目的：针对眼科学传统病例教学中信息冗余导致认知过载、偏离核心教学目标的问题，创新性应用奥卡姆剃刀原理构建精简病例教学资源并验证其效果。

方法：本研究为前瞻性随机对照研究。以2023年6月至2025年5月在空军军医大学唐都医院眼科实习的2019级和2020级五年制临床医学专业实习学生为研究对象，采用随机数字表法分为两组：试验组采用奥卡姆剃刀原理精简的临床病例(剥离无关信息，聚焦核心原则、临床思维与诊治流程)，对照组采用原始完整临床病例教学。通过知识测试、课堂表现评价、教学案例评价及学生满意度对进行教学效果评估。

结果：本研究共纳入学生120名，所有学生均完成研究。试验组60名学生中男43名， 女17名，平均年龄21.72±0.76岁； 对照组60名学生中男41名， 女19名，平均年龄21.68±0.57岁(均P>0.05)。 试验组学生眼外伤章节得分率、案例分析题得分率均显著高于对照组(83.21%±7.96% vs 74.25%±11.01%； 84.31%±8.08% vs 67.62%±11.63%，均P<0.001)。教师评价显示，试验组学生在案例关键点获取、临床思维逻辑性等维度评分均优于对照组(均P<0.001)。试验组案例复杂度与难度评价(即对案例的认知负荷)显著低于对照组，案例结构清晰度、思维启发性及教学价值评分均高与对照组(均P<0.001)。教学满意度试验组为95%，高于对照组的83%(P<0.05)。

结论：奥卡姆剃刀原理指导的病例精炼能显著降低认知负荷，提升医学生对核心诊疗原则的掌握效率、临床思维精准度和流程执行力，为临床教学改革提供创新路径。

METHODS:This was a prospective randomized controlled trial. Intern students from the 2019 and 2020 cohorts of the five-year clinical medicine program who completed their ophthalmology clerkship at the Department of Ophthalmology, Tangdu Hospital, Air Force Medical University between June 2023 and May 2025 were enrolled. By using a random number table, they were randomly assigned to an experimental group and a control group. Cases refined by Occam's Razor principle(removing irrelevant information and focusing on core principles, clinical reasoning, and the diagnostic and therapeutic workflow)were adopted for the experimental group, whereas the original complete cases were used for the control group. Teaching effectiveness was assessed through knowledge tests, classroom performance evaluation, teaching case assessment, and student satisfaction.

RESULTS:Totally 120 students were included in this study and all of them completed the research. There were 60 students in the experimental group(43 males and 17 females, mean age 21.72±0.76 y)and 60 students in control group(41 males and 19 females, mean age 21.68±0.57 y)(all P>0.05). The score rates on the ocular trauma section and on the case analysis questions were significantly higher in the experimental group than in the control group(83.21%±7.96% vs 74.25%±11.01%; 84.31%±8.08% vs 67.62%±11.63%; both P<0.001). Teacher evaluations indicated that the experimental group achieved better scores than the control group in aspects such as identification of key case points and logical clinical reasoning(all P<0.001). A significantly lower cognitive load score was observed in the experimental group, whereas higher scores were obtained for clarity of case structure, thought-provoking quality, and teaching value(all P<0.001). The teaching satisfaction rate reached 95% in the experimental group, which was higher than the 83% observed in the control group(P<0.05).

CONCLUSION: Refined cases guided by Occam's Razor principle can significantly reduce cognitive load, enhance medical students' efficiency in mastering core diagnostic and therapeutic principles, improve the precision of clinical reasoning, and strengthen execution of clinical procedures, thereby providing an innovative pathway for clinical teaching reform.