Innovative multimodal Educational Strategies: Assessing the Impact of Integrative Teaching Methods on Standardized Neurology Resident Training 

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Methods: From January 2022 to December 2024, a total of 103 neurology residents undergoing standardized training at the First Affiliated Hospital of Zhengzhou University were selected as the study subjects. A quantitative research design was employed, and participants were randomly divided into an experimental group and a control group. The experimental group (51 participants) utilized a novel teaching model that integrated micro-learning, bedside teaching, and CBL, while the control group (52 participants) employed Lecture-Based Learning (LBL) method s. The study focused on several indicators, including theoretical assessment scores from standardized training, student satisfaction and interest in the teaching content, clinical competency evaluations, and self-assessments by instructors. Results: The novel teaching model combining micro-learning, bedside teaching, and CBL significantly outperformed traditional teaching methods in improving residents' theoretical assessment scores (83.02 ± 7.33 vs. 76.04 ± 7.19) and clinical competency evaluations, particularly in comprehensive ability assessments (85.55 ± 5.24 vs. 75.10 ± 7.86). Students also reported a marked increase in satisfaction with the teaching content and learning interest (P < 0.01). Furthermore, instructors expressed a high level of recognition for the new course model in their post-class self-evaluations (P < 0.01). Conclusion: The findings of this study indicate that the integration of micro-learning, bedside teaching, and CBL can provide a more effective teaching model for the training of neurology residents, offering strong support for future reforms and developments in medical education. Case-Based Learning (CBL) Micro-Learning Bedside Teaching Lecture-Based Learning (LBL) Standardized Training for Neurology Residents Figures Figure 1 1. Introduction Since the official launch of standardized residency training in China in 2014[ 1 ], neurology has played a crucial role as an important medical discipline in the training of residents. However, the current state of neurology education still faces numerous challenges. On one hand, the complexity and diversity of neurological diseases demand rigorous logical thinking and extensive practical experience for clinical diagnosis and treatment. Traditional teaching methods(Lecture-Based Learning (LBL)) often emphasize the transmission of textbook knowledge, resulting in a lack of effective training in students' clinical reasoning and practical skills[ 2 ].As the incidence of neurological disorders continues to rise, clinicians must possess enhanced judgment and decision-making abilities to address various clinical scenarios. The clinical manifestations, pathophysiology, and anatomical structures associated with neurological diseases are inherently complex, posing significant challenges to understanding[ 3 , 4 ].Therefore,effectively intergrating this knowledge into training to enhance residents’ comprehensive abilities has become an impoetant topic in educational research[ 5 ]. Moreover, current neurology education often lacks sufficient time allocation for case discussions and clinical skills training, leading to a lack of confidence among students when confronted with real cases[ 6 ].Recent studies indicate that while many residents have a solid grasp of foundational knowledge, their ability to apply this knowledge in clinical practice remains inadequate, particularly in areas such as patient assessment, diagnostic decision-making, and treatment planning[ 7 ].Consequently, there is an urgent need for reform in the educational model of neurology to better meet clinical demands and improve residents' ability to navigate complex situations. Previous literature has reported that the unique characteristics of neurology necessitate a teaching model that combines various instructional methods[ 8 ], however,there is currently a lack of exploration into the application of multiple teaching modalities in neurology. Bedside teaching allows students to observe patients' clinical presentations firsthand while providing opportunities to practice clinical skills in real-time. The case-based learning (CBL) model promotes critical thinking and problem-solving skills through the analysis of specific clinical scenarios[ 9 ]. Micro-lessons, delivered through short videos, systematically provide background knowledge and theoretical frameworks, enabling learners to review foundational knowledge and relevant anatomical structures prior to class. This approach, particularly in presenting anatomical structures and pathophysiological mechanisms in a vivid and interactive manner, facilitates more effective participation in subsequent case discussions [ 10 ].Research shows that innovative teaching models such as micro-lessons and bedside teaching not only stimulate students' interest in learning but also help them integrate theory with practice, enhancing their clinical skills and cognitive abilities[ 11 , 12 ].Furthermore, the flexibility and accessibility of micro-lessons empower students to learn at different times and locations, further strengthening their self-directed learning capabilities. This study aims to systematically evaluate the specific advantages of combining CBL with micro-lessons and bedside teaching in the standardized training of neurology residents, exploring how this innovative multi-modal teaching approach can more effectively assist students in mastering the complexities of neurology and enhancing their clinical capabilities and practical skills. 2. Methods 2.1 Participangts This study involved 103 residents from the neurology department at the First Affiliated Hospital of Zhengzhou University from 2022 to 2024. All participants were employed medical graduates or postgraduate students with a certain level of clinical knowledge and skills. Informed consent was obtained from all participants before the study commenced to ensure ethical compliance throughout the process. Participants were randomly assigned to two groups using a random number table method. The experimental group (CBL+ML+BTgroup n=51) received a teaching model that integrated case-based learning (CBL) with micro-lessons and bedside teaching, while the control group(LBLgroup n=52) continued with traditional teacher-centered lectures. The random grouping process was conducted by independent researchers to ensure fairness and scientific validity.A comparative analysis of the demographic characteristics of the two groups, including gender and age, as well as the pre-test scores, revealed no statistically significant differences(p＞0.05)(Table1). 2.2 Study design Experimental Group: This group employed a blended teaching model combining micro-lessons, bedside teaching, and CBL. Prior to the course, micro-lessons provided an introduction to relevant diseases, anatomical structures, and pathophysiological mechanisms. Students were also given preparatory materials, including the latest consensus or guidelines regarding disease advancements, to review. The course began with bedside examinations of patients to assess clinical symptoms and signs, followed by case discussions where students analyzed specific cases within small groups, exploring typical clinical presentations, pathophysiological mechanisms, differential diagnoses, and treatment options. After each case discussion, teachers provided summaries and feedback to reinforce students' learning outcomes. Control Group: This group continued with Lecture-Based Learning methods, primarily relying on lectures and classroom explanations, focusing on knowledge transmission and memorization. The content covered was the same as that of the experimental group, but it lacked targeted bedside teaching, case analysis, and interactive discussions. 2. 3 Evaluation Method This study assessed the learning outcomes of the two groups of residents through the following indicators: Theory Assessment: A standardized theoretical examination was conducted at the end of the training, utilizing a closed-book format to evaluate residents' mastery of neurology-related theoretical knowledge, including understanding of disease mechanisms, diagnostic criteria, and treatment plans. Comprehensive Ability Evaluation: At the end of the training, residents were assessed through a standardized examination format that evaluated their ability to collect patient histories, perform physical examinations, document cases, and analyze clinical scenarios, as well as their clinical reasoning and rapid response skills. This comprehensive evaluation also assessed communication and teamwork abilities using multi-dimensional scoring scales. Satisfaction Survey: A self-designed questionnaire was administered to gauge satisfaction with the teaching model, the practicality of the teaching content, and the effectiveness of teacher guidance, using a five-point scale (1 - very dissatisfied; 5 - very satisfied)[13]. Interest Inventory : Students' interest in learning neurology was collected through a questionnaire, assessing the appeal and engagement of the course, using a seven-point scale (1 - not interested at all; 7 - very interested). Teacher s Self-Evaluation: Instructors evaluated the course content and teaching effectiveness using a questionnaire, employing a five-point scale (1 - very dissatisfied; 5 - very satisfied)[14]. 2. 