Chinese Journal of Medical Education

Exploration of curriculum development for death education in graduate nursing programs

Xu Yahong, An Ying, Xu Yimin, Liu Yisi, Yue Peng

2025, 45 (7): 481-485. DOI: 10.3760/cma.j.cn115259-20240731-00808

Abstract ( 6 )

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Based on the learning needs and characteristics of nursing graduate students, this study team, guided by social constructivist theory and project-based learning theory, developed a graduate-level course titled Death Education and Coping with Death. The course included three topics: “Perspectives on Life and Death from a Multidisciplinary View”,“Life Value and Coping with Death” and “Death Education and Death Education Projects”. Three-tier project-based teaching model was developed: “Exploring oneself-Approaching the Frontier-Aligning with the Profession”. A preliminary implementation of the course was carried out with 10 nursing graduate students at Capital Medical University from September to December 2023. Results indicated that students reported a positive learning experience and widely affirmed the course′s content and pedagogical approach. The course effectively promoted shifts in students′ attitudes toward death and enhanced their practical competencies in death education. The course content and teaching strategies align well with the learning characteristics of graduate students, demonstrating both effectiveness and feasibility, and may serve as a valuable reference for the development of death education curricula for graduate students in medical schools.

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Investigation on the current status of scientific research literacy and its influencing factors analysis among undergraduate students in preventive medicine

Su Xuan, Wu Qianqian, Chen Renjuan, Feng Yancheng, Du Xiaoyan, Zhang Hairui, Ma Yonghong, Men Ke

2025, 45 (7): 486-491. DOI: 10.3760/cma.j.cn115259-20240605-00562

Abstract ( 9 )

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Objective To investigate the current status of scientific research literacy and its influencing factors among undergraduate students majoring in preventive medicine at medical universities, thereby informing the further optimization of their training program. Methods In April 2024, a total of 348 undergraduate students in preventive medicine enrolled in 2019~2021 at a medical university in Shaanxi Province were surveyed using a questionnaire designed by the researchers. The survey content mainly included students′ basic information, current scientific research literacy levels, and their participation in research activities. Descriptive analyses, Mann-Whitney U tests, and Kruskal-Wallis H tests were conducted to compare scientific research literacy scores with varying characteristics. A multivariate logistic regression analysis was performed to determine the influencing factors of scientific research literacy in this population. Results Students scored 3.5 (0.9) on research literacy, with the highest mark in research spirit [3.6(1.0)], followed by research awareness [3.4(1.0)] and research methodology [3.2(0.8)]. Multiple regression analysis revealed that students who participated in research activities were more likely to possess basic scientific research literacy (OR=2.738, 95% CI: 1.509~4.965) and master basic research methods (OR=2.159, 95% CI: 1.276~3.652). Students aspiring to postgraduate education were more likely to possess a research spirit (OR=2.080, 95% CI: 1.062~4.075). Female students demonstrated a higher likelihood of basic research awareness compared to male counterparts (OR=2.104, 95% CI: 1.219~3.633). Research awareness was stronger among students whose at least one parent holds a diploma or undergraduate degree, compared to those whose parents have a high school education or less (OR=2.702, 95%CI: 1.004~7.276; OR=2.801, 95%CI: 1.204~6.517). All differences were statistically significant (all P<0.05). Conclusions While undergraduate students from 2019~2021 at a medical university in Shaanxi Province show good scientific literacy overall, their grasp of research methods is notably weaker. Gender, parental education, postgraduate intentions, and research participation are key factors influencing their research literacy. Therefore, it is imperative to enhance research methodology training within undergraduate preventive medicine education. By fostering active student engagement in research and employing individualized approaches tailored to student differences, their scientific research literacy could be improved.

