Chinese Journal of Medical Education

Analysis of the types of participation in shared governance by medical school teachers

Qin Xiaxia, Tian Yinan, Wu Yuhua, Shen Yuee, Ma Xing, Li Xiaomeng, Sundas Bint e Ehsan, Zhang Shue, Yang Libin

2026, 46 (7): 481-485. DOI: 10.3760/cma.j.cn115259-20251210-01603

Abstract ( 44 )

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Objective To explore typical models of teachers' participation in shared governance in medical schools and inform medical schools to effectively stimulate teachers' enthusiasm for participation therein. Methods From June to August 2025, semi-structured interviews were conducted with 18 teachers from a medical school in Heilongjiang Province. The interview data were analyzed using a three-level coding process based on grounded theory, with the aid of NVivo 20 qualitative analysis software. Results Four primary types of participation by medical school teachers in shared governance have been identified: passive-responsive participation, elected-appointed participation, emotionally-driven participation, and empowered-collaborative participation. Conclusions The participation of medical school teachers in shared governance takes various forms. It is recommended that, for teachers who adopt a passive, reactive approach, their role perception should be reshaped, and mechanisms for empowerment should be established; for those appointed through election, their rights and responsibilities should be clarified, and incentives and guidance should be strengthened; for those driven by emotional factors, mechanisms linking emotional feedback with recognition of their value should be established; and for those who are empowered and collaborative, a collaborative environment characterized by resource support and open trust should be fostered. This will serve to reinforce the central role of teachers in shared governance and promote the establishment of a new framework for shared governance characterized by diverse collaboration and efficient operation.

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Research on application effect of LSPPDM model in teaching competency training of clinical teachers

Yu Shanshan, Wang Shiyu, Wang You, Wang Shuang

2026, 46 (7): 486-489. DOI: 10.3760/cma.j.cn115259-20250907-01082

Abstract ( 34 )

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Objective To explore the application effect of the LSPPDM (learn, see, practice, prove, do, maintain) model in the training of clinical teachers' teaching competence. Methods A total of 155 clinical teachers at Zhongnan Hospital of Wuhan University from January 2024 to January 2025 were selected and trained using the LSPPDM model. Before and after the training, the teaching competency self-assessment scale was used to investigate, and the teachers conducted self-assessments of their teaching competency in five dimensions: knowledge instruction, skill teaching, clinical teaching, education research, and student supervision ability. Paired-sample t-test was used for data analysis. Results A total of 42 clinical teachers participated in this study. After training, the scores of clinical teachers in the five dimensions of theoretical teaching ability, skill teaching ability, clinical teaching ability, teaching research ability, and student supervision ability were significantly higher than those before training[(82.15±15.16) vs. (58.13±25.12), (80.12±20.16) vs. (57.33±23.15), (75.78±18.95) vs. (54.52±21.02), (70.17±18.26) vs. (56.12±24.89), (72.19±18.90) vs. (56.85±24.67)], with all differences being statistically significant (all P<0.001). Conclusions Faculty training based on the LSPPDM model can effectively improve the teaching competency of clinical teachers.

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A study on the differential driving effects of medical students' subjective well-being and situational well-being in ideological and political education on their satisfaction with ideological and political education

Bai Yang, Jing Zhengwei, Li Qingliang, Liu Jing, He Xiaolu

2026, 46 (7): 490-495. DOI: 10.3760/cma.j.cn115259-20250903-01060

Abstract ( 28 )