4 Satistical Analysis Data collected were analyzed using SPSS statistical software. To compare the performance of the two groups across various observation indicators, normally distributed continuous data (e.g., assessment scores, satisfaction ratings, and interest ratings) were expressed as mean ± standard deviation (mean ± s). Differences between the two groups were analyzed using independent samples t-tests or rank-sum tests. A significance level of p < 0.05 was set to determine whether the differences between the experimental and control groups were statistically significant. Graphical representations were created using GraphPad Prism 8.0. 3. Results 3.1 Clinical Theory Assessment The experimental group achieved an average score of 83.02 ± 7.33, while the control group had an average score of 76.04 ± 7.19. The t-test results indicated a statistically significant difference between the two groups (t = -4.873, p < 0.001)(Table 2). This suggests that residents taught using the CBL combined with micro-lessons and bedside teaching outperformed those taught through traditional methods in their mastery of clinical theoretical knowledge, reflecting the effectiveness of case discussions and micro-learning.(Fig. 1A) 3.2 Comprehensive Ability Evaluation In the comprehensive ability assessments, including case analysis, the experimental group scored an average of 86.25 ± 6.52, compared to 75.10 ± 7.86 in the control group. The t-test results also showed a significant difference between the two groups (t = -7.608, p < 0.001)(Table 2). This indicates that the experimental group exhibited superior clinical reasoning and case analysis abilities, suggesting that the new multimodal teaching approach helps enhance residents' overall performance, particularly in communication and teamwork skills, likely due to their more active and participatory learning style.(Fig. 1A) 3.3 Satisfaction Survey In the satisfaction survey, the experimental group reported a satisfaction score of 4.22 ± 0.61, while the control group scored 2.96 ± 0.62. The t-test revealed a significant difference (t = -10.303, p < 0.001)(Table 2). These results indicate that the residents in the experimental group had a significantly higher level of recognition and satisfaction with the innovative multimodal teaching model compared to the control group, suggesting that this new teaching method better meets the learning needs of neurology residents.(Fig. 1B) 3.4 Interest Inventory Regarding the interest ratings, the experimental group received a score of 5.59 ± 0.85, whereas the control group scored 3.60 ± 1.01. The t-test results similarly showed a significant difference between the two groups (p < 0.001)(Table 2). This finding demonstrates that the new multimodal teaching approach significantly enhances students' interest and engagement in learning, potentially fostering greater enthusiasm and commitment to the field of neurology among residents.(Fig. 1B) 3.5 Teachers Self-Evaluation Instructors evaluated the course content and student reactions after the sessions, resulting in a score of 7.45 ± 1.29 for the experimental group and 5.27 ± 0.78 for the traditional teaching group. The difference between the two groups was significant (p < 0.001)(Table 2), indicating that teachers found the multimodal teaching approach to be more effective in delivering content and engaging students compared to traditional methods.(Fig. 1B) 4. Disscussion Neurology is a highly complex and challenging discipline within the medical field, encompassing numerous diseases and various pathophysiological mechanisms,The nervous system has a complex structure and function, comprising various components, including the brain, spinal cord, and peripheral nerves. As learners strive to understand these anatomical features, they often encounter significant challenges[ 15 ].This challenge is particularly evident in certain neurological disorders, such as Parkinson's disease and epilepsy, where clinical manifestations can be highly characteristic. Observing real cases provides a more intuitive understanding than reading rigid textbook descriptions, which enhances residents' comprehension and memory, fostering a holistic understanding of these diseases. Therefore, studying and practicing in this field requires residents not only to master extensive professional knowledge but also to possess strong spatial and three-dimensional thinking abilities to appropriately localize and characterize various neurological disorders[ 16 ].This is where the advantages of case-based learning (CBL) combined with bedside teaching come into play—through real clinical cases, students can delve into the anatomical background, pathophysiological mechanisms, and clinical presentations of specific diseases, while micro-videos reinforce their understanding and retention of these complex concepts[ 5 ]. This study validated the effectiveness of the CBL combined with micro-lessons and bedside teaching model in training neurology residents through comparative analysis, revealing significant advantages. The experimental group outperformed the control group in clinical theory assessments and comprehensive ability evaluations. This indicates that the micro-lesson format allows learners to grasp knowledge quickly while also stimulating their interest and critical thinking[ 17 ], Learning from real bedside cases enables residents to deepen their understanding of theoretical knowledge in a genuine clinical environment[ 6 ], The CBL model encourages active participation and critical thinking among students, facilitating progress through problem discussions and reflecting the interactive and participatory nature of the learning process [ 18 ], This approach effectively enhances their motivation and learning outcomes. The study found that the innovative multimodal teaching model enabled residents to engage in continuous self-reflection and adjustment during the learning process[ 5 ]. Traditional teaching methods often lack feedback and communication, whereas CBL encourages residents to interact and collaborate through group discussions and role-playing, thereby deepening their understanding and retention of knowledge[ 19 ]. This not only aids in mastering theoretical knowledge but also promotes the application of clinical skills[ 20 ].The CBL model encourages residents to take on more active roles in their education, enhancing their initiative and engagement in learning, which in turn improves their comprehensive ability evaluation scores[ 21 ]. Additionally, the introduction of the micro-lesson model provides residents with a flexible learning approach. In the rapidly evolving field of neurology, knowledge is updated frequently, and micro-lessons can convey core concepts in a short time, allowing residents to deepen their understanding of specific knowledge points anytime and anywhere [ 22 ].Furthermore, for complex anatomical structures or intricate conduction pathways that are difficult to understand in neurology, creating micro-video animations or 3D visualizations can significantly aid students in comprehension and retention while increasing their interest in learning[ 23 ]. The study results indicate that residents rated the micro-lesson model very positively, believing that it effectively supplements the shortcomings of traditional teaching, particularly in reinforcing the learning and understanding of specific knowledge points in a short period. It is noteworthy that this study also found a significant improvement in clinical skills and communication abilities among residents participating in the CBL combined with bedside teaching. This phenomenon is closely related to the increased communication between students and patients during bedside teaching, as well as the enhancement of clinical skills through bedside examinations and procedures [ 24 ], Numerous studies have shown that teamwork and effective communication are essential components of modern medical education[ 25 ].Through team discussions and collaborative decision- making, residents are able to practice and learn in a simulated real-world environment, which greatly benefits their future clinical practice. Additionally, the bedside teaching process continuously reinforces students' clinical communication and examination skills. This model also positively impacts residents' clinical reasoning, patient education, and teamwork skills[ 26 ]. Data indicate that residents experienced a significant increase in overall satisfaction with the course and their learning interest, particularly in terms of engagement and a sense of achievement. This suggests that the combination of micro-lessons, bedside teaching, and CBL not only successfully imparts knowledge but also plays a crucial role in cultivating residents' interest in learning and positive attitudes. Previous studies have confirmed that integrated teaching models, such as flipped classrooms, timely teaching, and problem-based learning, represent the future of neurology education[ 8 ].Enhancing teaching satisfaction and interest significantly influences physicians' learning motivation and future career development, encouraging them to maintain a continuous learning attitude in their professional growth[ 27 ]. Moreover, the results of this study show that the self-evaluations of teachers using the micro-video, bedside teaching, and CBL model were significantly higher than those of teachers employing traditional teaching methods. This advantage can be attributed to several factors. First, the micro-lesson format allows educators to deliver concise and focused