To investigate the effects of BOPPPS combined with scenario-based simulation teaching method in cardiac physical examination.

A total of 90 third-year undergraduate students majoring in clinical medicine (class of 2022) from Hunan University of Chinese Medicine from September to December 2025 were selected and randomly divided into an experimental group and a control group by the random number table method, with 45 students in each group. The experimental group adopted the BOPPPS structured design concept, incorporating scenario-based simulation teaching method for instruction in cardiac physical examination, while the control group followed the traditional teaching model. Independent samples t-test and Mann-Whitney U test were used to compare the distributions of clinical skill examination scores and knowledge test scores between the 2 groups. Paired-samples t-tests were used to compare intragroup changes in learning engagement before and after the teaching intervention, while independent samples t-tests were performed for intergroup comparisons of learning engagement and course satisfaction scores. Qualitative analysis was performed on the reflective journals and interviews of students in 2 groups.

One week after course completion, the skills assessment score of the experimental group (86.47±2.15)was significantly higher than that of the control group (71.82±3.06), and the difference was statistically significant (t=26.26, P< 0.01). The excellent rate on the knowledge test among students in the experimental group (84.4%, 38/45) was higher than that in the control group (42.2%, 19/45), and the difference in grade distribution between the two groups was statistically significant (Z=4.19, P< 0.01). Before the teaching intervention, no significant differences were found between the 2 groups in the 4 dimensions of vigor, dedication, absorption, and behavioral self-assessment, or in the total score (all P> 0.05). After the teaching intervention, the experimental group scored significantly higher than the control group on all dimensions and the total score (t=7.332, 7.947, 6.881, 6.434, 24.928, all P<0.01). Regarding learning satisfaction, the experimental group scored significantly higher than the control group on all 8 dimensions: clarity of teaching objectives, logical coherence of teaching structure, authenticity of simulation scenarios, depth of classroom engagement, quality of reflection and feedback, knowledge integration and application, team collaboration experience, and appropriateness of learning workload (t=5.010, 5.087, 5.657, 6.774, 7.011, 5.380, 2.300, 2.263, all P< 0.05). Further qualitative analysis combining students′ reflective journals and interview data revealed a fundamental shift in the learning mode of students in the experimental group: they transitioned from conventional passive " procedural practice" to active " meaningful inquiry". Within structured teaching scenarios, students completed early clinical thinking training and gradually cultivated and established professional identity.

The combination of the BOPPPS model and scenario-based simulation teaching can significantly improve both skill performance and knowledge excellence rates in cardiac physical examination. Furthermore, it effectively facilitates students′ transition from procedural operations to meaningful inquiry-based learning.