Application of Clinical Pathway and Case-Based Learning in Residency Training of Pediatric Cardiology

Residency training provides systematic, competency-based education for medical graduates. Although specialised knowledge and clinical skills are crucial in pediatric cardiology, training in China is often limited to 2-3 months with lecture-heavy approaches. We explored integrating clinical pathway(CP) and case-based learning (CBL) models to enhance training efficiency.

The study involved 47 second-year pediatric trainees in Guangdong Provincial People's Hospital (2021-2024), randomly divided into a traditional teaching (TT) group and a CP-CBL group. Both groups underwent a 3-month training period, with no significant baseline differences (age: 21.6 ± 1.2 vs 22.1 ± 0.8 years; eight male trainees/group). The TT group received conventional lectures and ward-based learning. In the CP-CBL group, standardized instruction for common diseases was delivered through CP, whereas atypical/complex cases were taught with CBL. Both groups covered identical syllabus and duration. Outcomes were assessed through a theoretical test, case analysis, and an anonymous trainee questionnaire with a 5-point Likert scale. Group means were compared using Welch's t-tests (α = 0.05) in R software (significance level: p < 0.05).

Among 47 pediatric trainees, 24 (51.1%) were assigned to the CP-CBL group. No significant differences in age, experience, or prior CP-CBL exposure were observed between groups. All trainees completed the rotation exam. The CP-CBL group outperformed the TT group in comprehensive assessments (case analysis + theory exams), with 37.5% vs 4.3% of trainees scoring >90 points respectively. Trainees in the CP-CBL group reported higher satisfaction with learning interest (p < 0.01) and perceived skill improvement (p < 0.01), but no significant differences in course organisation (p = 0.49) or instructor performance (p = 0.79).

In pediatric cardiology training, CP-CBL outperformed TT in both knowledge acquisition and learner engagement.