content, while also enabling the 3D visualization of anatomical structures and imaging, achieving efficient learning outcomes in a short time[ 28 ].The bedside teaching process facilitates the integration of theory and practice, allowing students to easily understand clinical situations. Teachers can also observe students' performance in real time and provide feedback, aligning closely with specific learning objectives, thereby enhancing students' comprehension and engagement[ 29 ]. Educators often feel more capable and confident when using teaching methods that align with students' needs and preferences. Second, the integration of CBL promotes active learning and encourages critical thinking, enriching the learning experience for students and enabling teachers to adopt more student-centered teaching approaches [ 30 ].Furthermore, the collaborative nature of CBL fosters feedback and discussion, which can enhance teachers' self-reflective practices. Engaging in discussions about real cases encourages educators to continuously evaluate and refine their teaching strategies, contributing to professional development and increased job satisfaction. Although the new teaching methods require teachers to invest considerable time in preparing lesson plans, the positive feedback received has not negatively impacted the self-satisfaction ratings of students and teachers [ 31 ].Therefore, the combination of micro-lessons, bedside teaching, and CBL clearly creates a more favorable teaching and learning environment than traditional methods, resulting in higher self-evaluation scores for teachers. This underscores the importance of innovative medical education strategies to promote the mutual growth of educators and learners[ 8 ]. Despite the positive effects of the combined teaching models of micro-learning, bedside teaching, and CBL in the training of neurology residents, some limitations remain. First, the sample size of this study was relatively small and limited to a single medical center, which may affect the generalizability of the results. Future research should consider expanding the sample size and conducting comparisons across multiple institutions to verify the reproducibility and applicability of the findings. Second, the study did not adequately account for individual differences and learning styles among residents during implementation. Different educational backgrounds and learning approaches may influence learning outcomes. Therefore, future research should explore how to implement differentiated instruction based on individual differences to enhance learning effectiveness. 5. Conclusion This study demonstrates the effectiveness of combining micro-learning, bedside teaching, and CBL in training neurology residents. The approach significantly improves learning outcomes, increases interest, satisfaction, and comprehensive abilities, with teachers also noting enhanced teaching effectiveness in their self-evaluations. Amid challenges in neurology education, this innovative multimodal teaching strategy offers new insights for improving training systems to better meet the demands of modern healthcare. Further research into the application of this model across different medical fields is encouraged to expand its usage. Specifically, exploring how to implement these teaching methods in specialized areas like neurology in clinical and research settings remains a key focus. Declarations Acknowledgements We would like to acknowledge the physicians and nurses at the First Affiliated Hospital of Zhengzhou University Neurological Intensive Care Unit. Funding This study was supported by the Henan Provincial Key Scientific Research Project of Higher Education Institutions (23A320022) and the 2022 “Four New” Teaching Reform Research and Practice Projects of Zhengzhou University (2022zzusx021). Authors’ contributions PH and XL designed the study. PH wrote the main manuscript, analyzed the data, and prepared the tables and figures. PH WM, RW, NS, and FY collected the data. PH made modifications to the figures. XL led the research group and critically revised the article. All authors reviewed the manuscript and approved the submitted version. Potential Conflicts of Interest Nothing to report. Data Availability The data that support the findings of this study are available from the corresponding author upon reasonable request. Ethics approval and consent to participate This study was submitted to and approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University(Approval No. 2023-KY-0375-001),in accordance with the Declaration of Helsinki (1964). We obtained written informed consent from all participants involved in this study, including patients, students, and faculty members. Consent for publication Not applicable. Author details 1Neurological Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, 450001Zhengzhou, Henan,China. 2Department of Obstetrics, the First Affiliated Hospital of Zhengzhou University,450001Zhengzhou, Henan,China. References Sun T, Wang Y. Standardized training for resident doctors in China. J Biomed Res. 2014;28:155–6. Bi M, Zhao Z, Yang J, Wang Y. Comparison of case-based learning and traditional method in teaching postgraduate students of medical oncology. Med Teach. 2019;41:1124–8. Fazl A, Fleisher J. Anatomy, Physiology, and Clinical Syndromes of the Basal Ganglia: A Brief Review. Semin Pediatr Neurol. 2018;25:2–9. Lucio LL, Freddi TAL, Ottaiano AC. The Abducens Nerve: Anatomy and Pathology. Semin Ultrasound CT MR. 2022;43:414–9. Pan Y, Chen X, Wei Q, Zhao J, Chen X. Effects on applying micro-film case-based learning model in pediatrics education. BMC Med Educ. 2020;20:500. Dewey JJ, Cho TA. Bedside Teaching in Neurology. Semin Neurol. 2018;38:441–8. Nicholl DJ, Appleton JP. Clinical neurology: why this still matters in the 21st century. J Neurol Neurosurg Psychiatry. 2015;86:229–33. Schaefer SM, Dominguez M, Moeller JJ. (2018) The Future of the Lecture in Neurology Education. Semin Neurol. 38: 418–427. Zhao W, He L, Deng W, Zhu J, Su A, Zhang Y. The effectiveness of the combined problem-based learning (PBL) and case-based learning (CBL) teaching method in the clinical practical teaching of thyroid disease. BMC Med Educ. 2020;20:381. Zhao Z, Lv D, Chen L. Application of Problem-Based Learning Combined with Micro-Video Teaching in Burn Surgery and Its Impact on Satisfaction with Teaching. J Invest Surg. 2024;37:2403534. Delungahawatta T, Dunne SS, Hyde S, Halpenny L, McGrath D, O'Regan A, et al. Advances in e-learning in undergraduate clinical medicine: a systematic review. BMC Med Educ. 2022;22:711. Wu F, Wang T, Yin D, Xu X, Jin C, Mu N, et al. Application of case-based learning in psychology teaching: a meta-analysis. BMC Med Educ. 2023;23:609. Colthart I, Bagnall G, Evans A, Allbutt H, Haig A, Illing J, et al. The effectiveness of self-assessment on the identification of learner needs, learner activity, and impact on clinical practice: BEME Guide 10. Med Teach. 2008;30:124–45. Zhang X, Tse WW, Savalei V. Improved Properties of the Big Five Inventory and the Rosenberg Self-Esteem Scale in the Expanded Format Relative to the Likert Format. Front Psychol. 2019;10:1286. Pantano P, Chollet F, Paulson O, von Kummer R, Laihinen A, Leenders K, et al. EFNS Task Force on Teaching of Neuroimaging in Neurology Curricula in Europe: present status and recommendations for the future. Eur J Neurol. 2001;8:541–8. Isenmann S, Biesalski A, Zupanic M, Gerloff C. [University teaching in clinical neurology: present situation and future requirements]. Nervenarzt. 2013;84:1220–7. Monturo CA, Brockway C. Micro-Learning: An Innovative Strategy to Cultivate a Spirit of Inquiry, Step Zero. Worldviews Evid Based Nurs. 2019;16:416–7. Perez A, Howey M, Green JL, Nóbrega MTC, Kebbe M, Amin M, et al. Multiple cases in case-based learning: A qualitative description study. Eur J Dent Educ. 2023;27:1067–76. Haley CM, Brown B, Koerber A, Nicholas CL, Belcher A. Comparing Case-Based with Team-Based Learning: Dental Students' Satisfaction, Level of Learning, and Resources Needed. J Dent Educ. 2020;84:486–94. Burgess A, Matar E, Roberts C, Haq I, Wynter L, Singer J, et al. Scaffolding medical student knowledge and skills: team-based learning (TBL) and case-based learning (CBL). BMC Med Educ. 2021;21:238. Gul A, Khan RA, Yasmeen R, Ahsan NU. How Case Based Learning Promotes Deep Learning In Preclinical Years Of Medical Students? J Ayub Med Coll Abbottabad. 2020;32:228–33. Wu YY, Liu S, Man Q, Luo FL, Zheng YX, Yang S, et al. Application and Evaluation of the Flipped Classroom Based on Micro-Video Class in Pharmacology Teaching. Front Public Health. 2022;10:838900. O'Rourke JC, Smyth L, Webb AL, Valter K. How Can We Show You, If You Can't See It? Trialing the Use of an Interactive Three-Dimensional Micro-CT Model in Medical Education. Anat Sci Educ. 2020;13:206–17. Garibaldi BT, Russell SW. Strategies to Improve Bedside Clinical Skills Teaching. Chest. 2021;160:2187–95. Alamoudi AA, Al Shawwa LA, Gad H, Tekian A. Team-based learning versus traditional didactic lectures in teaching clinical biochemistry at King Abdulaziz University; learning outcomes and student satisfaction. Biochem Mol Biol Educ. 2021;49:546–59. Burgess A, van Diggele C, Roberts C, Mellis C. Key tips for teaching in the clinical setting. BMC Med Educ. 2020;20:463. Hernández EH, Lozano-Jiménez JE, de Roba Noguera JM, Moreno-Murcia JA. Relationships among instructor autonomy support, and university students' learning approaches, perceived professional competence, and life satisfaction. PLoS ONE. 2022;17:e0266039. Sozmen EY. Perspective on pros and cons of microlearning in health education. Essays Biochem. 