Objective To observe the effects of role swap teaching rounds with conceive-design-implement-operate (CDIO) teaching mode in improving the clinical thinking abilities of standardized training residents. Methods A total of 124 students in the Department of Cardiology, the First Affiliated Hospital of Naval Military Medical University from July 2021 to December 2022, were randomly divided into the experimental group (n=62) and the control group (n=62). The experimental group students were trained with the CDIO mode guided role swap teaching rounds, while the control group were applied with traditional teaching rounds. Before graduation, the clinical thinking abilities and clinical comprehensive abilities of both groups were evaluated. In addition, the experimental group students filled in questionnaires to evaluate the teaching effects. Results The critical thinking, systematic thinking and evidence-based thinking abilities of the experimental group were better than those of the control group (P＜0.05). Moreover, according to the Mini-CEX scale, the experimental group residents represented better capability in clinical reception, disease analysis and diagnosis and communication (P＜0.05). The questionnaire survey showed that the new teaching method inspired the interest and passion for learning of the standardized training residents, developed their clinical thinking ability, organizational capability, verbal dexterity, and the learning efficiency. Conclusion CDIO mode guided role swap teaching rounds is helpful to improve the clinical thinking abilities of standardized training residents.