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The application of Teach-back teaching method in the document writing training for resident anesthesiologists

Huang Qi, Yao Yuanyuan, Wang Yi, Yu Jing, Yang Jinting, Yan Min

2025, 45 (7): 492-495. DOI: 10.3760/cma.j.cn115259-20240621-00635

Abstract ( 12 )

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Objective To explore the application and effect analysis of Teach-back teaching method in the training of anesthesiology. Methods In September 2023, a total of 40 new residents in the anesthesia professional base of the Second Affiliated Hospital of Zhejiang University School of Medicine for standardized residency training enrolled in the study, and were divided into the experimental group and the control group according to the random number table method. The experimental group adopted the Teach-back teaching method, whereas those in the control group were taught by traditional teaching methods. Immediately after training and 3 weeks after training, the content quality of anesthesia documents of the two groups was evaluated, and the satisfaction of the trainees and the supervising doctors was investigated. Paired t test, independent sample t test and Chi-square test were used to analyze the relevant data. Results Evaluation immediately after training: the scores of anesthesia record writing and the satisfaction scores of the experimental group were higher than those of the control group [(95.4±5.5) vs. (91.6±5.7); (64.5±1.4) vs. (62.3±3.9), all P< 0.05]. Evaluation after 3 weeks training, the anesthesia record writing scores of the control group were higher than those immediately after the training [(97.2±2.3) vs. (91.6±5.7), P=0.001]. There was no significant difference between the scores of anesthesia medical records written by the experimental group and those immediately after training[(96.2±2.6) vs. (95.4±5.5), P=0.487]. However, there were no statistical significance in the scores of writing anesthesia medical records and the satisfaction scores of supervising doctors between the two groups [(96.2±2.6) vs. (97.2±2.3); (34.6±2.9) vs. (35.6±3.0), all P>0.05]. Conclusions Teach-back teaching method can effectively improve the quality of anesthesia documents and the satisfaction score of trainees in the department of anesthesiology and help them who are new to clinical anesthesia to better understand the anesthesia records and improve the training effect.

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Exploring collaborative governance pathways for artificial intelligence empowered medical education

Zhang Ruyi, Zhou Yun′ao, Peng Yingchun

2025, 45 (7): 496-501. DOI: 10.3760/cma.j.cn115259-20240730-00800

Abstract ( 11 )

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The transformative potential of artificial intelligence (AI) in medical education, characterized by its robust capabilities in data mining, image processing, and machine learning, is widely recognized. However, several challenges have been identified, including limited interpretability, questionable content accuracy, data security risks, cognitive biases among educators and students, and the absence of regulatory mechanisms. To address these concerns and ensure the sustainable development of AI-empowered medical education, a comprehensive study was conducted employing literature analysis and theoretical research.Based on stakeholder theory and collaborative governance theory, it systematically analyzes the core challenges of AI in medical education and explores the collaborative governance pathways among stakeholders such as engineers, medical experts/medical educators, students, and educational institutions. Effective governance was found to necessitate multi-stakeholder engagement across all implementation phases. During production, data governance must be strengthened to enhance AI interpretability and accuracy. For quality assurance, standardized evaluation systems should be established. Prior to deployment, strict reviews and rights protection measures are essential. In application, improving AI literacy among educators and students is critical. Ongoing regulation necessitates dynamic risk monitoring, while accountability mechanisms must clarify responsibility boundaries. Through the integration of technological innovation, institutional refinement, and stakeholder capacity-building, the convergence of medical education and modern technology can be achieved.

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Design and practice of in-hospital train-the-trainer program based on experiential learning for simulation faculty

Wang Jiayu, Shi Ting, Zhang Yin

2025, 45 (7): 502-507. DOI: 10.3760/cma.j.cn115259-20240622-00642

Abstract ( 4 )

