Objective To explore the efficacy of an innovative 3D virtual classroom in cardiology education within internal medicine, aiming to enhance teaching quality and cultivate outstanding medical professionals. Methods This study identified existing challenges in internal medicine education and developed an "Innovative 3D Virtual Classroom" model, employing a six-dimensional pedagogical framework: integration, cohesion, expansion, extension, interaction, and evaluation. The curriculum content, teaching examples, tools, and environment were redesigned accordingly. Eighty clinical medicine students were stratified and randomly assigned to either a control group (traditional teaching methods) or an experimental group (innovative teaching approach) for the Cardiac Arrhythmias module. Post-intervention, teaching effectiveness was assessed through instructor evaluations (theoretical knowledge and clinical reasoning assessments) and student feedback (questionnaires). Results The experimental group demonstrated significantly higher scores in theoretical knowledge, clinical reasoning, and overall performance compared to the control group (P＜0.001). Teaching satisfaction scores showed significant improvements across all dimensions (P＜0.001), with the most notable enhancement in classroom interaction. Conclusion The innovative 3D virtual classroom, through its immersive learning environment and multidimensional interactive mechanisms, significantly improves knowledge translation and clinical decision-making skills among medical students. This approach provides a novel solution to bridge the "theory-practice gap" in medical education and offers evidence-based support for reforming medical education in the era of intelligent technologies.