Chinese Journal of Medical Education

Design, effectiveness, and optimization of an intercollegiate support program in medical education

Deng Wei, Du Yu, Wang Yiduan, Zhang Yifan, Chen Qingwei, Ke Dazhi, Li Guiqiong, Wu Zhiqin, Ye Liwen, Luo Aoran, He Fapei, Jian Xun

2026, 46 (8): 561-566. DOI: 10.3760/cma.j.cn115259-20251008-01249

Abstract ( 9 )

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Objective To evaluate the intervention effect of the Chongqing Medical University-Liangshan Health School (LHS) paired assistance program on medical education in underdeveloped regions. Methods A sequential explanatory mixed-methods design was adopted. In the quantitative phase, a questionnaire survey was conducted among 650 project stakeholders (students and teachers from LHS, supporting teachers from Chongqing Medical University, and medical administrators in Liangshan Prefecture) to collect quantitative data such as satisfaction, teaching confidence, and curriculum relevance. In the qualitative phase, semi-structured in-depth interviews were carried out with 32 representative participants to interpret and elaborate on the quantitative results. Paired t-test and correlation analysis were used for the analysis of quantitative data. Results The program′s core interventions were effectively implemented. Quantitative evaluation revealed high overall satisfaction [(4.62±0.58) on a 5-point scale]. LHS teachers showed a significant increase in teaching confidence after training [(4.67±0.57) vs. (3.25±0.42), P<0.01]. A total of 324(92.5%) students perceived the curriculum as aligned with primary care needs. Clinical internship satisfaction (4.63±0.51) was strongly correlated with self-assessed clinical competence (4.55±0.60), r=0.72, P<0.01. While traditional face-to-face support was superior in interactivity and learning depth, digital resources scored higher in accessibility, though their impact was limited by a ″digital divide″. Qualitative analysis uncovered key mechanisms: the transition from ″knowledge transfer″ to ″capacity empowerment″, the crucial role of contextualized clinical practice, the ″double-edged sword″ effect of digital resources, and the systemic shift from external ″blood transfusion″ to internal ″blood production″. Conclusions The systematically designed inter-institutional support program substantially improved faculty capacity, curriculum relevance, and clinical training quality in Liangshan, and has demonstrated initial features of the transition from a ″blood transfusion″ support model to a ″blood production″ model. Future iterations should prioritize a blended support model integrating online preparatory learning with hands-on, in-person training, while actively addressing the digital divide to achieve more precise and sustainable capacity building.

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Exploration of artificial intelligence empowering the ″scientific research training″ course for medical students

Gao Furong, Xu Jie, Jin Caixia, Li Jiao, Wang Juan, Liu Yuhong, Li Siguang, Zhang Ling, Cao Jinfeng, Zhang Xiaoqing, Lyu Lixia

2026, 46 (8): 567-572. DOI: 10.3760/cma.j.cn115259-20250903-01055

Abstract ( 23 )

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The rapid advancement of artificial intelligence (AI) is driving the transformation of medical education toward a data-driven model, creating new opportunities for scientific research training among medical students. Currently, scientific research training in medical education generally faces challenges such as high entry barriers and difficulties for students to independently complete the entire process from topic selection to research design. To address these issues, this study developed an integrated smart teaching model of ″objectives-activities-evaluation″ driven by a ″task engine″ based on the principles of ″learner-centered″ and ″constructive alignment″. Through sequenced tasks, AI tools were deeply integrated into core teaching components, including virtual topic selection, research design, and outcome evaluation. Teaching practices were conducted with 135 students enrolled in the clinical medicine (″5+3″ integration) program, class of 2023, at Tongji University School of Medicine, and the teaching effectiveness was evaluated via questionnaires. The results showed that the course significantly enhanced medical students′ AI literacy: in terms of basic AI capabilities, the proportion of medical students with no prior AI knowledge decreased from 10.4% (14/135) before the course to 0.8% (1/131) after the course; in conceptual understanding, the percentages of medical students familiar with machine learning, deep learning, and natural language processing increased from 75.6% (102/135), 68.9% (93/135), and 43.0% (58/135) to 91.6% (120/131), 88.5% (116/131) and 70.2% (92/131), respectively; in tool application, the proportion of medical students using AI tools multiple times daily rose from 3.7% (5/135) to 55.0% (72/131), and those believing AI significantly improves research efficiency increased from 20.0% (27/135) to 68.7% (90/131); in critical thinking, the percentage of meidical students actively verifying the reliability of AI-generated information increased from 36.3% (49/135) to 55.0% (72/131), and those questioning and validating AI conclusions rose from 33.3% (45/135) to 48.1% (63/131). The study demonstrates that systematically incorporating AI via a task engine can effectively enhance medical students′ conceptual understanding and tool application of AI, significantly improving the efficiency of research training. However, its effect on cultivating critical thinking skills was relatively limited, suggesting that AI-empowered teaching should guard against technology dependence during implementation and promote the simultaneous development of higher-order thinking through structured designs such as mandatory verification and reflective exercises.

