Abstract: Objective: To explore the guiding significance of medical simulation assessment proposition thinking and methods for clinical teaching.Methods: Combining twoyears of propositional experience of the National Medical College Students Clinical Skills Competition,clinical medical characteristics were summarized and analyzed.Results: Propositions should be based on how to strengthen the clinical foundation, clinical thinking,basic operations,human care and doctor-patient communication.The questions should include:content and purpose of assessment,stem,clinical thinking process and setting in the case scenario,the stem contains the core system,operational norms,human care and doctor-patient communication.The proposition should also pay attention to the refinement of the problem,the model of the simulation operation should be available,and the operation environment should be safe.Conclusions: The moreclose to the clinic,clinical thinking and objective in the competition,the better.