“Script Killing” immersive teaching improves the competency of emergency medicine residents rotating across departments

Objective To evaluate whether “Script Killing” immersive teaching improves job competency among resident physicians rotating through the emergency department across departments. Methods We conducted a cohort-allocated controlled educational study at Zhengzhou People’s Hospital (November 2024 to March 2025). Thirty-six rotating residents were allocated by cohort to an intervention group ( n = 18; “Script Killing” immersive role-play, also referred to as a murder-mystery game–based scenario teaching) or a control group ( n = 18; traditional teaching). Outcomes included written theoretical assessment, objective structured clinical examination (OSCE), teaching satisfaction, recognition of the teaching process, clinical decision-making indicators (e.g., triage accuracy and reasonableness of emergency management plans), and 3-month knowledge retention. Results After 3 months, the intervention group scored higher than controls in theoretical knowledge (86.82 ± 2.85 vs. 72.45 ± 3.25) and OSCE performance (92.47 ± 3.22 vs. 75.18 ± 4.08) (both p < 0.001). Triage accuracy was higher in the intervention group (94.44% vs. 66.67%, p = 0.034). The reasonableness of management plans was numerically higher but did not reach statistical significance (88.89% vs. 61.11%, p = 0.054). At 3-month follow-up, the intervention group showed better knowledge retention, with smaller declines in theoretical and OSCE scores from baseline ( p < 0.001). Conclusion “Script Killing” immersive teaching was associated with improved examination performance, OSCE skills, and key decision-making behaviors, with higher learner satisfaction and improved knowledge retention among cross-department rotating residents in the emergency department.