Chinese Journal of Medical Education

Current status and future development of simulation-based medical education

Zhang Yuanyuan, Liu Jing, Wen Zhang, Jiang Guanchao

2025, 45 (4): 241-246. DOI: 10.3760/cma.j.cn115259-20250211-00137

Abstract ( 94 )

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In the development process of medical education, the traditional teaching model has limitations in cultivating the practical abilities of medical students, and simulation-based medical education (SBME) has emerged as the times require. This article systematically expounds on the development status of SBME, covering its main forms, application status, educational effects, and future development directions. SBME has diverse forms, covering the entire medical education process and various disciplines. It plays a crucial role in clinical practice and assessment certification, and can effectively improve various skills, medical quality, and patient safety. However, there are still problems such as uneven distribution of resources and insufficient coverage of specialized skills training. In the future, SBME will develop in the directions of new technology application, teacher training and curriculum development, diversified integration of training methods, and the construction and optimization of the evaluation system, so as to deepen the integration with traditional practices, build a full-cycle training system with ″competence as the core″, and serve the ″Healthy China″ strategy.

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Investigation and analysis on current situation of medical simulation center in residency training institutions in China in 2024

Liu Jing, Liu Qilin, Han Yizhe, Zhang Yuanyuan, Jiang Guanchao

2025, 45 (4): 247-251. DOI: 10.3760/cma.j.cn115259-20250205-00114

Abstract ( 43 )

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Objective To understand the current situation of medical simulation center(referred as simulation center) in residency training institutions in China in 2024, so as to provide basis for formulating the standard medical simulation center and simulation training procedures. Methods In October 2024, organized by the Chinese Medical Association, a questionnaire survey was implemented at medical simulation centers at residency institutions located in general hospitals in China. The results were analyzed by descriptive statistics. Results A total of 318 qualified residency institutions participated in the survey. There were 99.7%(317/318) of the simulation centers have the function area more than 600 m². Among these centers, 42.8%(136/318) had their leaders working less than 24 hours per week for their centers. The proportion of the centers with 0-1 full-time management personnel was 23.9%(76/318). The proportion of centers with more than 50 faculty members was 60.7%(193/318). The proportion of centers with an annual training capacity of over 20 000 man-hours was 46.5%(148/318). The proportion of simulation centers that offer basic skills training courses, specialized skills training courses, and comprehensive skills training courses as compulsory courses was 86.5%(275/318), 43.7%(139/318), and 18.6%(59/318), respectively. Conclusions The medical simulation centers have received significant investment in hardware construction. The number of teaching staff and the depth of various courses have increased compared to before. However, continuous improvement is still needed in terms of staffing, faculty development, and investment in center leaders.

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A comprehensive review on scenario-based simulation in clinical practice-based education in China

Wang Jiayu, Lin Jian, Qian Yiwei, Shi Ting

2025, 45 (4): 252-256. DOI: 10.3760/cma.j.cn115259-20240907-00933

Abstract ( 56 )

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Clinical scenario-based simulation is a critical instructional method for cultivaing the clinical competence of healthcare practitioners. In order to enhance the understanding of clinical scenario-based simulation among medical educators and to achieve teaching effectiveness through the implementation of clinical scenario-based simulation, this article reviewed key literature on scenario-based simulation in healthcare education, delineated the essence and current application status of this method and revealed prevalent challenges within China's healthcare simulation centers, including a shortage of simulation operation specialists, limited teacher competence, and low learner awareness. To address these issues, the article proposes strengthening faculty development, increasing learner engagement, and advancing the standardization and institutionalization of scenario-based simulation curricula. These suggestions are intended to foster the advancement of scenario-based simulation in medical education and to elevate the caliber and effectiveness of clinical practice-based education in China.