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In order to explore a promotable and effective train-the-trainer program conducted by core simulation faculty within the hospital, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine has organized and implemented an in-hospital train-the-trainer program for simulation faculty based on experiential learning since 2022. This study introduces the design and implementation of the train-the-trainer program and investigates its effectiveness. All 26 trainees have participated in teaching practice, four teaching teams formed, and 23(88.5%) of the 26 trainees have served as debriefers once or more. The results of the questionnaire showed that out of 26 trainees, 26(100.0%) trainees believed the training could improve their knowledge structure for scenario-based simulation, 25(96.2%) trainees believed that the training can stimulate them to actively explore relevant knowledge in scenario-based simulation, 25(96.2%) trainees recognized the training method at each stage, 26(100.0%) trainees believed that the training will be helpful for their future teaching practice. Focus group interviews were conducted with trainees, and the results showed that the design and implementation of such programs need to follow the learning cycle, and transforming teaching thinking patterns is the fundamental factor for novice simulation faculty to master the teaching method of scenario-based simulation. It can be seen that train-the-trainer program that conforms to the experiential learning theory helps novice teachers master the teaching method of scenario-based simulation, and achieving self-reflection and transformation of their own teaching thinking patterns. This study can inform medical institutions in China to play the role of core simulation faculty and carry out effective train-the-trainer program for simulation faculty.

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Construction and application of an intelligent information management platform for a medical simulation center

Ding Min, Liu Shengjun, Sun Xiaoliang, Ma Ruolin, Gu Haojie, Shan Qiyuan, Kang Baoli, Xu Zengguang, Xu Wei, Chen Chi

2025, 45 (7): 508-513. DOI: 10.3760/cma.j.cn115259-20240812-00842

Abstract ( 5 )

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Objective To explore the application of the intelligent information management platform for a medical simulation center in the quality control of teaching and training. Methods A questionnaire survey and performance analysis was employed. Shanghai East Hospital, Tongji University initiated the design and development of the management platform in 2020 to implement comprehensive management. A total of 192 residents and 273 instructors from the Medical Simulation Teaching and Research Office from July 2020 to July 2023 were enrolled in the study. A self-designed questionnaire was used to assess their usage of the management platform, and the pass rates of the residents in the Medical Practitioner Examination and residency training final examinations, as well as their annual assessment scores, were compared. Data were analyzed with ANOVA and chi-square tests. Results Both residents and instructors reported high satisfaction with the management of facilities, teaching equipment, simulation models, courses, and scheduling. For example, satisfaction with facility management was 100.0%(192/192) among residents and 99.6%(272/273) among instructors (P=0.401). The third-year annual assessment scores of the 2020 cohort of residents (post-implementation) were higher than those in the first year (pre-implementation): (90.29±6.38) vs. (87.88±7.81), P=0.018. The pass rate of the Medical Practitioner Examination and Comprehensive Graduation Examination among residents post-implementation of the management platform (2021) was higher than that pre-implementation of the management platform (2020): 97.3%(72/74) vs. 88.9%(56/63), P=0.048; 100.0%(78/78) vs. 94.6%(70/74), P=0.037. Conclusions The management platform was well-received by both residents and instructors, contributed to improving annual assessment scores and Medical Practitioner Examination and Comprehensive Graduation Examination pass rates, and effectively enhanced the efficiency and quality of residency training management.

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Translational research on the teaching and learning of comprehensive basic medical laboratory based on the results of multi-source scientific research

Cong Jianchao, Xu Shengnan, Wu Junzhu, Li Ke, Wang Hui, Liu Jun, Liu Yanhong

2025, 45 (7): 514-518. DOI: 10.3760/cma.j.cn115259-20240318-00271

Abstract ( 6 )

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Basic medical comprehensive experiments play a significant role in medical education, serving as a crucial component in cultivating students′ practical abilities, scientific research thinking, and innovative capabilities. However, current basic medical experimental teaching still faces issues such as monotonous content, insufficient comprehensiveness, and disconnection from clinical practice. To address these problems, the School of Basic Medical Sciences at Wuhan University initiated a reform in 2023. Based on preliminary research, the school integrated multi-source achievements, including undergraduate scientific innovation projects, faculty research projects, and relevant literature in the field of basic medical sciences. Experimental achievements from disciplines such as morphology, functional science, and molecular biology were transformed into teaching content for basic medical comprehensive experiments. By combining these with existing experimental teaching materials, a research achievement-driven teaching model for basic medical comprehensive experiments was established. This model promotes the comprehensive integration of basic medical experimental courses, ensures that the curriculum keeps pace with cutting-edge advancements in the field, and fosters students′ interest in scientific research and research-oriented thinking.