2022;66:39–44. Harris DG. Overcoming the challenges of bedside teaching in the palliative care setting. BMJ Support Palliat Care. 2011;1:193–7. Jacobs NN, Calvo L, Dieringer A, Hall A, Danko R. Motivational Interviewing Training: A Case-Based Curriculum for Preclinical Medical Students. MedEdPORTAL. 2021;17:11104. Gasim MS, Ibrahim MH, Abushama WA, Hamed IM, Ali IA. Medical students' perceptions towards implementing case-based learning in the clinical teaching and clerkship training. BMC Med Educ. 2024;24:200. Tables Table1：Comparison of participant demographic information and pre-course tests CBL+ML+BT（n=51） LBL（n=52） t /χ 2 /Z P Gender(male) 19（52） 17（51） 0.338 0.502 Age 25.60 ±2.11 25.23 ±2.10 -0.907 0.750 Score 79.84 ±6.68 78.94 ±6.53 -0.692 0.671 MF:Micro Film;CBL: Case-based learning,LBL:traditional lecture-based teaching Table 2:Courses Performance of CBL+ML+TB and LBL Group CBL+ML+TB（n=51） LBL（n=52） t /χ 2 /Z P Theoretical Knowledge 83.02 ± 7.33 76.04 ± 7.19 -4.873 0.000 Interest Inventory 5.59±0.85 3.60±1.01 -6.063 0.000 Comprehensive evaluation 85.55±5.24 75.10±7.86 -7.608 0.000 Satisfaction 4.22±0.61 2.96±0.62 -7.435 0.000 Instructors Self-evaluation 7.45±1.29 5.27±0.78 -4.781 0.000 MF:Micro Film;CBL: Case-based learning,LBL:traditional lecture-based teaching Additional Declarations No competing interests reported. Supplementary Files GraphicalAbstract.tif Graphical Abstract Abbreviations:CBL,Case-Based Learning (CBL); LBL,Lecture-Based Learning. Cite Share Download PDF Status: Published Journal Publication published 10 Jul, 2025 Read the published version in BMC Medical Education → Version 1 posted Editorial decision: Revision requested 16 May, 2025 Reviews received at journal 14 May, 2025 Reviewers agreed at journal 21 Apr, 2025 Reviewers agreed at journal 16 Apr, 2025 Reviews received at journal 31 Mar, 2025 Reviewers agreed at journal 31 Mar, 2025 Reviewers invited by journal 28 Mar, 2025 Editor assigned by journal 21 Mar, 2025 Submission checks completed at journal 21 Mar, 2025 First submitted to journal 21 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6154199","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":435525696,"identity":"74cc3187-e810-42a1-bc67-3def138cd233","order_by":0,"name":"Peipei huang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4ElEQVRIiWNgGAWjYBACAyjNw8/efPBBQkUNCVoke44lGzw4c4x4LQwGN3LMJB+2MBPWYi6R/Ozh1x02MgYHcswqEhvYGPjbuxPwarGckWZuLHsmjUfywLGyG4k7ZBgkzpzdgN9hNxLMpCXbDvPwHWzediPxDBuDgUQuIS3p34Ba/vMwHGYwK0hsYyZGC9DXH9sO8AgcYzFjIE7LmTdl0oxnkoGBzJYskXDmGA9hvxxP3yb5c4edPb/844Mff1TUyPG39+LXAgLMvA0IDg9B5SDA+LOBoJpRMApGwSgYyQAAiCdMcrXHMOkAAAAASUVORK5CYII=","orcid":"","institution":"First Affiliated Hospital of Zhengzhou University","correspondingAuthor":true,"prefix":"","firstName":"Peipei","middleName":"","lastName":"huang","suffix":""},{"id":435525697,"identity":"9d8d60b3-a9c2-40be-ab53-9e9a97d55151","order_by":1,"name":"Wang Miao","email":"","orcid":"","institution":"First Affiliated Hospital of Zhengzhou University","correspondingAuthor":false,"prefix":"","firstName":"Wang","middleName":"","lastName":"Miao","suffix":""},{"id":435525698,"identity":"5cea42ac-8c6b-4a32-a708-fbf94b9c7cf9","order_by":2,"name":"rui wang","email":"","orcid":"","institution":"First Affiliated Hospital of Zhengzhou University","correspondingAuthor":false,"prefix":"","firstName":"rui","middleName":"","lastName":"wang","suffix":""},{"id":435525699,"identity":"07f25aa5-ad29-434a-a0cb-7da1a20dc118","order_by":3,"name":"nannan shen","email":"","orcid":"","institution":"First Affiliated Hospital of Zhengzhou University","correspondingAuthor":false,"prefix":"","firstName":"nannan","middleName":"","lastName":"shen","suffix":""},{"id":435525700,"identity":"41d2563e-1a71-44c6-a448-aef0e0651ac8","order_by":4,"name":"Fan Yang","email":"","orcid":"","institution":"First Affiliated Hospital of Zhengzhou University","correspondingAuthor":false,"prefix":"","firstName":"Fan","middleName":"","lastName":"Yang","suffix":""},{"id":435525701,"identity":"4067a53e-169d-4bb1-91b2-c38c5c216ae1","order_by":5,"name":"xiufang xiu","email":"","orcid":"","institution":"First Affiliated Hospital of Zhengzhou University","correspondingAuthor":false,"prefix":"","firstName":"xiufang","middleName":"","lastName":"xiu","suffix":""}],"badges":[],"createdAt":"2025-03-04 11:53:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6154199/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6154199/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-025-07507-x","type":"published","date":"2025-07-10T15:57:29+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":79648702,"identity":"20380bf9-5823-45f5-bc2d-be465a91a119","added_by":"auto","created_at":"2025-04-01 07:28:43","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":59536,"visible":true,"origin":"","legend":"\u003cp\u003eA comparative analysis of the new integrative teaching methods and the traditional teaching mode\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of theoretical achievement and comprehensive ability(A); Comparison of learning interest, satisfaction and self-evaluation of teachers(B).(*indicates P＜0.05,** indicates P＜0.001).\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations:CBL,Case-Based Learning (CBL); ML,Micro-learning; BT,Bedside Teaching; LBL,Lecture-Based Learning.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"OnlineFigure1.png","url":"https://assets-eu.researchsquare.com/files/rs-6154199/v1/02cd5a9a757223dacc279b97.png"},{"id":86699488,"identity":"5cd527e3-5d93-453d-ba06-fdc2163a5683","added_by":"auto","created_at":"2025-07-14 16:10:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":879051,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6154199/v1/c41ca73b-6b50-4577-b6f4-3ed648aca0cc.pdf"},{"id":79647367,"identity":"ab86600a-9eb2-4364-9736-60a9fed39b0f","added_by":"auto","created_at":"2025-04-01 07:20:43","extension":"tif","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":5524960,"visible":true,"origin":"","legend":"\u003cp\u003eGraphical Abstract\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations:CBL,Case-Based Learning (CBL); LBL,Lecture-Based Learning.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"GraphicalAbstract.tif","url":"https://assets-eu.researchsquare.com/files/rs-6154199/v1/e17cc1131713fcba329f09dc.tif"}],"financialInterests":"No competing interests reported.","formattedTitle":"Innovative multimodal Educational Strategies: Assessing the Impact of Integrative Teaching Methods on Standardized Neurology Resident Training ","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eSince the official launch of standardized residency training in China in 2014[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], neurology has played a crucial role as an important medical discipline in the training of residents. However, the current state of neurology education still faces numerous challenges. On one hand, the complexity and diversity of neurological diseases demand rigorous logical thinking and extensive practical experience for clinical diagnosis and treatment. Traditional teaching methods(Lecture-Based Learning (LBL)) often emphasize the transmission of textbook knowledge, resulting in a lack of effective training in students' clinical reasoning and practical skills[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].As the incidence of neurological disorders continues to rise, clinicians must possess enhanced judgment and decision-making abilities to address various clinical scenarios. The clinical manifestations, pathophysiology, and anatomical structures associated with neurological diseases are inherently complex, posing significant challenges to understanding[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].Therefore,effectively intergrating this knowledge into training to enhance residents’ comprehensive abilities has become an impoetant topic in educational research[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eMoreover, current neurology education often lacks sufficient time allocation for case discussions and clinical skills training, leading to a lack of confidence among students when confronted with real cases[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].Recent studies indicate that while many residents have a solid grasp of foundational knowledge, their ability to apply this knowledge in clinical practice remains inadequate, particularly in areas such as patient assessment, diagnostic decision-making, and treatment planning[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].Consequently, there is an urgent need for reform in the educational model of neurology to better meet clinical demands and improve residents' ability to navigate complex situations. Previous literature has reported that the unique characteristics of neurology necessitate a teaching model that combines various instructional methods[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], however,there is currently a lack of exploration into the application of multiple teaching modalities in neurology.