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Objective To investigate the differentiated driving effects of medical students' subjective well-being and situational well-being in ideological and political education on their satisfaction with ideological and political education. Methods From March to June 2025, a convenience sampling method was used to select 226 full-time students from a medical university as participants. The PERMA-Profiler scale was used to measure their subjective well-being. A self-developed ″Situational Well-being in Ideological and Political Education Questionnaire″ was used to measure their situational well-being in ideological and political education. A single item (0-10) was used to assess their satisfaction with ideological and political education. Confirmatory factor analysis was employed to examine the structural validity of the Situational Well-being Questionnaire. Wilcoxon signed-rank tests were used to compare the scores with theoretical median values. Multiple linear regression analysis was conducted to examine the effects of the two types of well-being on satisfaction. Results For the situational well-being questionnaire, Cronbach's α coefficients for all dimensions were ≥0.90, composite reliability (CR) values were ≥0.90, and average variance extracted (AVE) values were ≥0.74. The model fit was acceptable (χ²/df=2.34, CFI=0.97, RMSEA=0.08). The median scores for the dimensions of subjective well-being among medical students ranged from 7.67 to 8.33. The median scores for the dimensions of situational well-being in ideological and political education ranged from 4.00 to 4.33. All scores were significantly higher than the respective theoretical median values (5 and 3, all P<0.001). No statistically significant differences were found in either type of well-being by gender or educational level (all P>0.05). Multiple linear regression analysis showed that both situational well-being in ideological and political education (β=0.41, P<0.001) and subjective well-being (β=0.23, P=0.002) positively influenced medical students' satisfaction with ideological and political education, with the former having a significantly stronger effect than the latter. Conclusions Medical students' subjective well-being and their situational well-being in ideological and political education are both relatively high. Both types of well-being positively influence satisfaction with ideological and political education, but the driving effect of situational well-being in ideological and political education is considerably stronger than that of subjective well-being. This suggests that enhancing students' immediate positive psychological experiences within the context of ideological and political education is a key practical focus for improving satisfaction with ideological and political education.

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Research progress on simulation-based assessment of entrustable professional activities (EPAs)

Jiang Hui, Chen Xiaoling, Zeng Duo, Wang Xiandi, He Manqing, Wang Kunjie, Pu Dan

2026, 46 (7): 496-501. DOI: 10.3760/cma.j.cn115259-20250424-00464

Abstract ( 28 )

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Competency-based medical education (CBME) is one of the core features of the third generation of medical education reform. The entrustable professional activity (EPA) framework is a valuable assessment method. EPAs aim to assess medical students' clinical competency for specific roles by observing their behaviors. Ideally, it should be conducted in the workplace, but numerous challenges exist, prompting some scholars to propose implementing EPAs based on simulation. Currently, simulation-based EPA assessment is a relatively novel research field, with studies focusing on acceptability, reliability, and validity, and influencing factors. Simulation-based EPA assessment has high acceptability and provides learners with a psychologically safe environment; in terms of validity, it can effectively differentiate learners across different competency levels; regarding reliability, inter-rater consistency is higher in simulated settings than in clinical settings, although the correlation between simulation-based and workplace-based assessment results remains controversial; entrustment decisions are influenced by factors such as raters' understanding of ″entrustment″, scenario authenticity, and the diversity of clinical tasks. Although current evidence remains limited, simulation offers clear advantages for EPA assessment: it provides a controlled, low-risk environment that can effectively address issues such as lack of standardization and patient safety concerns in workplace-based assessment. Nonetheless, challenges persist, including high costs, technical constraints, and the need for robust standard-setting. Simulation-based EPA assessment primarily serves to standardize competence verification and enable low-stakes training and evaluation, offering learners a safe space for practice. In contrast, workplace-based EPA assessment remains the ultimate basis for entrustment decisions. The two modalities are complementary. Future research should further explore simulation-based EPA assessment to enhance the scientific rigor and operational feasibility of competence evaluation, thereby advancing the development of competency-based medical education.

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Ethical governance and teaching optimization of generative artificial intelligence in the ″Anatomy and Physiology″ course

Li Xinhui, Wang Niqing, Jin Jingjing

2026, 46 (7): 502-508. DOI: 10.3760/cma.j.cn115259-20250731-00865

Abstract ( 23 )

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This study systematically explores the application of generative AI technology in the basic biomedical course ″Anatomy and Physiology″, as well as the risk control mechanism. The goal is to develop a teaching system that is ethically sensitive, logically structured, and effective. First, the study developed a ethical risk identification and evaluation framework based on the GB/T 27921-2023 standard, which clarified the main ethical risk sources in the classroom, such as data leakage, information bias, ability degradation, and teacher weakening. This framework also innovatively created an ethical risk matrix, providing a quantitative tool for AI governance in medical education. Second, based on the three-dimensional integration concept of ″knowledge dimension-ability dimension-ethics dimension″, the study proposed a teaching strategy system that is structured, visible, capable of evaluation, and ethical. This system significantly improves students' three-dimensional recognition accuracy and enhances their critical awareness of technology. Finally, the study developed a virtual and physical fusion electric physiology experiment platform that combines intelligent bodies, knowledge graphs, and AI-assisted case libraries. This platform saves experimental resources and optimizes clinical thinking training. The results of this study demonstrate strong practical value, real-world relevance, and potential for widespread application, providing replicable exemplary support for the digital transformation and intelligent development of medical courses.