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Construction and practice of clinical skills course for international students in China by integrating digital intelligent resources

Li Wei, Ma Siyuan, Hui Jialiang, Yan Maidong, Liang Xiyue, Zhou You, Wan Liya, Yuan Yiming, Sun Xiexu, Hu Zhenfu

2026, 46 (8): 573-578. DOI: 10.3760/cma.j.cn115259-20250815-00960

Abstract ( 6 )

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In order to systematically enhance the clinical competency of international medical students in China, Southern Medical University has independently developed and delivered specialized clinical skills courses for these students since 2018, guided by outcome-based education (OBE) and competency-based education (CBE) theories. The overall effectiveness of curriculum implementation is comprehensively assessed through students′ academic performance, questionnaire feedback, and relevant curriculum construction outcomes. By 2024, a total of six cohorts have completed the courses, with a cumulative enrollment of 482 international students. The proportion of students with excellent academic performance increased from 42.4% (39/92) in the first cohort to 62.8% (27/43) in the sixth cohort, whereas the failure rate decreased from 5.4% (5/92) in the initial cohort to zero in the sixth. Post-unit questionnaire surveys administered annually since 2021 indicated high overall satisfaction among international students: 86.7% (560/646) of respondents expressed satisfaction with the curriculum design, 87.9% (568/646) acknowledged the rationality of teaching methodologies, 87.9% (568/646) gave positive ratings to teacher-student interaction, and 87.0% (562/646) were willing to recommend the courses as high-quality undergraduate programs. Additionally, international student teams supported by the curriculum have won awards for two consecutive years in the national learning in China-clinical thinking and skills competition for international students. Supported by this curriculum construction initiative, six innovation and entrepreneurship projects at the national, provincial and university levels have been successfully approved, and three teacher-student collaborative research outcomes have achieved industrial transformation. Furthermore, the courses have been accredited as Guangdong provincial first-class offline undergraduate courses and Guangdong provincial university demonstrative ideological and political courses. In conclusion, the established clinical skills courses can effectively motivate international students′ learning initiative, facilitate their proficient grasp of core clinical skills, and have gained wide recognition from learners and educational administrative authorities.

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Analysis of nursing teachers′ attitudes towards organ system-integrated curriculum, influencing factors and coping strategies

Zhu Xuemei, Xu Chunjiao, Yue Yang, Du Xin, Cui Yan, Geng Yang

2026, 46 (8): 579-587. DOI: 10.3760/cma.j.cn115259-20250705-00748

Abstract ( 7 )