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Research on the construction of entrustable professional activities index for general practitioner residents

Wang Qi, Liu Yanli, Sun Chen, Ma Li

2025, 45 (7): 519-524. DOI: 10.3760/cma.j.cn115259-20240506-00454

Abstract ( 5 )

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Objective To construct the index of entrustable professional activities (EPAs) for general practitioner residents. Methods From October 2021 to March 2022, based on literature review, semi-structured interviews, the EPAs indicators were preliminary formulated. The Delphi method was adopted, after two rounds of letter consultation among 15 experts, the EPAs were screened and optimized. Results The established index of EPAs for general practitioner resident includes 19 items of indicators and 73 items of content descriptions. The expert authority coefficient was 0.93, the positive coefficient of two rounds of consulting experts were 100.0% and 93.0% respectively, and the variable coefficient of experts′ opinions were 0.49 and 0.41 respectively. Conclusions The index of EPAs for general practitioner resident is comprehensive and practical, and the construction process is scientific and reliable. It can provide simple and feasible standards and evaluation methods for the training of general practitioner resident.

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Exploring the application of parallel chart writing training in standardized residency training for obstetrics and gynecology residents

Qian Jing, Zhang Wei, Shang Hongkai, Xu Song

2025, 45 (7): 525-529. DOI: 10.3760/cma.j.cn115259-20240729-00795

Abstract ( 8 )

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Objective To explore the effect of training in parallel chart writing for obstetrics and gynecology trainees in the standardized residency training (hereinafter referred to as residency training). Methods A convenience sampling method was employed to enroll 23 residents in the Department of Obstetrics and Gynecology at the Affiliated Hangzhou First People′s Hospital, School of Medicine, Westlake University from June to December 2023 to participate in a parallel chart writing training course, which included six academic hours of theoretical training and six academic hours of practical training. The empathy levels of the residents were assessed before and after training using the Chinese version of the Jefferson Empathy Scale - Student Version. The teaching effect was evaluated through a satisfaction questionnaire after training. The paired sample t-test was used to analyze relevant data. Results The empathy scores of the residents before and after the parallel chart writing training were 102.8±12.1 and 119.4±10.6, respectively. The difference was statistically significant (P<0.001). The questionnaire survey results showed that 91.3%(21/23) of the residents rated the course as “good” or “very good”, 87.0%(20/23) believed that the course helped improve their empathy and doctor - patient communication skills, and 91.3%(21/23) thought that the course promoted reflection in their clinical practice. However, 56.5%(13/23) of the residents felt that the course significantly increased their learning burden. Conclusions Training in parallel chart writing can enhance the empathy of residents in obstetrics and gynecology, improve their doctor-patient communication skills and clinical practice reflection. However, it also increase their learning burden. It is suggested that integrating parallel chart writing training into daily clinical work can avoid additional time costs.

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The application of assessment feedback models grounded in milestone-based competency assessment in the neurology fellowship training

Ye Shan, Liu Xiangyi, Zhao Chen, Ma Xinran, Song Hongsong, Zhang Yingshuang, Liu Xiaolu, Zhao Haiyan, Liu Xiaoxuan, Sun Aping, Fu Yu, Li Aiwei, Li Yan, Han Jiangli, Shen Ning, Fan Dongsheng

2025, 45 (7): 530-536. DOI: 10.3760/cma.j.cn115259-20240121-00076

Abstract ( 5 )

