The value of publishing case reports for the professional development of Chinese residents: a qualitative study

In comparison with high-income countries, medical education resources in low- and middle-income countries (LMICs), such as China, are severely lacking. In China, residents' clinical work is characterized by extensive demands and mechanized approaches, resulting in a paucity of opportunities for active thinking and learning during clinical rotations. Moreover, these residents lack the time and experience necessary for scientific research training. However, these countries possess a wealth of case resources, including numerous classical and complex cases that hold significant teaching and publication value. The effective utilization of this advantage and the integration of case reporting as a distinctive graduate medical education (GME) platform remain to be explored.

The study was conducted between September 2023 and March 2024 in Beijing, China. Purposive sampling was used to recruit 15 residents who were in the first or second stage of standardized residency training and had successful experience in publishing case reports. Semi-structured in-depth interviews were conducted on a one-on-one basis to explore the role of case reports in the professional development of residents in LMICs. Thematic analysis was employed to analyze the data.

Of the 15 participants, 3 were male and 12 were female, with an average age of 27.2±2.6 years. 12 subthemes were extracted, from which 5 themes were identified, including clinical professional competency, scientific research competency, collaborative and communicative competency, sources of pressure and implementation evaluation. In terms of clinical competency, publishing case reports can increase residents' basic medical knowledge reserve, practical ability of diagnosis and treatment, and self-learning in daily clinical practice. In terms of scientific research competency, the case report can guide young residents to commence their academic careers, improve academic writing skills and strengthen their initiative in scientific research. Furthermore, it has been demonstrated that case reports can enhance awareness and skills in multidisciplinary collaborations, as well as communication with patients, supervisors and journal editors/reviewers. Heavy clinical responsibilities during residency training are common external pressures while anxiety is a common internal pressure during case report writing. Feasible aspects of integrating case report training into GME in LMICs include the relatively low time commitment and abundant case resources. However, challenges include inconsistent training and assessment standards.

It is suggested that case report training be specially integrated into GME in LMICs with sufficient valuable case resources and capacity to manage complex cases, based on the value of case report experience in the career development of residents and the current situation of medical education in these countries.