\u003c/p\u003e\u003cp\u003eBedside teaching allows students to observe patients' clinical presentations firsthand while providing opportunities to practice clinical skills in real-time. The case-based learning (CBL) model promotes critical thinking and problem-solving skills through the analysis of specific clinical scenarios[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Micro-lessons, delivered through short videos, systematically provide background knowledge and theoretical frameworks, enabling learners to review foundational knowledge and relevant anatomical structures prior to class. This approach, particularly in presenting anatomical structures and pathophysiological mechanisms in a vivid and interactive manner, facilitates more effective participation in subsequent case discussions [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].Research shows that innovative teaching models such as micro-lessons and bedside teaching not only stimulate students' interest in learning but also help them integrate theory with practice, enhancing their clinical skills and cognitive abilities[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].Furthermore, the flexibility and accessibility of micro-lessons empower students to learn at different times and locations, further strengthening their self-directed learning capabilities.\u003c/p\u003e\u003cp\u003eThis study aims to systematically evaluate the specific advantages of combining CBL with micro-lessons and bedside teaching in the standardized training of neurology residents, exploring how this innovative multi-modal teaching approach can more effectively assist students in mastering the complexities of neurology and enhancing their clinical capabilities and practical skills.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cp\u003e\u003cstrong\u003e2.1\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eParticipangts\u003c/strong\u003e\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003eThis study involved 103 residents from the neurology department at the First Affiliated Hospital of Zhengzhou University from 2022 to 2024. All participants were employed medical graduates or postgraduate students with a certain level of clinical knowledge and skills. Informed consent was obtained from all participants before the study commenced to ensure ethical compliance throughout the process.\u003c/p\u003e\n\u003cp\u003eParticipants were randomly assigned to two groups using a random number table method. The experimental group (CBL+ML+BTgroup n=51) received a teaching model that integrated case-based learning (CBL) with micro-lessons and bedside teaching, while the control group(LBLgroup n=52) continued with traditional teacher-centered lectures. The random grouping process was conducted by independent researchers to ensure fairness and scientific validity.A comparative analysis of the demographic characteristics of the two groups, including gender and age, as well as the pre-test scores, revealed no statistically significant differences(p＞0.05)(Table1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003cstrong\u003e\u003cbr\u003e \u003cem\u003eExperimental Group:\u0026nbsp;\u003c/em\u003e\u003c/strong\u003eThis group employed a blended teaching model combining micro-lessons, bedside teaching, and CBL. Prior to the course, micro-lessons provided an introduction to relevant diseases, anatomical structures, and pathophysiological mechanisms. Students were also given preparatory materials, including the latest consensus or guidelines regarding disease advancements, to review. The course began with bedside examinations of patients to assess clinical symptoms and signs, followed by case discussions where students analyzed specific cases within small groups, exploring typical clinical presentations, pathophysiological mechanisms, differential diagnoses, and treatment options. After each case discussion, teachers provided summaries and feedback to reinforce students\u0026apos; learning outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eControl Group:\u003c/em\u003e\u003c/strong\u003e This group continued with Lecture-Based Learning methods, primarily relying on lectures and classroom explanations, focusing on knowledge transmission and memorization. The content covered was the same as that of the experimental group, but it lacked targeted bedside teaching, case analysis, and interactive discussions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.\u003c/strong\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Evaluation\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003eThis study assessed the learning outcomes of the two groups of residents through the following indicators:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheory Assessment:\u003c/strong\u003e A standardized theoretical examination was conducted at the end of the training, utilizing a closed-book format to evaluate residents\u0026apos; mastery of neurology-related theoretical knowledge, including understanding of disease mechanisms, diagnostic criteria, and treatment plans.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComprehensive Ability Evaluation:\u003c/strong\u003e At the end of the training, residents were assessed through a standardized examination format that evaluated their ability to collect patient histories, perform physical examinations, document cases, and analyze clinical scenarios, as well as their clinical reasoning and rapid response skills. This comprehensive evaluation also assessed communication and teamwork abilities using multi-dimensional scoring scales.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSatisfaction Survey:\u003c/strong\u003e A self-designed questionnaire was administered to gauge satisfaction with the teaching model, the practicality of the teaching content, and the effectiveness of teacher guidance, using a five-point scale (1 - very dissatisfied; 5 - very satisfied)[13].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInterest\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eInventory\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Students\u0026apos; interest in learning neurology was collected through a questionnaire, assessing the appeal and engagement of the course, using a seven-point scale (1 - not interested at all; 7 - very interested).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTeacher\u003c/strong\u003e\u003cstrong\u003es\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Self-Evaluation:\u003c/strong\u003e Instructors evaluated the course content and teaching effectiveness using a questionnaire, employing a five-point scale (1 - very dissatisfied; 5 - very satisfied)[14].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.\u003c/strong\u003e\u003cstrong\u003e4\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eSatistical Analysis\u003c/strong\u003e\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003eData collected were analyzed using SPSS statistical software. To compare the performance of the two groups across various observation indicators, normally distributed continuous data (e.g., assessment scores, satisfaction ratings, and interest ratings) were expressed as mean \u0026plusmn; standard deviation (mean \u0026plusmn; s). Differences between the two groups were analyzed using independent samples t-tests or rank-sum tests. A significance level of p \u0026lt; 0.05 was set to determine whether the differences between the experimental and control groups were statistically significant. Graphical representations were created using GraphPad Prism 8.0.\u003c/p\u003e"},{"header":"3. Results","content":"\u003ch2\u003e3.1 Clinical Theory Assessment\u003c/h2\u003e\u003cp\u003eThe experimental group achieved an average score of 83.02 ± 7.33, while the control group had an average score of 76.04 ± 7.19. The t-test results indicated a statistically significant difference between the two groups (t = -4.873, p \u0026lt; 0.001)(Table\u0026nbsp;2). This suggests that residents taught using the CBL combined with micro-lessons and bedside teaching outperformed those taught through traditional methods in their mastery of clinical theoretical knowledge, reflecting the effectiveness of case discussions and micro-learning.(Fig.\u0026nbsp;1A)\u003c/p\u003e\u003cp\u003e\u003cb\u003e3.2 Comprehensive Ability Evaluation\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn the comprehensive ability assessments, including case analysis, the experimental group scored an average of 86.25 ± 6.52, compared to 75.10 ± 7.86 in the control group. The t-test results also showed a significant difference between the two groups (t = -7.608, p \u0026lt; 0.001)(Table\u0026nbsp;2). This indicates that the experimental group exhibited superior clinical reasoning and case analysis abilities, suggesting that the new multimodal teaching approach helps enhance residents' overall performance, particularly in communication and teamwork skills, likely due to their more active and participatory learning style.(Fig.\u0026nbsp;1A)\u003c/p\u003e\u003cp\u003e\u003cb\u003e3.3 Satisfaction Survey\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn the satisfaction survey, the experimental group reported a satisfaction score of 4.22 ± 0.61, while the control group scored 2.96 ± 0.62. The t-test revealed a significant difference (t = -10.303, p \u0026lt; 0.001)(Table\u0026nbsp;2). These results indicate that the residents in the experimental group had a significantly higher level of recognition and satisfaction with the innovative multimodal teaching model compared to the control group, suggesting that this new teaching method better meets the learning needs of neurology residents.(Fig.