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The application and prospects of embodied artificial intelligence in medical education

Cheng Wenjie, Lyu Feng, Min Su

2026, 46 (7): 509-514. DOI: 10.3760/cma.j.cn115259-20250427-00476

Abstract ( 96 )

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Embodied artificial intelligence (EAI), as a crucial branch of artificial intelligence, is reshaping the technological logic and humanistic core of medical education. Currently, the application of EAI in medical education has demonstrated significant potential, offering innovative pathways to overcome the limitations of traditional practical resources, shorten skill transfer cycles, and construct new immersive learning paradigms. However, its development remains in the primary stage, facing three critical challenges: insufficient technological maturity and accessibility, a significant deficiency in the humanistic dimension, and relatively lagging evaluation mechanisms. Looking ahead, the deepened development of EAI in medical education urgently requires: constructing a ″technology-humanism″ dual-track driven framework, establishing a dynamic multi-dimensional evaluation system, and implementing long-term tracking mechanisms. By overcoming these challenges, EAI holds the potential to evolve from its current role as an auxiliary tool into a core force driving paradigm shifts in medical education. This will contribute to cultivating a new generation of healthcare professionals with exceptional clinical competence for the Healthy China Initiative.

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Construction of a knowledge graph for the textbook History of Chinese Medicine based on large language models and Neo4j

Liu Siyan, Zhou Yaqian, Chu Jiaqi, Jiang Yutong, Sun Lingzhi

2026, 46 (7): 515-520. DOI: 10.3760/cma.j.cn115259-20251102-01390

Abstract ( 21 )

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History of Chinese medicine is a compulsory course in traditional Chinese medicine (TCM) universities and colleges. Its complex knowledge system poses certain challenges to teaching. Existing research on TCM knowledge graphs has not covered the systematic knowledge involved in this course. This study aims to leverage modern information technology to achieve knowledge structuring and visualization of the History of Chinese Medicine textbook, thereby supporting TCM education. By employing a large language model combined with manual verification, a bottom-up approach was adopted to construct the knowledge graph, which was then stored in the Neo4j graph database. A knowledge graph containing 2 879 entities and 2 487 semantic relationships was successfully built. The model achieved a triplet extraction precision of 65.42%, recall of 77.82%, and an F1 score of 71.09%, demonstrating high consistency between manual verification and model extraction results. This knowledge graph provides teaching visualization and associative retrieval support, possesses diverse educational potential, and offers a reference example and framework for intelligent innovation in medical humanistic education.

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Development and implementation of a PTA Scale-based assessment framework for functional medicine laboratory reports

Feng Xuemei, Ni Wenwen, Liu Yan, Rong Weifang

2026, 46 (7): 521-526. DOI: 10.3760/cma.j.cn115259-20250802-00875

Abstract ( 19 )

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Objective To construct and implement an evaluation system for medical functional experiment reports based on the primary trait analysis (PTA) scale, and to inform the scientific evaluation of experimental teaching. Methods A preliminary evaluation framework was developed through literature analysis. Indicators were screened via two rounds of Delphi expert consultation involving 23 experts, and indicator weights were determined using the Analytic Hierarchy Process. Experimental reports from 27 students enrolled in the 2022 cohort of the five-year clinical medicine program at Shanghai Jiao Tong University School of Medicine were used as the evaluation sample. The reports were assessed using both the PTA scale method (PTA group) and the traditional method (control group), and the application effects were compared. Results The effective questionnaire recovery rate for both rounds of expert consultation was 100.0%. The expert authority coefficients were 0.86 and 0.92, and Kendall's coefficients of concordance were 0.265 and 0.334 (all P<0.001), respectively. The final evaluation system comprised 3 first-level indicators (Basic Experimental Ability, Scientific Thinking, Academic Norms), 8 second-level indicators, and 21 third-level indicators. Empirical research showed that theinterquartile range (IQR) of scores in the PTA group was greater than that in the control group, enabling better differentiation of students' ability levels and identification of their weaknesses. Conclusions The PTA scale-based evaluation system for medical functional experiment reports is both scientific and practical. It aligns with the teaching orientation of formative evaluation and provides a paradigm for the precision evaluation reform of medical experimental teaching.