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Objective To analyze the effectiveness of the assessment feedback model grounded in milestone-based competency assessment standards in the neurology fellowship training. Methods In 2023, all 14 neurology specialists (including 6 doctoral students and 8 physicians from the hospital, with varying numbers of specialists from different training years) who underwent standardized training at the Department of Neurology, Peking University Third Hospital, from 2019 to 2022 were enrolled. The milestone-based competency assessment standards established earlier were applied, and a continuous follow-up was conducted using the assessment-feedback-training cycle model to evaluate the effectiveness of the specialist training. Chi-square test and Kruskal-Wallis tests were used to analyze the relevant data. Results As the seniority of the specialists increased, their competency scores increased annually in all competency dimensions. However, the proportion of meeting standards fluctuated and did not match the increased consistency with the scores [for example, in the clinical teaching dimension, the scores of the specialists from the first year of specialized training to the third year were 2.0 (2.5), 4.0(1.2), and 6.0(1.2), respectively, and the differences in ratings between adjacent years were statistically significant (all P<0.05), while the proportion of meeting standards were 4/10, 3/10, and 3/6, respectively]. Dynamic follow-up radar charts for individuals indicated that the trajectories of competency improvement among different specialists were significantly different. Conclusions The assessment feedback model grounded in milestone-based competency assessment standards can be used for the assessment and monitoring of the competency development among neurology specialists, and targeted training can be conducted based on these results. During the training process, it is not only necessary to focus on the development of the overall level but also to pay attention to the individual differences among specialists, tailoring teaching according to their individual aptitude. Assessing specialists based on the level they need to achieve in different years of seniority can increase the sensitivity of the assessment and promote the enhancement of competency.

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Investigation on the service status and training needs of primary care physicians in three regions of Tibet

Liu Yalin, Yu Dehua, Zhan Huajian, Li Jinhong, Bai Tiao, Qiu Wei, Fu Qiangqiang, Ma Le, Pu Zhen, Wang Leijun, Yang Sen

2025, 45 (7): 537-541. DOI: 10.3760/cma.j.cn115259-20240408-00363

Abstract ( 4 )

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Objective To investigate the service status and training needs of primary care physicians in some areas of Tibet, with the aim of improving the level of local primary medical services. Methods By stratified random sampling, the primary care physicians in Shigatse, Nyingchi and Ngari districts of Tibet were surveyed from March to June 2023. Descriptive statistical analysis was employed to evaluate the demographic characteristics, service implementation and training needs of primary care physicians. Results In terms of service status, hypertension, acute infection and joint pain were the most common diseases. In terms of basic medical services,blood pressure and respiratory rate measurement,wound dressing change and home visits were the main tasks; public health services mainly included health education, hypertension management, and vaccination. The analysis of training needs showed that primary care physicians had a strong demand for training in practical skills, emerging technologies, and first-aid knowledge, and preferred offline training modes, sush as real-operation demonstrations, and face-to-face teaching. In addition, in terms of pre-hospital first-aid and infectious disease knowledge training, the top three first-aid training demands were cardiopulmonary resuscitation,trauma management and acute altitude sickness treatment. In terms of infectious disease training, the primary areas of need included the prevention and control of tuberculosis, hepatitis, and echinococcosis. Conclusions Primary care physicians in Tibet have urgent training needs in practical skills, medical knowledge and first-aid skills, and face-to-face training and on-site operation demonstration have the most favorable effects. In particular, it is necessary to strengthen training in cardiopulmonary resuscitation, trauma management and prevention and treatment of infectious diseases, thereby strengthening the theoretical and practical abilities of primary care physicians and improving the level of primary healthcare.