\u0026nbsp;1B)\u003c/p\u003e\u003cp\u003e\u003cb\u003e3.4 Interest Inventory\u003c/b\u003e\u003c/p\u003e\u003cp\u003eRegarding the interest ratings, the experimental group received a score of 5.59 ± 0.85, whereas the control group scored 3.60 ± 1.01. The t-test results similarly showed a significant difference between the two groups (p \u0026lt; 0.001)(Table\u0026nbsp;2). This finding demonstrates that the new multimodal teaching approach significantly enhances students' interest and engagement in learning, potentially fostering greater enthusiasm and commitment to the field of neurology among residents.(Fig.\u0026nbsp;1B)\u003c/p\u003e\u003cp\u003e\u003cb\u003e3.5 Teachers Self-Evaluation\u003c/b\u003e\u003c/p\u003e\u003cp\u003eInstructors evaluated the course content and student reactions after the sessions, resulting in a score of 7.45 ± 1.29 for the experimental group and 5.27 ± 0.78 for the traditional teaching group. The difference between the two groups was significant (p \u0026lt; 0.001)(Table\u0026nbsp;2), indicating that teachers found the multimodal teaching approach to be more effective in delivering content and engaging students compared to traditional methods.(Fig.\u0026nbsp;1B)\u003c/p\u003e"},{"header":"4. Disscussion","content":"\u003cp\u003eNeurology is a highly complex and challenging discipline within the medical field, encompassing numerous diseases and various pathophysiological mechanisms,The nervous system has a complex structure and function, comprising various components, including the brain, spinal cord, and peripheral nerves. As learners strive to understand these anatomical features, they often encounter significant challenges[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].This challenge is particularly evident in certain neurological disorders, such as Parkinson's disease and epilepsy, where clinical manifestations can be highly characteristic. Observing real cases provides a more intuitive understanding than reading rigid textbook descriptions, which enhances residents' comprehension and memory, fostering a holistic understanding of these diseases. Therefore, studying and practicing in this field requires residents not only to master extensive professional knowledge but also to possess strong spatial and three-dimensional thinking abilities to appropriately localize and characterize various neurological disorders[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].This is where the advantages of case-based learning (CBL) combined with bedside teaching come into play\u0026mdash;through real clinical cases, students can delve into the anatomical background, pathophysiological mechanisms, and clinical presentations of specific diseases, while micro-videos reinforce their understanding and retention of these complex concepts[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis study validated the effectiveness of the CBL combined with micro-lessons and bedside teaching model in training neurology residents through comparative analysis, revealing significant advantages. The experimental group outperformed the control group in clinical theory assessments and comprehensive ability evaluations. This indicates that the micro-lesson format allows learners to grasp knowledge quickly while also stimulating their interest and critical thinking[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], Learning from real bedside cases enables residents to deepen their understanding of theoretical knowledge in a genuine clinical environment[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], The CBL model encourages active participation and critical thinking among students, facilitating progress through problem discussions and reflecting the interactive and participatory nature of the learning process [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], This approach effectively enhances their motivation and learning outcomes.\u003c/p\u003e \u003cp\u003eThe study found that the innovative multimodal teaching model enabled residents to engage in continuous self-reflection and adjustment during the learning process[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Traditional teaching methods often lack feedback and communication, whereas CBL encourages residents to interact and collaborate through group discussions and role-playing, thereby deepening their understanding and retention of knowledge[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. This not only aids in mastering theoretical knowledge but also promotes the application of clinical skills[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].The CBL model encourages residents to take on more active roles in their education, enhancing their initiative and engagement in learning, which in turn improves their comprehensive ability evaluation scores[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdditionally, the introduction of the micro-lesson model provides residents with a flexible learning approach. In the rapidly evolving field of neurology, knowledge is updated frequently, and micro-lessons can convey core concepts in a short time, allowing residents to deepen their understanding of specific knowledge points anytime and anywhere [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].Furthermore, for complex anatomical structures or intricate conduction pathways that are difficult to understand in neurology, creating micro-video animations or 3D visualizations can significantly aid students in comprehension and retention while increasing their interest in learning[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The study results indicate that residents rated the micro-lesson model very positively, believing that it effectively supplements the shortcomings of traditional teaching, particularly in reinforcing the learning and understanding of specific knowledge points in a short period.\u003c/p\u003e \u003cp\u003eIt is noteworthy that this study also found a significant improvement in clinical skills and communication abilities among residents participating in the CBL combined with bedside teaching. This phenomenon is closely related to the increased communication between students and patients during bedside teaching, as well as the enhancement of clinical skills through bedside examinations and procedures [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], Numerous studies have shown that teamwork and effective communication are essential components of modern medical education[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].Through team discussions and collaborative decision- making, residents are able to practice and learn in a simulated real-world environment, which greatly benefits their future clinical practice. Additionally, the bedside teaching process continuously reinforces students' clinical communication and examination skills. This model also positively impacts residents' clinical reasoning, patient education, and teamwork skills[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eData indicate that residents experienced a significant increase in overall satisfaction with the course and their learning interest, particularly in terms of engagement and a sense of achievement. This suggests that the combination of micro-lessons, bedside teaching, and CBL not only successfully imparts knowledge but also plays a crucial role in cultivating residents' interest in learning and positive attitudes. Previous studies have confirmed that integrated teaching models, such as flipped classrooms, timely teaching, and problem-based learning, represent the future of neurology education[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].Enhancing teaching satisfaction and interest significantly influences physicians' learning motivation and future career development, encouraging them to maintain a continuous learning attitude in their professional growth[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMoreover, the results of this study show that the self-evaluations of teachers using the micro-video, bedside teaching, and CBL model were significantly higher than those of teachers employing traditional teaching methods. This advantage can be attributed to several factors. First, the micro-lesson format allows educators to deliver concise and focused content, while also enabling the 3D visualization of anatomical structures and imaging, achieving efficient learning outcomes in a short time[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].The bedside teaching process facilitates the integration of theory and practice, allowing students to easily understand clinical situations. Teachers can also observe students' performance in real time and provide feedback, aligning closely with specific learning objectives, thereby enhancing students' comprehension and engagement[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Educators often feel more capable and confident when using teaching methods that align with students' needs and preferences. Second, the integration of CBL promotes active learning and encourages critical thinking, enriching the learning experience for students and enabling teachers to adopt more student-centered teaching approaches [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].Furthermore, the collaborative nature of CBL fosters feedback and discussion, which can enhance teachers' self-reflective practices. Engaging in discussions about real cases encourages educators to continuously evaluate and refine their teaching strategies, contributing to professional development and increased job satisfaction. Although the new teaching methods require teachers to invest considerable time in preparing lesson plans, the positive feedback received has not negatively impacted the self-satisfaction ratings of students and teachers [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e].Therefore, the combination of micro-lessons, bedside teaching, and CBL clearly creates a more favorable teaching and learning environment than traditional methods, resulting in higher self-evaluation scores for teachers. This underscores the importance of innovative medical education strategies to promote the mutual growth of educators and learners[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite the positive effects of the combined teaching models of micro-learning, bedside teaching, and CBL in the training of neurology residents, some limitations remain. First, the sample size of this study was relatively small and limited to a single medical center, which may affect the generalizability of the results. Future research should consider expanding the sample size and conducting comparisons across multiple institutions to verify the reproducibility and applicability of the findings. Second, the study did not adequately account for individual differences and learning styles among residents during implementation. Different educational backgrounds and learning approaches may influence learning outcomes. Therefore, future research should explore how to implement differentiated instruction based on individual differences to enhance learning effectiveness.