The key factor in ensuring and enhancing the quality of health systems is high-level education that transforms learners into qualified health professionals. [12] In recent years, many countries promote competence-oriented medical education. [13]The reform of medical education in China also emphasizes the importance of post competency.
Traditional training is the common pedagogical method for learning clinical skills, and the aim of medical educators is to identify the best methods for undergraduates to prepare for their professional career. [14]Centered on medical students, role-playing method creates an environment that is similar to the process of clinical diagnosis and treatment to combine theory with clinical practice which can improve students’ comprehensive analysis ability, clinical performance and communication skills. [15, 16]So PRP, which is proved to achieve similar results as using standardized patients in medical education [17, 18], can encourage them to participate in and help them to develop their autonomous learning and communicative competence. [19]Video feedback can stimulate their interest in learning actively. [20]In this study, we found that video recording and role play, which are student-centered, make sure students pay more attention on the course. All students make full preparation for it, some find lots of props, some dress in uniform, and others do make-up slightly. The Ability Improvement Questionnaire also shows that this novel teaching method combining video recording, role playing, video feedback and PBL can improve students' learning interest and autonomous learning ability more than the traditional teaching method.
PRP can simulate the situation of facing real patients, meanwhile, video recording and feedback can review various details and their own performance in PRP from different perspectives, enable students to discover mistakes they did not realize before and conducive to self-reflection[21]. Through repeated presentation, it is not inferior to face-to-face guidance from experts in improving clinical knowledge and skills of medical students [22]. The self-analysis, evaluation and feedback of PRP videos and the summary, analysis, evaluation and feedback of instructors can not only improve learning efficiency as effectively as the feedback from experts [23], but also provide additional repeatable learning resources for students. [24] In this way, the clinical experience of medical students can be enriched and their learning ability and proficiency in clinical skills can be improved. [25, 26]Studies have confirmed [27] that video feedback combined role playing can significantly improve the clinical communication skills and knowledge application ability of medical students. In our study, the questionnaire shows that the study group is better than the control group in terms of improving teamwork ability, cultivating clinical thinking ability, actively acquiring knowledge ability, language expression ability, understanding knowledge points in the course, and is superior to the control group in improving interpersonal communication ability and active problem solving ability. ACIR shows that the study group is significantly better than the control group in organization, timeline, and transition statements, open questioning, smooth progress, and avoid repetition, summarizing, understandable language, and documentation.
Video feedback can record students' learning behavior and feed back to them, which can slow down the forgetting speed of acquired knowledge and skills. Researches show that [28, 29] video feedback method is of great help to improve the clinical training scores of medical students and their long-term mastery of clinical knowledge. In this research, the study group significantly outperformed the control group at the total score of ACIR and the theoretical test scores at the end of the course.
In terms of improving the confidence of becoming a real doctor, the satisfaction of the two groups of students was 70.6% and 51.5%, respectively. The study group is better than the control group, which is lower in the two groups although the ratios are both over 50%. On the one hand, it shows that students are not confident enough to face real patients; on the other hand, the teaching method of video feedback combined with PRP cases is helpful to enhance professional confidence of medical students [30]. Therefore, we should carry out more similar exercises to improve the post competency of medical students.
A research shows [31] that it is effective for medical undergraduates to use video and role-play to promote their counseling skills. This study also shows that video feedback combined with peer role playing is obviously superior to the control group in the teaching mode of OSBC + PBL for medical students, which is worth promoting. However, the limitations lie on the aspects following stated. Initially, the sample size is insufficient and the grouping is not meticulous enough. Secondly, the questionnaire is prepared by the authors according to the teaching practice and students' feedback, rather than standardized questionnaires. Last but not least, only ACIR was performed to assess clinical communication skills. In short, further research is anticipated.