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Construction and practical application of a risk management model for clinical professional master's education

Lyu Ying, Wu Yajun, Han Bing, Cui Wenjing, Lyu Tingyu, Zhou Jing

2026, 46 (7): 527-533. DOI: 10.3760/cma.j.cn115259-20250722-00816

Abstract ( 33 )

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Objective To construct a risk management model for the training of professional master's degree candidates in clinical medicine and empirically evaluate the application effect of this model in optimizing the training management process and improving training quality. Methods This study was conducted from September 2023 to October 2024 at the Second Affiliated Hospital of Harbin Medical University. A cluster sampling method was used to select 406 clinical professional master's students from the 2022 cohort trained under the traditional model (traditional management group) and 368 clinical professional master's students from the 2023 cohort trained under the education failure mode and effects analysis (EFMEA) management model (EFMEA quality control group) as the study subjects.Based on failure mode and effects analysis and the characteristics of professional master's training, an EFMEA management model was constructed following a cycle of ″risk anticipation, quantitative assessment, precise intervention, dynamic adjustment, and outcome validation.″Wilcoxon rank-sum test and Chi-square test were used to analyze the relevant data. Results The EFMEA management model identified 23 potential failure modes in the traditional management model and pinpointed 8 high-risk items. Compared with the traditional management group, the total risk priority number (RPN) value of the EFMEA quality control group was significantly reduced from 566.78 to 167.24, with a decrease of 70.5%. The pass rate for the skills exam of the Medical Licensing Examination increased from 97.3% (395/406) to 100.0% (368/368), and the pass rate for the comprehensive medical exam increased from 86.2% (350/406) to 98.4% (362/368), with statistically significant differences (all P<0.001). The professional master's candidates in the EFMEA quality control group reported a relatively high proportion of positive evaluations of the EFMEA management model, and 60.9% (224/368) of them believed that it was helpful to improve the clinical diagnosis and treatment ability. Conclusions The EFMEA management model can systematically identify and effectively reduce key risks in the training process of professional master's candidates, optimize the training management process, and help improve the training quality of clinical professional master's candidates.

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Design and implementation of an intelligent agent-assisted cystoscopy training curriculum for surgical residents

Wang Chenghe, Gu Qian, Chen Lu, Li Yinglin, He Hongchao, Huang fang, Xu Danfeng

2026, 46 (7): 534-538. DOI: 10.3760/cma.j.cn115259-20251025-01348

Abstract ( 24 )

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Cystoscopy is a commonly used diagnostic and therapeutic technique in urology. Training surgical residents to independently perform cystoscopy can effectively alleviate human resource shortages and improve the efficiency of medical services. We designed and implemented a cystoscopy training course employing a blended teaching approach of ″intelligent agent pre-tutoring + virtual simulation training + clinical case training″. Forty novice surgical resident physicians rotating in the Department of Urology at Shanghai Jiao Tong University School of Medicine, Ruijin Clinical Medical College from January to July 2025 enrolled in the study. After completing theoretical learning and interactive training guided by the agent, they proceeded to simulator operation training and assessment. Upon passing the simulator-based test, they received clinical practice training and evaluation. The teaching outcomes showed that all residents passed the simulator assessment with an operation time of (276.25±24.23) seconds, a simulator score of (94.65±3.04) points, and the number of injury and bleeding was 0(0) times. In real cases operation assessment, all residents were able to independently complete the examination under the guidance of a supervisor, with an operation time of (559.50±57.15) seconds and an examiner's score of (89.71±3.18) points. The teaching satisfaction survey indicated that the satisfaction rates for participants' interest in the teaching method, improvement in knowledge comprehension, and enhancement of operational confidence were 97.5%(39/40), 100.0%(40/40), and 95.0%(38/40), respectively. The design and implementation of this course can improve surgical residents' theoretical understanding and operational skills in cystoscopy, providing a new model for clinical skills training.