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Objective To investigate the attitudes, influencing factors and coping strategies of nursing teachers toward the organ system-integrated curriculum. Methods This study employed a convenience sampling method to select 170 full-time and part-time nursing teachers from 3 universities in Heilongjiang Province that had carried out the organ system-integrated curriculum reform as the research objects, with data collected from June to November 2020. This study adopted a self-designed e-questionnaire on nursing teachers′ attitudes toward the organ system-integrated curriculum. The questionnaire consists of 33 items across three dimensions: value identification (19 items), affective tendency (7 items), and participation intention (7 items). Each item is rated on a 5-point Likert scale, with responses ranging from ″never″ to ″always″ and assigned scores from 1 to 5, respectively. The score ranges for the three dimensions are 19～95 for value identification, 7～35 for affective tendency, and 7～35 for participation intention. The total score of the questionnaire ranges from 33 to 165, with higher scores indicating a more positive attitude of nursing teachers toward curriculum integration. The Cronbach′s alpha of the questionnaire is 0.922, and the KMO measure is 0.918. Electronic questionnaires were used, with a total of 175 questionnaires sent out and 170 valid ones recovered, representing an effective questionnaire recovery rate of 97.1%. SPSS 26.0 statistical software was used for independent-samples t-test,ANOVA, non-parametric test, linear regression analysis, one-way ANOVA and multiple linear regression analysis of the data. Results The 170 nursing teachers achieved a relatively high total score on attitudes toward curriculum integration (140.18±18.42), while the score on the participation intention dimension was relatively low (25.60±8.00). Nursing teachers from University H had the highest attitude score (143.83±15.73).After controlling for age and educational background, the results of multiple linear regression analysis showed that there were statistically significant differences in the scores of curriculum integration attitude and value identity dimension among nursing teachers from the three universities (all P<0.05). Teaching years and participation in integrated curriculum preparation were influencing factors of nursing teacher's curriculum integration attitude (all P<0.05). Conclusions Nursing teachers hold a positive attitude towards the value identification of curriculum integration, but their participation intention needs to be improved. Personalized intervention for nursing teachers in different career cycles, enhancing inter-school interaction and communication, and strengthening nursing teachers′ participation in curriculum integration preparation for curriculum integration are key links in promoting the reform of the organ-system integrated curriculum.

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Exploration of a systematic training model for the teaching competency of young medical faculty

Zheng Lanbin, Qiu Guannan, Zhou Shu′aijun, Cai Jingyi

2026, 46 (8): 588-593. DOI: 10.3760/cma.j.cn115259-20251223-01679

Abstract ( 17 )

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To address the common challenges faced by medical teachers, including the lack of systematic training in pedagogical skills, outdated teaching philosophies and methods, and time fragmentation caused by the combination of multiple responsibilities in clinical work, research, and teaching, Peking University Health Science Center initiated and has continually refined the Young Teacher Training Program using the Technological Pedagogical Content Knowledge (TPACK) model as its framework since 2014. The program features a structured curriculum comprising four modules—Professional Literacy, Teaching Philosophy and Methods, Educational Technology, and Observation & Practice—and employs a blended learning approach with a flexible schedule. It is systematically implemented through measures such as needs analysis, resource development, practice feedback, and community support. Over a decade of exploration, the program has reached over 2 000 young teachers from all on-campus colleges, affiliated hospitals, co-built hospitals, and teaching hospitals of Peking University Health Science Center. Practice indicates that the program has achieved extensive coverage, effectively accommodated the professional development pace of medical teachers through its flexible learning mechanism, strengthened their professional identity as medical educators, facilitated the renewal of teaching philosophies and improvement of teaching practices, and fostered the multidimensional development and value transmission of teachers, providing an empirical reference for the development of medical faculty.

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Exploration of a research competency development model for the undergraduate-to-graduate transition in medical education

Chen Yongjie, Lu Wenli, Zhu Yun, Wang Yuan, Zhang Yacong, Zhou Lihui, Zhang Tao

2026, 46 (8): 594-599. DOI: 10.3760/cma.j.cn115259-20250917-01146

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In the current undergraduate education stage of medical students, teaching primarily focuses on knowledge transmission, while systematic training in the complete process of scientific research is relatively lacking. To address the gap in research competency during the transition from undergraduate to postgraduate education, the School of Public Health at Tianjin Medical University launched the Joint Undergraduate Master Program (JUMP) in 2025. Through systematic curriculum design and tiered instruction, the program aims to equip medical undergraduates with fundamental research competencies and literacy, enable them to master the full set of research skills required to complete their undergraduate thesis projects, and further strengthen their research skills so as to facilitate a smooth transition to postgraduate study in terms of both research skill acquisition and academic role transformation. The program developed six core modules, namely academic career planning, medical research design and proposal writing, programming fundamentals and statistical software, data management and statistical analysis, literature retrieval and reading, and academic writing, and research frontiers. It adopted a blended teaching model of “face-to-face instruction + synchronous online delivery + recorded playback” and established a three-tier collaborative management system consisting of program leaders, module coordinators, and teaching assistants. In terms of curriculum development, 90 teaching hours were completed in the first phase, 197 instructional videos were produced, and an initial course resource repository was established. The course has also been formally incorporated into the elective course catalog for both undergraduate and postgraduate students, as well as the planning for a micro-credential program. In terms of student research training, 155 students participated in the first phase of the JUMP program. Overall course satisfaction reached 95.5% (148/155). A total of 82.6% (128/155) of the students reported that the program significantly reduced their unfamiliarity with research, and 87.3% (103/118) believed that it laid a solid foundation for research learning at the postgraduate level. The completion rate of the R language practice tasks was 100.0% (155/155), and the average class attendance was 89.0% (138/155). Practice has shown that the first phase of JUMP achieved positive outcomes in improving medical students′ learning engagement, research awareness, and initial research competency development, and to a certain extent enhanced undergraduates′ research capability, laying a solid foundation for a smooth undergraduate-to-postgraduate transition.