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThis study demonstrates the effectiveness of combining micro-learning, bedside teaching, and CBL in training neurology residents. The approach significantly improves learning outcomes, increases interest, satisfaction, and comprehensive abilities, with teachers also noting enhanced teaching effectiveness in their self-evaluations. Amid challenges in neurology education, this innovative multimodal teaching strategy offers new insights for improving training systems to better meet the demands of modern healthcare. Further research into the application of this model across different medical fields is encouraged to expand its usage. Specifically, exploring how to implement these teaching methods in specialized areas like neurology in clinical and research settings remains a key focus.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to acknowledge the physicians and nurses at the First Affiliated Hospital of Zhengzhou University Neurological Intensive Care Unit.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Henan Provincial Key Scientific Research Project of Higher Education Institutions (23A320022) and the 2022 \u0026ldquo;Four New\u0026rdquo; Teaching Reform Research and Practice Projects of Zhengzhou University (2022zzusx021).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePH and XL designed the study. PH wrote the main manuscript, analyzed the data, and prepared the tables and figures. PH WM, RW, NS, and FY collected the data. PH made modifications to the figures. XL led the research group and critically revised the article. All authors reviewed the manuscript and approved the submitted version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePotential Conflicts of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNothing to report.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was submitted to and approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University(Approval No. 2023-KY-0375-001),in accordance with the Declaration of Helsinki (1964). We obtained written informed consent from all participants involved in this study, including patients, students, and faculty members.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1Neurological Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, 450001Zhengzhou, Henan,China.\u003c/p\u003e\n\u003cp\u003e2Department of Obstetrics, the First Affiliated Hospital of Zhengzhou University,450001Zhengzhou, Henan,China.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSun T, Wang Y. Standardized training for resident doctors in China. J Biomed Res. 2014;28:155\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBi M, Zhao Z, Yang J, Wang Y. Comparison of case-based learning and traditional method in teaching postgraduate students of medical oncology. Med Teach. 2019;41:1124\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFazl A, Fleisher J. Anatomy, Physiology, and Clinical Syndromes of the Basal Ganglia: A Brief Review. Semin Pediatr Neurol. 2018;25:2\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLucio LL, Freddi TAL, Ottaiano AC. The Abducens Nerve: Anatomy and Pathology. Semin Ultrasound CT MR. 2022;43:414\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePan Y, Chen X, Wei Q, Zhao J, Chen X. Effects on applying micro-film case-based learning model in pediatrics education. BMC Med Educ. 2020;20:500.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDewey JJ, Cho TA. Bedside Teaching in Neurology. Semin Neurol. 2018;38:441\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNicholl DJ, Appleton JP. Clinical neurology: why this still matters in the 21st century. J Neurol Neurosurg Psychiatry. 2015;86:229\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchaefer SM, Dominguez M, Moeller JJ. (2018) The Future of the Lecture in Neurology Education. Semin Neurol. 38: 418\u0026ndash;427.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhao W, He L, Deng W, Zhu J, Su A, Zhang Y. The effectiveness of the combined problem-based learning (PBL) and case-based learning (CBL) teaching method in the clinical practical teaching of thyroid disease. BMC Med Educ. 2020;20:381.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhao Z, Lv D, Chen L. Application of Problem-Based Learning Combined with Micro-Video Teaching in Burn Surgery and Its Impact on Satisfaction with Teaching. J Invest Surg. 2024;37:2403534.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDelungahawatta T, Dunne SS, Hyde S, Halpenny L, McGrath D, O'Regan A, et al. Advances in e-learning in undergraduate clinical medicine: a systematic review. BMC Med Educ. 2022;22:711.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWu F, Wang T, Yin D, Xu X, Jin C, Mu N, et al. Application of case-based learning in psychology teaching: a meta-analysis. BMC Med Educ. 2023;23:609.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eColthart I, Bagnall G, Evans A, Allbutt H, Haig A, Illing J, et al. The effectiveness of self-assessment on the identification of learner needs, learner activity, and impact on clinical practice: BEME Guide 10. Med Teach. 2008;30:124\u0026ndash;45.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang X, Tse WW, Savalei V. Improved Properties of the Big Five Inventory and the Rosenberg Self-Esteem Scale in the Expanded Format Relative to the Likert Format. Front Psychol. 2019;10:1286.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePantano P, Chollet F, Paulson O, von Kummer R, Laihinen A, Leenders K, et al. EFNS Task Force on Teaching of Neuroimaging in Neurology Curricula in Europe: present status and recommendations for the future. Eur J Neurol. 2001;8:541\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIsenmann S, Biesalski A, Zupanic M, Gerloff C. [University teaching in clinical neurology: present situation and future requirements]. Nervenarzt. 2013;84:1220\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMonturo CA, Brockway C. Micro-Learning: An Innovative Strategy to Cultivate a Spirit of Inquiry, Step Zero. Worldviews Evid Based Nurs. 2019;16:416\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePerez A, Howey M, Green JL, N\u0026oacute;brega MTC, Kebbe M, Amin M, et al. Multiple cases in case-based learning: A qualitative description study. Eur J Dent Educ. 2023;27:1067\u0026ndash;76.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaley CM, Brown B, Koerber A, Nicholas CL, Belcher A. Comparing Case-Based with Team-Based Learning: Dental Students' Satisfaction, Level of Learning, and Resources Needed. J Dent Educ. 2020;84:486\u0026ndash;94.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBurgess A, Matar E, Roberts C, Haq I, Wynter L, Singer J, et al. Scaffolding medical student knowledge and skills: team-based learning (TBL) and case-based learning (CBL). BMC Med Educ. 2021;21:238.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGul A, Khan RA, Yasmeen R, Ahsan NU. How Case Based Learning Promotes Deep Learning In Preclinical Years Of Medical Students? J Ayub Med Coll Abbottabad. 2020;32:228\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWu YY, Liu S, Man Q, Luo FL, Zheng YX, Yang S, et al. Application and Evaluation of the Flipped Classroom Based on Micro-Video Class in Pharmacology Teaching. Front Public Health. 2022;10:838900.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eO'Rourke JC, Smyth L, Webb AL, Valter K. How Can We Show You, If You Can't See It? Trialing the Use of an Interactive Three-Dimensional Micro-CT Model in Medical Education. Anat Sci Educ. 2020;13:206\u0026ndash;17.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGaribaldi BT, Russell SW. Strategies to Improve Bedside Clinical Skills Teaching. Chest. 2021;160:2187\u0026ndash;95.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlamoudi AA, Al Shawwa LA, Gad H, Tekian A. Team-based learning versus traditional didactic lectures in teaching clinical biochemistry at King Abdulaziz University; learning outcomes and student satisfaction. Biochem Mol Biol Educ. 2021;49:546\u0026ndash;59.