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Developing a course syllabus for geriatric medicine training for resident instructors

Deng Linzi, Liu Shangxin, Li Hongyu, Shen Ji, Xi Huan

2026, 46 (7): 539-543. DOI: 10.3760/cma.j.cn115259-20251027-01361

Abstract ( 19 )

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Objective This study aims to develop a training course syllabus in geriatric medicine for resident instructors to enhance their relevant knowledge. Methods From January 2024 to July 2025, 44 experts from various resident programs in 15 provinces were invited to participate in the study. Through literature review and expert interviews, an initial outline for a training course syllabus of geriatric medicine for resident instructors was developed. Three rounds of expert consultation using the Delphi method were conducted. The experts evaluated the importance of the course syllabus content and provided specific suggestions for modification. Quality control and statistical analysis were conducted using the expert positive coefficient, authority coefficient, group coordination coefficient, average score of questionnaire items, frequency of full scores, and coefficient of variation. Results The response rates of expert consultation were 100.0%, 94.4%, and 100.0%, indicating high levels of expert participation. The authority coefficients of the experts were 0.84, 0.88, and 0.97, suggesting strong reliability. The intra-group consistency coefficients were 0.98, 0.96, and 0.95, reflecting a high degree of consensus among the experts. The training course syllabus consists of three modules: basic knowledge of geriatric medicine, clinical characteristics, and teaching features. The mean importance scores of these modules ranged from 4.91 to 4.97, with a coefficient of variation ranging from 0.01 to 0.02. The three modules included 8 training components and 19 teaching items. The average importance values for the training components ranged from 4.69 to 5.00, with a coefficient of variation from 0.01 to 0.06. The average importance values of the teaching items ranged from 4.71 to 5.00, with a coefficient of variation from 0 to 0.05. Conclusions This study designed a training course syllabus for resident instructors to develop the concept of geriatric medicine. The course syllabus covers core knowledge and skills in geriatric medicine that demonstrate scientific validity and reliability, effectively meeting the need to promote geriatric medical concepts among resident instructors.

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Effectiveness evaluation of the simulated vaginal operative delivery training program based on Kirkpatrick's model and diffusion of innovations theory

Sun Xiao, Zhang Mengying, Sun Yu

2026, 46 (7): 544-548. DOI: 10.3760/cma.j.cn115259-20250812-00942

Abstract ( 20 )

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Objective To conduct a multidimensional effectiveness evaluation of the simulated vaginal operative delivery training program conducted in the Department of Obstetrics and Gynecology, Peking University First Hospital, based on Kirkpatrick's four-level evaluation model and the Diffusion of Innovations Theory, and to provide evidence for optimizing obstetric operative training. Methods A questionnaire survey method was employed. A total of 96 participants from 5 training sessions conducted from May 2022 to May 2024 were included in the study. Data were collected through questionnaires and one-year post-training follow-ups to evaluate training effectiveness from the three dimensions (reaction, learning, and behavior) of Kirkpatrick's four-level evaluation model. The Diffusion of Innovations Theory was introduced to describe the collective impact triggered by the training. Data were described using mean scores, numbers, and percentages. Results Reaction level: The average satisfaction scores ranged from 19.3 to 19.7 (out of 20), all indicating ″very satisfied″. Learning level: The intended clinical application rates for the four courses, from highest to lowest, were forceps delivery simulation [89/96 (92.7%)], vacuum extraction simulation [80/96 (83.3%)], forceps technique [74/96 (77.1%)], and vacuum extraction technique [59/96 (61.5%)]. Behavior level: One year post-training, 41 participants were followed up; 29 (70.7%) had applied the learned techniques. Forceps delivery was most applied [23 (79.3%)], followed by vacuum extraction [6 (20.7%)]. Of these, 28 (96.5%) performed their first procedure within 0-3 months post-training. Furthermore, 32 (78.0%) reported significant improvement in procedural standardization. Regarding collective impact, the training program demonstrated positive diffusion effects on clinical practices across 10 participating hospitals, showing potential for regional practice improvement. Conclusions The training program achieved high satisfaction and significant knowledge/skill improvement, with high and timely behavioral transfer, especially for forceps delivery. Using the Diffusion of Innovations Theory as a complementary framework effectively describes the diffusion of trained behaviors from individual mastery to group practice, laying a foundation for future evaluation of long-term organizational benefits.