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Key points and status analysis of the medical simulation center environment construction

Li Wei, Tian Jing

2025, 45 (4): 257-263. DOI: 10.3760/cma.j.cn115259-20250206-00115

Abstract ( 19 )

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Medical simulation center is a clinical competence training institution and a research and transformation institution integrating teaching, examination and research, and its environment construction is crucial to the development of the center's work. Compared with foreign countries, the construction of medical simulation centers in China is still in the initial stage, so it is of great significance to clarify the requirements of environment construction and learn from foreign construction experience for the construction of medical simulation centers in China. Based on the current status of the construction of representative medical simulation centers at home and abroad, this review analyzes the differences in the environmental construction of medical simulation centers at home and abroad and provides guidance for the construction and development of medical simulation centers in China by combining with the published guidelines for the construction of medical simulation centers.

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Current status, methods, and prospects of in situ simulation in medical education

Ge Jiongshan, Shi Di, Liu Jihai

2025, 45 (4): 264-271. DOI: 10.3760/cma.j.cn115259-20250131-00107

Abstract ( 27 )

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In situ simulation, a form of simulation training conducted within actual clinical settings, has gained considerable traction in medical education in recent years. While it bears similarities to traditional center-based simulation training, it also presents distinct differences. This article provides a comprehensive review of the current research landscape regarding in-situ simulation, both domestically and internationally, examining its value in enhancing non-technical skills, evaluating systems and processes, and identifying potential medical safety risks. Additionally, it highlights the existing gaps in the development of in-situ simulation between China and abroad. To support simulation educators in optimizing their teaching and assessment practices, this article systematically delineates the entire implementation process of in-situ simulation, from needs analysis to instructional execution. A comparative analysis of in-situ simulation and center-based simulation is presented, along with recommendations for its judicious implementation. Furthermore, the article addresses the challenges encountered by in-situ simulation in various domains, including curriculum development, resource integration, the application of emerging technologies, the establishment of evaluation systems, medical ethics, and patient safety, while proposing viable solutions. It is the authors' aspiration that in-situ simulation will see broader application in medical education across China, thereby enhancing the training of healthcare professionals and significantly improving the quality of healthcare delivery.

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Analysis of the current situation of and strategies for surgical simulation teaching

Fu Lei, Tian Jing, Xiao Yao

2025, 45 (4): 272-278. DOI: 10.3760/cma.j.cn115259-20241119-01193

Abstract ( 28 )

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Medical simulation teaching plays an indispensable role in surgical operative skills training. However, its development still faces numerous challenges. This paper reviews the current state of simulation training in basic specialized surgical skills and analyses the primary challenges in surgical simulation teaching in China. These include the lack of professional surgical simulation teaching faculties, the absence of standardized and structured training curriculums, and the shortage of high-fidelity training models and equipment. Furthermore, this paper proposes several feasible strategies for improvement, such as enhancing faculty development, designing innovative and practical simulation training courses, developing training equipment tailored to educational needs, and promoting the seamless integration of surgical simulation teaching with clinical practice. The ultimate goal is to further enhance the quality and effectiveness of surgical simulation teaching in China.

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Application of high-fidelity lung model in simulation training of thoracoscopic skills

Liu Ganwei, Jiang Guanchao

2025, 45 (4): 279-282. DOI: 10.3760/cma.j.cn115259-20241105-01148

Abstract ( 32 )

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Objective To evaluate the educational value of a high-fidelity lung model in training foundational skills for thoracoscopic lung resection. Methods A self-controlled study design was employed. Fifteen novice surgeons without prior thoracoscopic surgical experience, who participated in a thoracoscopic skills training program at Peking University People's Hospital from May 2022 to September 2023, were enrolled. The surgeons underwent a two-week structured curriculum covering five core thoracoscopic procedures: thoracic exploration, vascular dissection and division, lymphadenectomy, lung wedge resection, and specimen retrieval using an endoscopic retrieval bag. Skill assessments were conducted before and after training for each procedure. Paired-sample t-tests were used to compare skill scores before and after training. Results Following training, participants demonstrated significant improvements in all five core thoracoscopic skills compared to baseline [(1.0 ± 0) vs. (2.9 ± 0.8), (1.0 ± 0) vs. (3.2 ± 0.9), (1.0 ± 0) vs. (2.9 ± 0.4), (1.4 ± 0.5) vs. (3.7 ± 0.9), and (1.0 ± 0) vs. (2.6 ± 0.6), all P<0.001]. Conclusions Simulation-based training utilizing a high-fidelity lung model significantly enhances thoracoscopic surgical skills among novice surgeons. This approach provides an innovative solution for safe and efficient thoracoscopic skills training.

