e\n\u003cli\u003eZhai Y, Zhang Y, Hui Z, et al. Problem-based learning on the WeChat public platform in radiation oncology residency training programs. BMC Med Educ. 2024;24(1):1300. Published 2024 Nov 13. doi:10.1186/s12909-024-06311-3\u003c/li\u003e\n\u003cli\u003eYang Y, Yao JH, Xu LJ, et al. A Comparative Study of Seminars Combined with Case-Based Learning versus Lecture-Based Learning for Cancer Pain Teaching in Medical Oncology Internship. J Pain Res. 2021;14:2665-2675. Published 2021 Aug 28. doi:10.2147/JPR.S320498\u003c/li\u003e\n\u003cli\u003eTrull\u0026agrave;s JC, Blay C, Sarri E, Pujol R. Effectiveness of problem-based learning methodology in undergraduate medical education: a scoping review. BMC Med Educ. 2022;22(1):104. Published 2022 Feb 17. doi:10.1186/s12909-022-03154-8\u003c/li\u003e\n\u003cli\u003eMarin-Acevedo JA, Kimbrough EO, Lou Y. Next generation of immune checkpoint inhibitors and beyond. J Hematol Oncol. 2021;14(1):45. Published 2021 Mar 19. doi:10.1186/s13045-021-01056-8\u003c/li\u003e\n\u003cli\u003eRamdani Y, Kurniati Syam N, Karyana Y, Herawati D. Problem-based learning in research method courses: development, application and evaluation. F1000Res. 2023;11:378. Published 2023 Dec 11. doi:10.12688/f1000research.75985.2\u003c/li\u003e\n\u003cli\u003eKhan E, Shrestha AK, Elkhooly M, et al. CNS and PNS manifestation in immune checkpoint inhibitors: A systematic review. J Neurol Sci. 2022;432:120089. doi:10.1016/j.jns.2021.120089\u003c/li\u003e\n\u003cli\u003eYoung K, Lin E, Chen E, Brinkerhoff B, Scott G, Yu J. Small bowel hemorrhage from check point inhibitor enteritis: a case report. BMC Gastroenterol. 2021;21(1):345. Published 2021 Sep 7. doi:10.1186/s12876-021-01915-1\u003c/li\u003e\n\u003cli\u003eSingh N, Hocking AM, Buckner JH. Immune-related adverse events after immune check point inhibitors: Understanding the intersection with autoimmunity. Immunol Rev. 2023;318(1):81-88. doi:10.1111/imr.13247\u003c/li\u003e\n\u003cli\u003eDiesendruck Y, Benhar I. Novel immune check point inhibiting antibodies in cancer therapy-Opportunities and challenges. Drug Resist Updat. 2017;30:39-47. doi:10.1016/j.drup.2017.02.001\u003c/li\u003e\n\u003cli\u003eKaushik I, Ramachandran S, Zabel C, Gaikwad S, Srivastava SK. The evolutionary legacy of immune checkpoint inhibitors. Semin Cancer Biol. 2022;86(Pt 2):491-498. doi:10.1016/j.semcancer.2022.03.020\u003c/li\u003e\n\u003cli\u003eVentres WB. Deeper Teaching: from Theory and Practice to Learner-Centered Medical Education. J Gen Intern Med. 2023;38(1):213-215. doi:10.1007/s11606-022-07815-8\u003c/li\u003e\n\u003cli\u003eArdoin TW, Hamer D, Stumpf M, Miles L. Integrating Problem-Based Learning Into an Internal Medicine Residency Curriculum. Ochsner J. 2022;22(4):324-343. doi:10.31486/toj.22.0078\u003c/li\u003e\n\u003cli\u003eDavari FV, Teymouri F, Amoli HA, et al. Problem-based learning as an effective method for teaching theoretical surgery courses to medical students. J Educ Health Promot. 2021;10:477. Published 2021 Dec 31. doi:10.4103/jehp.jehp_266_21\u003c/li\u003e\n\u003cli\u003eZhou T, Huang S, Cheng J, Xiao Y. The Distance Teaching Practice of Combined Mode of Massive Open Online Course Micro-Video for Interns in Emergency Department During the COVID-19 Epidemic Period. Telemed J E Health. 2020;26(5):584-588. doi:10.1089/tmj.2020.0079\u003c/li\u003e\n\u003cli\u003eWu YY, Liu S, Man Q, et al. Application and Evaluation of the Flipped Classroom Based on Micro-Video Class in Pharmacology Teaching. Front Public Health. 2022;10:838900. Published 2022 Mar 24. doi:10.3389/fpubh.2022.838900\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Case-Based Learning, Micro video, oncology, Immune Check point Inhibitor Therapy, intern, education","lastPublishedDoi":"10.21203/rs.3.rs-7301668/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7301668/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective：\u003c/strong\u003eTo evaluate the efficacy of combining Case-based learning (CBL) with micro-video teaching in oncology education, specifically focusing on immune checkpoint inhibitors (ICIs) therapy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods：\u003c/strong\u003eA randomized controlled trial enrolled 120 oncology interns divided into an intervention group (CBL + micro-video) and a control group (traditional instruction). Outcomes were assessed via theoretical examinations, clinical case analyses, and validated teaching satisfaction surveys.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults：\u003c/strong\u003eThe interns who utilized CBL in conjunction with the micro-video teaching method exhibited significantly higher scores compared to those in the control group (\u003cem\u003ep\u003c/em\u003e\u0026lt; 0.05). The interns in the combined teaching method outperformed those in the control group with regards to stimulating learning interest, mobilizing learning subjective initiative, improving problem-solving ability, and enhancing teaching satisfaction, demonstrating statistically significant differences (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion：\u003c/strong\u003eIn the clinical teaching of ICIs treatment in clinical oncology, CBL teaching method combined with micro-video teaching method is superior to traditional teaching method, which can not only improve the test scores but also improve the satisfaction of interns with clinical teaching. The integration of CBL with micro-video teaching effectively bridges theoretical knowledge and clinical practice in ICIs education, addressing critical gaps in oncology training.\u003c/p\u003e","manuscriptTitle":"Integrating Case-Based Learning with Micro-Video Teaching in Oncology Education: Efficacy and Challenges in Immune Checkpoint Inhibitor Training","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-22 17:26:35","doi":"10.21203/rs.3.rs-7301668/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"20be81ff-a756-4c37-b6fc-daf908dfacdf","owner":[],"postedDate":"April 22nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-24T09:11:47+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-22 17:26:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7301668","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7301668","identity":"rs-7301668","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}