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Survey on the current situation and demand of training for first witnesses of children among medical staff in Hunan Province

Liu Pingping, Huang Jiaotian, Zhang Xinping, Fan Jianghua, Zhang Yu, Xiao Zhenghui, Lu Xiulan

2025, 45 (7): 542-546. DOI: 10.3760/cma.j.cn115259-20240515-00488

Abstract ( 6 )

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Objective To understand the level of medical personnel′s mastery of children′s on-site rescue capabilities in Hunan Province and to investigate the demand for conducting first witness training for children, in order to inform future training in this area. Methods From April 10 to 24, 2024, a self-made survey questionnaire was used to survey medical personnel in Hunan Province through WeChat questionnaires. The questionnaire data was collected and subjected to descriptive and chi square test. Results Among the 10 746 medical staff who participated in the survey, 5 862(54.6%) had received training as the first witness for children, and 9 313(86.7%) of medical staff believed that they had the ability to identify the critical condition of children. Among the self-evaluation of first witness abilities, the mastery rates of child cardiopulmonary resuscitation [9 674(90.0%)] and child Heimlich maneuver [10 089(93.9%)] were very high, while the mastery rates of child AED [7 900(73.5%)] and trauma four techniques [7 857(73.1%)] were relatively low. Among the investigators, 10 226(95.2%) believed there is a difference between adult and child first witnesses, and 10 524(97.9%) believed it is necessary to conduct training for child first witnesses. In addition, 9 988(92.9%) had a need to participate in the training of children′s first witnesses, and 7 927(73.8%) had a need to participate in the training of children′s first witness mentors. The higher the level of hospital institutions, the higher the professional titles of personnel, the longer the working years, the professionals engaged in pediatrics, and the investigators with the first witness training certificate, the higher the necessity of affirming the first witness of children, self-evaluation of the first witness ability, and training needs. The differences are statistically significant (all P<0.05). Conclusions Medical personnel in Hunan Province should strengthen the training of children′s first witnesses, especially in grassroots medical institutions, junior medical personnel, and child AED use and the four techniques of child trauma in children′s first witness abilities, which need to be further trained.

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Exploration of teaching laparoscopic cholecystectomy based on SPOC inprimary hospitals in extremely high-altitude areas

Xie Yi, Wang Guangyong, Jia Yangduoji, La Buxiaga, Li Zhe, Yu Feifei

2025, 45 (7): 547-552. DOI: 10.3760/cma.j.cn115259-20240615-00607

Abstract ( 4 )

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As the cornerstone of laparoscopic biliary surgery, laparoscopic cholecystectomy has been widely implemented in plain areas, yet a systematic training system for young surgeons remains underdeveloped. Since 2022, the Naval Medical Center has provided continuous ″group″ medical assistance to the People′s Hospital of Nyima County in Nagqu, Tibet Autonomous Region. During surgical support for this high-altitude primary hospital, the medical team adapted laparoscopic surgical training experience in plain areas to local conditions, developing an innovative surgical team training approach where Small Private Online Courses played a pivotal role. This approach established a customized, centralized online learning platform that effectively addressed the needs of remote, resource-limited high-altitude learners, providing flexible self-paced learning while ensuring high-quality, standardized content delivery. The curriculum progressively transitioned from open cholecystectomy training to minimally invasive small-incision cholecystectomy, ultimately advancing to laparoscopic cholecystectomy, with Small Private Online Courses consistently integrated throughout. This approach demonstrated remarkable efficacy in surgical education at extremely high-altitude primary hospitals.

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Comparison of the current status of the training models for child and adolescent psychiatrists between China and foreign countries and its implications

Yan Jiayi, Wang Hui, He Fan, Cheng Wenhong, Gao Xueping, Huang Yi, Ke Xiaoyan, Lu Jianping, Tang Ni, Cao Qingjiu, Si Tianmei

2025, 45 (7): 553-557. DOI: 10.3760/cma.j.cn115259-20240709-00721

Abstract ( 5 )

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Enhancing specialist training in child and adolescent psychiatry is essential for improving pediatric mental health care system in China. However, the training system remains underdeveloped and lacks a unified national standard. This study compares admission criteria, training management, and curricula across China, the UK, the US, and Canada, identifying domestic child and adolescent psychiatry specialist training gaps in training content, evaluation, and selection mechanisms. Based on international experience, we recommend refining evaluation systems, optimizing training programs, providing necessary financial support to specialists and give them corresponding policy preferences to standardize and sustain child and adolescent psychiatry specialist training.

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