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Analyses on undergraduate medical students' overseas visits and exchanges in China and its influencing factors

Hou Jianlin, Yu Chen, Cheng Huaqin, Fang Chenchen, Wang Weimin

2025, 45 (4): 283-287. DOI: 10.3760/cma.j.cn115259-20240705-00702

Abstract ( 33 )

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Objectives To analyze the situation and influencing factors of overseas visits and exchanges among undergraduate clinical medicine students using data collected from China Medical Student Survey. Methods Descriptive analysis, chi-square test, Logit model were used. Results A total of 219 396 medical undergraduate students from 123 medical colleges across the country participated in the survey, of which only 2.0% had overseas visiting and exchange experiences. In terms of the likelihood of participating in overseas visits and exchanges, urban students were higher than rural students (β=0.405, P<0.001), students from families with an annual income of over 150 000 to 300 000 Yuan and over 300 000 Yuan exceeded those with an annual income of less than 10 000 Yuan (β=0.375, P<0.001;β=0.845, P<0.001),students whose universities located in western China were lower than those located in eastern China (β=-0.159, P<0.001), students who studying at universities affiliated to the central government were higher than those studying at universities affiliated to provincial sectors(β=0.305,P=0.039),students who studying at world-class university and discipline construction programs were higher than those who studying at independent colleges (β=0.493,P=0.009;β=0.546,P<0.001). Conclusions The proportion of medical undergraduate students who participated in overseas visits and exchanges is too low and should be steadily increased. The likelihood of medical students from disadvantaged groups participating in overseas visits and exchanges is relatively low, and it is necessary to improve the financial aid system to address this issue. In addition, there are significant differences in undergraduate medical students' overseas visits and exchanges among different types of universities, which should be taken seriously.

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Research on teaching reform of medical information literacy course based on digital knowledge graph

Fang Yaqing, Zhu Lina, Hu Huimei, Wu Haihua

2025, 45 (4): 288-292. DOI: 10.3760/cma.j.cn115259-20240122-00080

Abstract ( 39 )

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The digital knowledge graph is an artificial intelligence-powered integrated knowledge network and a manifestation of competency-oriented pedagogical innovation. It organically connects various knowledge points to form a comprehensive, multidimensional knowledge framework, thereby enhancing teaching effectiveness and efficiency. To further improve students' ability to utilize information in solving practical problems, the School of Public Health at Hangzhou Medical College implemented digital knowledge graphs in its Medical Information Retrieval and Utilization course starting in 2023. This educational reform initiative includes three key components: developing digital knowledge graphs, establishing digital teaching models, and implementing digital assessment methods. Concurrently, the knowledge graph undergoes continuous optimization through students' learning activities, guiding learners to synthesize fragmented knowledge into systematic structures while providing efficient, targeted knowledge pathways. Post-course evaluations revealed a 97.6% satisfaction rate (284/291) among 291 class of 2022 students. The digital knowledge graph demonstrated significant efficacy in stimulating independent thinking and interdisciplinary integration, effectively advancing comprehensive information literacy cultivation.

