Participants were randomly assigned to experimental (SP-CBL) and control (traditional training) groups using computer-generated randomization. Blinding was not feasible due to the nature of the intervention.

This study was alignment with “Residency Training Competency Standards”, and Integration of “Healthy China 2030” family-community collaboration principles.

Our SP-CBL training program demonstrates strong alignment with national medical education standards, as evidenced by specific policy compliance metrics ( Table 2 ). Notably, simulations focusing on privacy protection achieved a 100% compliance rate with Undergraduate Medical Education Standards. Furthermore, 78% of our SP cases successfully covered emergency room (ER) and outpatient scenarios, directly addressing requirements outlined in Residency Training Base Standards. The program also effectively integrated informed consent role-play, showing a 95% compliance rate with the Regulations on Medical Dispute Prevention, thereby reinforcing the practical application of communication skills within critical legal and ethical frameworks.

To comprehensively evaluate the impact of the intervention across different time horizons, a multi-tiered competency tracking design was implemented. For short-term assessment, Objective Structured Clinical Examinations (OSCEs) were utilized, with results quantified using a detailed scoring table to capture immediate skill acquisition and performance. Mid-term competency was monitored through the analysis of internship complaint rates, drawing anonymized data directly from the hospital’s Human Resources (HR) system to reflect real-world communication effectiveness. Finally, long-term impact on professional readiness was assessed by tracking the National Medical Licensing Exam pass rates, utilizing anonymized data retrieved from the National Medical Education Examination Committee (NMEEC). This comprehensive approach allows for a robust understanding of skill development from immediate learning outcomes to sustained professional competence Outcome timeline for clarity showed in Table 3 .

SPSS 22.0 (IBM Corp, Armonk, NY, USA) was used for statistical analysis. Categorical data were described as frequencies (n) and percentages (%), and the chi-square test was used for the comparisons between the two groups. p < 0.05 was considered statistically significant.

The study revealed significant improvements in communication competency, with the most substantial gains observed at the “Shows how” level of situational response, demonstrating a remarkable 24.5% increase in scores (p < 0.001). Furthermore, a strong positive correlation was identified between the policy compliance rate and Objective Structured Clinical Examination (OSCE) scores (r = 0.73, p = 0.015), suggesting that adherence to policy-aligned training components directly contributes to higher practical communication proficiency.

The SP-CBL intervention demonstrated compelling evidence of clinical translation, extending beyond immediate training outcomes to real-world performance. The experimental group exhibited a significantly lower internship complaint rate, recording only 0.7 complaints per 1000 cases, a substantial improvement compared to 1.9 complaints per 1000 cases in the control group. Furthermore, the long-term impact was underscored by an increase of 6.2 percentage points in the National Medical Licensing Exam pass rate for the intervention group, with all data anonymized in adherence to national protocols. These findings collectively highlight the model’s effectiveness in preparing trainees for authentic clinical practice and enhancing their readiness for professional licensure.

This research not only demonstrates the efficacy of the SP-CBL model but also illuminates concrete Theory-Policy Synergy Pathways for its broader implementation and integration into medical education. The initial step involves Evidence Generation, where rigorous randomized controlled trials (RCTs) provide robust validation of SP + CBL’s efficacy in enhancing pediatric communication competencies. This empirical evidence then underpins the crucial stage of Standardization, facilitating the incorporation of these validated findings into comprehensive Pediatric Training Guidelines, ensuring uniformity and quality across educational programs.

Moving towards broader adoption, Institutionalization is key, involving the establishment of a national Standardized Patient (SP) case library certification system. Such a system would ensure the quality, relevance, and accessibility of training materials, promoting consistency and excellence in communication education. Finally, Resource Mobilization is critical for sustained implementation. This involves the strategic allocation of medical insurance funds for SP training, as explicitly supported by relevant policy documents such as the Ministry of Finance (MoF) Document No. 82 from 2021 ( Ministry of Finance, 2021 ). This multi-pronged approach ensures that effective pedagogical innovations are not only validated by theory but are also systematically translated into actionable policies and sustainable practices, thereby bridging the gap between educational research and national health objectives.

Based on the evidence and observed pathways, several Key Policy Recommendations are proposed to further integrate and sustain the benefits of SP-CBL training in medical education. Firstly, regarding Curriculum Accreditation, it is crucial to establish national Standardized Patient (SP) case review standards. This measure would ensure the quality and consistency of SP cases used across various institutions, drawing inspiration from established models such as the US National Board of Medical Examiners (NBME) SP Program, which rigorously validates its training and assessment materials ( Boulet et al., 2003 ).

Secondly, to foster the active participation and development of educators, Faculty Incentives are vital. This involves formally recognizing SP teaching contributions in academic promotion criteria, effectively expanding the existing “dual-qualified” faculty criteria to include expertise in SP-based pedagogy. This would incentivize faculty members to dedicate time and effort to developing and delivering high-quality SP training.

Lastly, for sustainable financial support, Insurance Linkage is recommended, specifically by exploring mechanisms for reimbursing SP training costs through continuing medical education budgets. This strategic financial integration would ensure that SP-CBL, a highly effective pedagogical tool, receives consistent and predictable funding, thereby facilitating its widespread and long-term implementation across medical training programs.