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The impact of supervisor guidance on the professional identity of professional master′s degree students in clinical medicine

Fang Chenchen, Cao Lianzhe, Guo Congbin, Hou Jianlin

2026, 46 (8): 600-603. DOI: 10.3760/cma.j.cn115259-20250910-01100

Abstract ( 7 )

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Objective This study aims to explore the impact of the frequency, method, and quality of supervisor guidance on the professional identity of professional master′s degree students in clinical medicine. Methods A questionnaire survey was conducted using the national survey of professional degree master′s graduates developed by the Graduate School of Education at Peking University. The survey was carried out among professional master′s degree students in clinical medicine from 55 institutions between May and July 2025. Descriptive statistics, chi-square tests, and ordinal logistic regression were used for data analysis. Results Among the 5 294 students who participated, 1 827 students (34.51%) received supervisory guidance several times per week; 1 937 students (36.59%) had co-supervisors or a supervisory team; and the mean score for perceived quality of supervisory guidance was (4.37±0.76). Students who received guidance several times per week (β=0.769, P<0.001) or once per week (β=0.377, P=0.002) reported higher professional identity than those who received guidance once every two to three months or less frequently. Students with co-supervisors or a supervisory team exhibited higher professional identity than those without (β=0.147, P=0.010). Perceived quality of supervisory guidance had a significant positive effect on professional identity (β=1.698, P<0.001). Conclusions The frequency, method, and quality of supervisory guidance influence the professional identity of clinical medical professional master′s degree students. Measures should be taken to standardize supervisory practices so as to enhance their professional identity.

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Bibliometric analysis of teaching dynamics and research hotspots in standardized residency training in emergency departments in China

Zhao Zhikang, Huang Li, Li Ke, Yang Yuxia, Wang Zhengbin, Wang Lei

2026, 46 (8): 604-609. DOI: 10.3760/cma.j.cn115259-20251015-01295

Abstract ( 8 )

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Objective To systematically analyze the teaching dynamics, research hotspots, and development trends in the field of standardized residency training in emergency departments in China using bibliometric and visualization techniques, so as to inform and guide future research in this field. Methods Literature on emergency residency training published from 2004 to 2024 was retrieved from the CNKI, Wanfang Data, and VIP databases. Data analysis was conducted using bibliometric and visualization tools such as NoteExpress, VOSviewer, and CiteSpace. Results A total of 387 valid articles were included, with an overall fluctuating upward trend in annual publications. The top authors in terms of publication volume included Wang Changyuan, Liu Jihai, Wang Yu, Guo Feng, and Yu Xuezhong, forming collaborative clusters centered around Wang Changyuan, Liu Jihai, Wang Yu, Li Qiang, and Tang Ziren, respectively. The top 5 institutions in terms of publication volume were Xuanwu Hospital of Capital Medical University, Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences, Shengjing Hospital of China Medical University, Beijing Chaoyang Hospital of Capital Medical University, and Peking University Third Hospital. The top 5 journals in terms of publication volume were China Continuing Medical Education, Chinese Journal of Graduate Medical Education, China Higher Medical Education, China Health Industry, and Chinese Journal of Emergency Medicine. The keywords with high frequency included job competency (20 times), clinical thinking (11 times), doctor-patient communication (11 times), clinical teaching (10 times), medical education (9 times), and mini-clinical evaluation exercise (9 times). The keywords with high emergence intensity after 2021 were represented by clinical teaching (2.03), medical education (1.76), competency (1.16), in-situ simulation (1.11), and teaching reform (0.78). Conclusions Research in the field of emergency residency training in China has centered on core topics such as job competency, clinical thinking, doctor-patient communication, Mini-CEX, and scenario simulation teaching. Future developments will focus more on aspects such as the deep integration of intelligent technology, innovative integration of teaching models, regional cooperation and the balanced allocation of educational resources, as well as humanistic education and long-term career development.

