Development and evaluation of a practical teaching model for medical laboratory interns based on the "quality-safety-patient-centered" triple helix framework

Balancing competency-based education, quality improvement, and patient-centered care remains a challenge in laboratory medicine internships. This study developed a "quality-safety-patient-centered" triple helix framework and evaluated its association with educational outcomes in an exploratory quasi-experimental setting.

This study employed a two-phase, quasi-experimental, non-randomized design with a historical control group. The control group (n = 30, grade 2022) received conventional teaching, while the experimental group (n = 32, grade 2023) underwent the Triple Helix-based model. Both completed a 48-week internship. Outcomes included the Triple Helix Integrated Literacy Scale, Mini-Clinical Evaluation Exercise (Mini-CEX), theoretical and practical examinations, process quality and safety indicators, and satisfaction ratings.

The experimental group showed higher scores than the control group on the Triple Helix Integrated Literacy Scale total score (106.25 ± 7.96 vs. 88.70 ± 8.25; mean difference 17.55, 95% CI: 13.42-21.66; P < 0.001), Mini-CEX comprehensive score (7.63 ± 0.53 vs. 6.47 ± 0.62; mean difference 1.16, 95% CI: 0.88-1.44; P < 0.001), theoretical examination score (87.91 ± 4.98 vs. 82.47 ± 5.86; mean difference 5.44, 95% CI: 2.67-8.21; P < 0.001), and practical skills (90.28 ± 4.87 vs. 84.13 ± 6.02; mean difference 6.15, 95% CI: 3.36-8.94; P < 0.001). For process indicators, the experimental group showed higher rates of quality control (QC) out-of-control management accuracy (93.8% vs. 70.0%; risk difference 23.75%, 95% CI: 5.33-42.17; P = 0.014), critical value notification timeliness (100% vs. 80.0%; risk difference 20.00%, 95% CI: 5.69-34.31; P = 0.010), and patient identification compliance rate (93.8% vs. 73.3%; risk difference 20.42%, 95% CI: 2.51-38.33; P = 0.040). Satisfaction ratings from clinicians, patients, and preceptors were all higher in the experimental group (all P < 0.001).

In this exploratory study, the triple helix teaching model was associated with better performance across quality, safety, and patient-centered competencies. Causal inference is limited by the historical control design, yet the framework may offer a promising direction for guiding teaching reform in laboratory medicine.