Comparative evaluation of competency-based and real-patient education in undergraduate clinical clerkships: insights from student feedback and performance

Clinical clerkships are a critical component of medical education, offering students hands-on experience in patient care and an opportunity to apply theoretical knowledge in real-world settings. Traditionally, clinical clerkships have been conducted through real-patient education (RPE), where students interact with actual patients under supervision. However, the introduction of competency-based education (CBE) has shifted the focus towards developing specific competencies through structured and often simulated learning experiences. This study aims to compare these two approaches based on student feedback and comprehensive evaluation to understand their impact on the clinical clerkship experiences of undergraduate medical students. This study was conducted at the Children’s Hospital of Chongqing Medical University, Chongqing, China. Students were divided into two groups: one experiencing a CBE integrated with RPE approach and the other a traditional RPE approach. A mixed-methods research approach was employed to leverage the strengths of both quantitative and qualitative dimensions in evaluating the revised pediatric clinical clerkship curriculum. Data were analyzed to compare these two methods. The difference between mean values was calculated using Student’s t-test. A P-value < 0.05 was considered statistically significant. Results indicate that students in the CBE group generally rated their teaching sessions higher across most metrics compared to those in the RPE group. This suggests that the CBE approach may be more effective in engaging students, enhancing their skills, and increasing overall satisfaction. Moreover, while there was no statistically significant difference in mean exam scores between groups, CBE increased the proportion of students scoring in the 70–89 range on knowledge-based tests and OSCEs. Our study indicates that the CBE clerkship model was better received and associated with higher student satisfaction. The significant differences in student feedback between the CBE and RPE approaches highlight the need for a review and improvement of teaching methods. An integrated approach, combining the strengths of CBE (structured competency development) and RPE (authentic patient interaction), shows promise in enhancing clinical training. Future studies should employ more robust qualitative methods to further explore the integrative learning experience and long-term outcomes.