Role exchange combined with reflection teaching advocates case as the center, taking students as the main body, through the role play to achieve role exchange, so as to improve communication skills. This study explored the application effect of role exchange combined with reflective teaching in pediatric emergency doctor-patient communication courses, selected 22 eight-year program students enrolled in 2015 who were interned in the department of emergency medicine of Beijing Children's Hospital, Capital Medical University from July to December 2022 as research subjects, and expounded the teaching design and implementation process of role exchange combined with reflective teaching in doctor-patient communication for pediatric emergencies. The teaching effect was evaluated by the process evaluation, summative test, and questionnaire survey. The results showed that the students' process evaluation score is (9.2±1.2) points, and the final evaluation score is (8.8±0.5) points. Among 22 students, 21 (95.5%) students were interested in the combination of role exchange and reflective teaching, and 21 (95.5%) students thought that the course was helpful to improve their ability to solve problems and communication skills. Role exchange combined with reflective teaching helps to improve the teaching effect of doctor-patient communication skills in pediatric emergency, which helps to stimulate students' learning motivation and enhance students' communication ability.