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Application of concept maps in the curriculum delivery of clinical medicine summary

Ding Yan, Liu Lingli, Chen Yuefu, Cao Xiangyu, Jin Ling, Huang Minjiang

2025, 45 (4): 293-297. DOI: 10.3760/cma.j.cn115259-20231230-00642

Abstract ( 32 )

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Objective To explore the effectiveness of concept maps in the curriculum delivery of clinical medicine summary. Methods A controlled experimental design was employed. Between March and June 2023,four classes of 120 students from the 2021 cohort of the four-year medical imaging technology program at Hunan University of Medicine were enrolled as research subject, two classes of 60 students were enrolled as the experimental group, while another two classes of 60 students served as the control group by drawing lots. In the clinical medicine summary course, students in the experimental group were taught using concept maps, whereas the control group received traditional teaching methods. After the course, the concept map drawing abilities of the experimental group were evaluated, and the evaluations on the application of concept maps of the experimental group were collected, and comparisons were made between the two groups in terms of regular grades and final exam scores and teaching satisfaction. Statistical analyses were performed using independent sample t-tests and χ² tests. Results The concept map scores of the experimental group before the introduction of concept maps were (78.62±4.77) points. After the concept map-based instruction, their scores on subsequent concept maps were (89.70±5.03), (90.97±4.29), and (91.27±3.68), which were all higher than the initial score (all P<0.05). The regular grade of the experimental group were (36.07±1.94), which were higher than those of the control group (33.93±1.96). The final exam scores of the experimental group were (50.35±3.78), which were higher than those of the control group (46.63±4.27). The experimental group rated their learning initiative as (3.68±1.30), higher than the control group's score of (3.03±1.77). The experimental group also rated their teaching satisfaction as (3.77±1.21), higher than the control group's rating of (2.98±1.94), with all statistical differences (all P<0.05). Conclusions The use of concept maps in the clinical medicine summary course helps students master concept map drawing, promotes active learning, increases student satisfaction with teaching, and enhances overall teaching effectiveness.

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Evaluation and reflection on the concurrent training mode of masters degree graduates in clinical medicine at certain university

Chen Huiling, Bai Yongping, Xie Mingxuan, Zhang Feng, Wang Aimin, Yi Pengfei, Zhu Xiaoyan

2025, 45 (4): 298-303. DOI: 10.3760/cma.j.cn115259-20240821-00873

Abstract ( 34 )

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Objective To comprehend the present status of clinical training and research capabilities among clinical medical master's degree students operating within a concurrent training model, it is imperative to undertake a thorough analysis of the prevailing challenges and to formulate recommendations and insights that will facilitate the enhancement of the training programme. Methods A questionnaire survey was conducted in March 2022 on second- and third-year postgraduate students of a clinical masters degree in medicine at certain hospital affiliated with a university in Hunan, China. The survey encompassed the clinical working hours of postgraduate students, the work attitude and teaching methods of lead instructors, the evaluation and feedback on the residency system, and the impact of concurrent training on career development in specialised masters degrees and on the enhancement of scientific research ability. Descriptive statistics were used to analyze relevant data. Results A total of 418 valid questionnaires were collected. Furthermore, 75.6%(316/418) of the students reported working in excess of 50 hours per week, with the most prevalent reasons for this being clinical work [90.4%(378/418)], medical record paperwork [88.3%(369/418)] and research tasks [82.8%(346/418)]. In addition, 54.8%(229/418) of the students expressed the opinion that the teaching faculty provided effective guidance and supervision during clinical rotations. A mere 33.3%(139/418) of the students reported that the teaching faculty frequently conducted teaching visits based on evidence-based medical data. A significant majority of 86.1%(360/418) of the students agreed that 360-degree evaluations were used to provide regular feedback to residents, but only 38.5%(161/418) of the students agreed with the use of 360-degree assessments, and only 38.5%(161/418) of the students agreed with the use of 360-degree assessments to provide regular feedback on resident evaluations. In the present study, the authors sought to ascertain the extent to which feedback on performance during clinical rotations was received by masters of specialties. The results indicated that 161 out of 418 masters of specialties had received such feedback, while 71.3%(298/418) of these believed that concurrent training would be beneficial for a future career in clinical medicine. Furthermore, only 47.1%(197/418) of masters of specialties believed that this training model would be beneficial for improving research skills. Conclusions Whilst the concurrent training model is endorsed by the majority of experts in the field, there is a necessity for the systematic optimisation of the clinical training system with regard to academic pressure, faculty level and evaluation mechanism for residency training. Furthermore, there is an urgent need to strengthen scientific research ability, which is a necessary skill for high-quality talents in clinical application.