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBurgess A, van Diggele C, Roberts C, Mellis C. Key tips for teaching in the clinical setting. BMC Med Educ. 2020;20:463.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHern\u0026aacute;ndez EH, Lozano-Jim\u0026eacute;nez JE, de Roba Noguera JM, Moreno-Murcia JA. Relationships among instructor autonomy support, and university students' learning approaches, perceived professional competence, and life satisfaction. PLoS ONE. 2022;17:e0266039.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSozmen EY. Perspective on pros and cons of microlearning in health education. Essays Biochem. 2022;66:39\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHarris DG. Overcoming the challenges of bedside teaching in the palliative care setting. BMJ Support Palliat Care. 2011;1:193\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJacobs NN, Calvo L, Dieringer A, Hall A, Danko R. Motivational Interviewing Training: A Case-Based Curriculum for Preclinical Medical Students. MedEdPORTAL. 2021;17:11104.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGasim MS, Ibrahim MH, Abushama WA, Hamed IM, Ali IA. Medical students' perceptions towards implementing case-based learning in the clinical teaching and clerkship training. BMC Med Educ. 2024;24:200.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable1：Comparison of participant demographic information and pre-course tests\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"545\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 171px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 102px;\"\u003e\n \u003cp\u003eCBL+ML+BT（n=51）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 106px;\"\u003e\n \u003cp\u003eLBL（n=52）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e/\u0026chi;\u003csup\u003e2\u003c/sup\u003e/Z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"35\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd height=\"21\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 171px;\"\u003e\n \u003cp\u003eGender(male)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e19（52）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e17（51）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.338\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.502\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 171px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e25.60 \u0026plusmn;2.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e25.23 \u0026plusmn;2.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e-0.907\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.750\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eScore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e79.84 \u0026plusmn;6.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e78.94 \u0026plusmn;6.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.692\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.671\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eMF:Micro Film;CBL: Case-based learning,LBL:traditional lecture-based teaching\u003c/p\u003e\n\u003cp\u003eTable 2:Courses Performance of CBL+ML+TB and LBL Group\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"545\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 171px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 102px;\"\u003e\n \u003cp\u003eCBL+ML+TB（n=51）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 106px;\"\u003e\n \u003cp\u003eLBL（n=52）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e/\u0026chi;\u003csup\u003e2\u003c/sup\u003e/Z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"35\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd height=\"21\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 171px;\"\u003e\n \u003cp\u003eTheoretical Knowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e83.02 \u0026plusmn; 7.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e76.04 \u0026plusmn; 7.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e-4.873\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.000\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 171px;\"\u003e\n \u003cp\u003eInterest Inventory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e5.59\u0026plusmn;0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e3.60\u0026plusmn;1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e-6.063\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.000\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eComprehensive evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e85.55\u0026plusmn;5.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e75.10\u0026plusmn;7.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-7.608\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSatisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.22\u0026plusmn;0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.96\u0026plusmn;0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-7.435\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eInstructors Self-evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.45\u0026plusmn;1.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5.27\u0026plusmn;0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-4.781\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eMF:Micro Film;CBL: Case-based learning,LBL:traditional lecture-based teaching\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Case-Based Learning (CBL), Micro-Learning, Bedside Teaching, Lecture-Based Learning (LBL), Standardized Training for Neurology Residents","lastPublishedDoi":"10.21203/rs.3.rs-6154199/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6154199/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e: This study explores the application effects of a novel teaching model that combines micro-learning, bedside teaching, and case-based learning (CBL) in the standardized training of neurology residents.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e From January 2022 to December 2024, a total of 103 neurology residents undergoing standardized training at the First Affiliated Hospital of Zhengzhou University were selected as the study subjects. A quantitative research design was employed, and participants were randomly divided into an experimental group and a control group. The experimental group (51 participants) utilized a novel teaching model that integrated micro-learning, bedside teaching, and CBL, while the control group (52 participants) employed \u003cstrong\u003eLecture-Based Learning (LBL) method\u003c/strong\u003es. The study focused on several indicators, including theoretical assessment scores from standardized training, student satisfaction and interest in the teaching content, clinical competency evaluations, and self-assessments by instructors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe novel teaching model combining micro-learning, bedside teaching, and CBL significantly outperformed traditional teaching methods in improving residents' theoretical assessment scores (83.02 ± 7.33 vs. 76.04 ± 7.19) and clinical competency evaluations, particularly in comprehensive ability assessments (85.55 ± 5.24 vs. 75.10 ± 7.86). Students also reported a marked increase in satisfaction with the teaching content and learning interest (P \u0026lt; 0.01). Furthermore, instructors expressed a high level of recognition for the new course model in their post-class self-evaluations (P \u0026lt; 0.01).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThe findings of this study indicate that the integration of micro-learning, bedside teaching, and CBL can provide a more effective teaching model for the training of neurology residents, offering strong support for future reforms and developments in medical education.\u003c/p\u003e","manuscriptTitle":"Innovative multimodal Educational Strategies: Assessing the Impact of Integrative Teaching Methods on Standardized Neurology Resident Training ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-01 07:20:38","doi":"10.21203/rs.3.rs-6154199/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-05-16T06:26:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-14T12:56:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"228644326132380870936901387885511270622","date":"2025-04-22T01:42:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"105229486298092529591763008152786855380","date":"2025-04-16T12:17:44+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-31T17:12:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"327482924141271027830193592816669124050","date":"2025-03-31T16:35:21+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-03-28T12:47:05+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-03-21T10:21:33+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-21T07:23:59+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-03-21T07:22:54+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b3dc9268-4d5f-4f6f-87e6-c0212e3c40b1","owner":[],"postedDate":"April 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-14T16:05:37+00:00","versionOfRecord":{"articleIdentity":"rs-6154199","link":"https://doi.org/10.1186/s12909-025-07507-x","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-07-10 15:57:29","publishedOnDateReadable":"July 10th, 2025"},"versionCreatedAt":"2025-04-01 07:20:38","video":"","vorDoi":"10.1186/s12909-025-07507-x","vorDoiUrl":"https://doi.org/10.1186/s12909-025-07507-x","workflowStages":[]},"version":"v1","identity":"rs-6154199","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6154199","identity":"rs-6154199","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}