Chaisawasthomrong C.Boongird A.Mahidol University2026-02-182026-02-182026-12-01BMC Medical Education Vol.26 No.1 (2026)https://repository.li.mahidol.ac.th/handle/123456789/115127Background: Neurosurgical education is shifting toward methods that foster clinical reasoning and decision-making beyond traditional lectures. Small group discussions (SGD) promote collaborative learning, while clinical preceptorships (CP) offer individualized, hands-on training. However, limited research has compared their effectiveness in undergraduate neurosurgical education. This study evaluates the impact of CP and SGD on knowledge acquisition and clinical preparedness among sixth-year medical students. Methods: In 2024, a quasi-experimental study involving 48 participants was conducted, including 31 sixth-year medical students assigned to either CP (n = 15) or SGD (n = 16), and 17 recently graduated physicians who served as the control group. Both groups completed pre- and post-intervention assessments that covered neurosurgical theory and clinical scenarios, based on the minimum requirements set by the Medical Council. Post-intervention outcomes were analyzed using t-tests. Correlation analysis examined the relationship between time and topic-specific retention. The control group consisted of interns rotating in the department of surgery who trained via the traditional method. Results: Post-intervention, both CP and SGD improved post-test scores. The SGD format required 1.5 h for 5–6 students, whereas the CP format required 1 h per student, with this difference being statistically significant (p < 0.001). CP students, however, significantly outperformed SGD in CT interpretation (85.0% vs. 70.0%, p < 0.01) and neurosurgical management modules (80.4% vs. 40.2%, p < 0.001). CP participants also demonstrated greater knowledge gains and committed fewer conceptual errors, particularly in etiology and management. A significant negative correlation was observed between time since the intervention and knowledge retention (r = − 0.739, p < 0.001). Conclusion: Neurosurgical education benefits from both SGD and CP. SGD enhances conceptual understanding and evidence-based learning, while CP strengthens hands-on application, CT interpretation, and management skills. To reinforce essential neurosurgical knowledge, a refresher session is recommended six months after the initial training.MedicineSocial SciencesArticleSCOPUS10.1186/s12909-026-08587-z2-s2.0-10502972794814726920