Objective To explore the design key points of discussion-oriented observation classes on political and virtuous awareness education,to clarifytheir implementation effects and to provide a reference for training to address the lack of faculty competence and methodological resources on political and virtuous awareness education. Methods Organized and designed by the Academic Affairs Office in Xiangya Hospital ofCentral South University, 14Discussion-oriented observation classes on political and virtuous awareness education were conducted from March to May and November to December 2023, following a three-phase workflow: pre-class preparation and design, in-class observation and discussion, and post-class evaluation and reflection. Data were collected in real time after classes, including 838 student questionnaire responses, feedback from 14 teaching instructors, calculating the item scores according to the Likert 10-point scale; and insights from 153 supervisors and peer teachers through real-time and end-of-term discussions. One week post-class, one-on-one interviews were conducted with 12 instructors. General descriptive statistical analysis was performed on the results. Results The results showed that the 14 teachers who participated in the teaching activities gave feedback after the class, stating that they had designed the teaching objectives, content and methods more meticulously (9.46±0.97) points, had more deeply considered the key points and difficulties of the ideological and political teaching in the course (9.46±0.97) points, had fully utilized the designed elements and cases of ideological and political teaching in the course (9.00±1.45) points, and had more opportunities to communicate and collaborate with other subject teachers (8.77±1.36) points. The 838 students' feedback indicated that the observation class made them feel that the teaching was meticulously designed (9.21±1.35) points, could always capture their attention (8.96±1.70) points, and were very willing to participate in the interactive activities of this class (8.87±1.78) points. All 12 teachers who participated in the interview believed that the discussion-based observation class improved their understanding of ideological and political teaching and teaching ability through in-depth teaching design and reflection and improvement, and would apply this experience to subsequent teaching.Experts and peers recommend that teachers integrate political and virtuous awareness elements by aligning them with the characteristics of the discipline, the unique features of the course, and student interests. They also advise administrative departments to institutionalize discussion-oriented observation classes and establish incentive mechanisms. Conclusions Discussion-oriented observation classes facilitated clinical teachers' instructional design and post-class reflection on political and virtuous awareness education in the curriculum, enhanced their teaching competence in this area, and exerted a positive impact on subsequent teaching practices. Meanwhile, these classes also enhanced students' learning experience.