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Research on examiner allocation for the practical skills examination of traditional Chinese medicine category physician qualification examination

Cao Wei, Hu Bin, Jiang Zhehan, Nie Jiashuai, Jin Huimin

2026, 46 (7): 549-553. DOI: 10.3760/cma.j.cn115259-20250530-00606

Abstract ( 18 )

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Objective This paper investigates the examiner allocation for the practical skills examination of medical qualification in traditional Chinese medicine to inform the rational allocation of examiners. Methods In March 2024, examination data were collected from 36 practical skills examination bases for traditional Chinese medicine practitioner qualification examinations in 18 provinces during 2021 to 2023. The student-examiner-time ratio (SETR) for each examination station across all relevant specialties was calculated, which is defined as the ratio of the number of examiners per group to the number of candidates they invigilate within one hour. The effects of candidate scale and examination year on the SETR were analyzed, and the numerical range of the percentile interval of the SETR was determined. Expert consultation was conducted, and the interval most frequently selected by experts was adopted as the standard range of the SETR for the corresponding examination stations. Results A total of 59 sets of data were collected for both the licensed traditional Chinese medicine category and the assistant licensed traditional Chinese medicine category, while 54 sets of data were obtained for the licensed integrated traditional Chinese and western medicine category. No statistically significant difference in the SETR of each examination station was observed among different candidate scales (all P>0.05). However, due to policy adjustments, statistically significant differences of SETR were found in the first and second examination stations of the licensed traditional Chinese medicine category, as well as in the first examination station of the assistant licensed traditional Chinese medicine category across different years (all P<0.05).The standard ranges of the SETR for each examination station were determined as follows: as licensed traditional Chinese medicine, 11.42-22.29 for the first station, 2.83-3.83 for the second station, and 2.94-4.44 for the third station; as assistant licensed traditional Chinese medicine, 14.41-33.33 for the first station, 2.81-4.25 for the second station, and 2.90-4.79 for the third station; as integrated traditional Chinese and western medicine, 10.28-23.64 for the first station, 2.58-3.80 for the second station, and 2.60-4.45 for the third station. Conclusions The standard range of the SETR reflects the characteristics of different specialties and examination stations, which can be used to guide practical skills examination bases in allocating examiners and is applicable to scenarios with different candidate scales. However, the standard range is affected by examination policy adjustments, and thus needs to be dynamically adjusted in a timely manner according to relevant policy changes.

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Training model for teaching competence among residents in the United Kingdom and its implications

Su Ya, Liu Fengtao, Shi Yulu, Huang Lyu, Dong Qiang, Chen Yan, Cheng Xin

2026, 46 (7): 554-557. DOI: 10.3760/cma.j.cn115259-20250713-00781

Abstract ( 31 )

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Clinical teaching competence is recognized as a core competency for residents in China. A systematic training framework has not yet been established. In the United Kingdom, teaching competence has been incorporated into the core competency framework for residents. In this study, the training model for teaching competence among UK residents was examined through literature review, policy analysis, and on-site investigation. In the UK, a structured developmental pathway was identified, characterized by a structured training approach, required teaching practice, continuous feedback and reflection, supervisor guidance, and standardized assessment. Based on these experiences, it is suggested that a systematic and competency-based teaching training and evaluation framework for residents could be developed in China, with strengthened training in teaching competence, closer integration of clinical teaching into routine practice, and the development of comprehensive mechanisms for feedback, reflection, and assessment. Through these measures, the teaching competence of residents is expected to be effectively developed.

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