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Correlation analysis of imposter phenomenon and anxiety among residents in standardized training

Wang Jieyan, Jiang Hongyan, Zhu Zedong, Wumier Wusimanjiang, Huang Lanxiang, Liu Chao, Peng Juan

2025, 45 (4): 304-309. DOI: 10.3760/cma.j.cn115259-20240401-00339

Abstract ( 31 )

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Objective To understand the relationship between imposter phenomenon and anxiety among residents in standardized training. Methods The study used a questionnaire survey method. From November 2023 to May 2024, 381 residents participating in the residency training program at three training bases in Hunan and Guangdong provinces were surveyed using the Impostor Phenomenon Scale and Anxiety Scale. The data were processed by t test, ANOVA and Spearman correlation analysis. Multivariate linear regression analysis explores the impact of the self-doubt dimension, passive disguise dimension, and external attribution dimension of self-ability negativity on anxiety. Results A total of 338 resident trainees participated in this study. The scores of imposter phenomenon and anxiety were 75.0 (31.0); (47.9±10.0), respectively. The score of imposter phenomenon was positively correlated with the score of anxiety (ρ=0.44, P<0.001). Anxiety scores were positively correlated with self-doubt dimension, passive camouflage dimension and external attribution dimension (ρ=0.37, ρ=0.34, ρ=0.44, all P<0.001). Multiple linear regression analysis showed that passive camouflage dimension (β=-0.56,P=0.034) and external attribution dimension (β=1.02,P＜0.001) had an impact on anxiety. Conclusions There is a positive correlation between imposter phenomenon and anxiety of residential training students. It is suggested that residential training managers should pay attention to process management, optimize the whole-process tutor management mechanism and communication feedback mechanism, so as to reduce the imposter phenomenon of residential training students and reduce their anxiety level.

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Construction of pharmacy professional development indicator system based on industrial demand orientation

Xu Yangming, Song Jianfei, Yao Wenbing

2025, 45 (4): 310-314. DOI: 10.3760/cma.j.cn115259-20240312-00239

Abstract ( 26 )

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Objective To construct a professional development index system for pharmacy-related majors based on industrial demand, in order to adapt to industrial demand in professional restructuring and talent cultivation. Methods The indexes were screened by literature analysis method and Delphi method, and the weights of the indexes were determined by using the percentage weight method. Results The effective recovery rate of the questionnaires in the 2 rounds of correspondence inquiry was ≥80%, the authority coefficient was 0.74, and the Kendall's W values were 0.110 and 0.150 (both P<0.001), finally forming a pharmacy professional development indicator system containing 4 primary indicators, 16 secondary indicators and 49 tertiary indicators. Conclusions The professional development index system of pharmacy-related majors is scientific and can inform the dynamic adjustment of professional settings and talent cultivation.

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A comparison of national nurse licensure examination in five countries and implications for China

Pan Shucheng, Shang Shaomei, Zhou Weijiao, Liu Hanyu, Feng Shicong, Jiang Zhehan

2025, 45 (4): 315-320. DOI: 10.3760/cma.j.cn115259-20240219-00151

Abstract ( 30 )

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National Nursing Licensure Examination (NNLE) is recognized as an entry-level examination for nursing occupation, securing the entry quality of the nursing workforce. This paper reviews current situation of NNLE systems in five countries, China, the United States, the United Kingdom, Japan, and South Korea, including their similarities and differences in the examination administration, legal frameworks, entry qualifications, specific examination formats (including types of questions, quantity, and duration), examination content, and pass rates. Furthermore, it proposes implications for future development of China's NNLE: firstly, to enhance legislative support for nurses; secondly, to foster the professional development of examination management organizations; thirdly, to optimize the educational requirements for nursing; fourthly, to employ sophisticated and simulation-based measurement techniques to facilitate multi-dimensional and dynamic examination assessments; and fifthly, to advocate for the establishment of a scientific and standardized examination system.

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