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Application of a structured interview tools-taking tool in the teaching practice of medical history collection for rheumatic diseases among residents

Cai Jianfei, Sun Qinlong, Bao Huafang, Wang Ling

2026, 46 (8): 610-614. DOI: 10.3760/cma.j.cn115259-20250424-00465

Abstract ( 8 )

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Objective To explore the value of structured history-taking tools in teaching history-taking for rheumatic diseases during residency training. Methods A controlled trial was conducted. A total of 96 residents rotating through the Department of Rheumatology and Immunology at Huadong Hospital Affiliated to Fudan University from August 2022 to December 2024 were enrolled and randomly assigned to either the experimental group (n=48) or the control group (n=48) by random number table method. The experimental group received a structured history-taking tool designed based on the diagnostic pathways of 14 domestic authoritative guidelines for rheumatic diseases, covering five dimensions: present illness, past medical history, personal history, marital and reproductive history, and family history, with small-class teaching (two residents per class) combined with real clinical cases. The control group received traditional history-taking instruction. The learning curves of history-taking completeness scores of residents in both groups were used as the primary outcome to evaluate teaching effectiveness. Linear mixed-effects models were employed to analyze the changes in the learning curves between the two groups. Results A total of 26 history-taking completeness assessments were completed by residents in both groups. Statistical analysis revealed a statistically significant interaction effect between teaching group and training cycle (χ²=643.778, df=4, P<0.001). The learning rate parameter k was higher in the experimental group than in the control group (0.187 vs. 0.120), and the experimental group reached the 80-point proficiency threshold approximately 8 training cycles earlier than the control group. Conclusions The structured history-taking tool helps to improve the learning curve of history-taking, providing a referable paradigm for clinical specialties that rely on classification-based diagnosis, such as rheumatic diseases.

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Construction and empirical research on a BOPPPS and large language models (LLMs) integrated teaching quality evaluation system

Ou Jian, Hu Yueqiang, Huang Hongna, Luo Jun, Wang Chunling, Liang Jiyao

2026, 46 (8): 615-621. DOI: 10.3760/cma.j.cn115259-20250815-00959

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Objective To construct a BOPPPS-Large Language Models (LLMs) integrated teaching quality evaluation system, verify its scientific rigor and applicability, and inform the establishment of similar digital teaching quality evaluation systems in the field of traditional Chinese medicine (TCM). Methods With the BOPPPS teaching model as the structural anchor and LLMs as the quantitative support, an evaluation system covering five core dimensions of core cognition, teaching process, teaching effect, non-cognitive ability, and long-term migration was constructed. A cluster randomized controlled trial was conducted from September 2023 to June 2024, and 120 undergraduate students of the 2021 cohort majoring in TCM who took the Traditional Chinese Internal Medicine course at Guangxi University of Chinese Medicine enrolled in the study. They were equally divided into the experimental group and the control group by random number table method, 60 students in the experimental group adopted the BOPPPS-LLMs integrated evaluation system, and 60 students in the control group continued with the traditional experience-based evaluation system. Independent samples t-test was used for inter-group comparison, Pearson correlation analysis was adopted to analyze the correlation between indicators, and Cronbach′s α coefficient was applied to test the internal consistency reliability of the system. Results The overall Cronbach′s α coefficient of the evaluation system was 0.86, indicating good internal consistency reliability. All indicators of the five core dimensions in the experimental group were significantly better than those in the control group (all P<0.001), for example, the confusion degree of case/text interpretation in the core cognition dimension was (18.5±3.8) points, which was significantly lower than (32.1±4.5) points in the control group; the average score of the final comprehensive assessment of the teaching effect dimension in the experimental group was (89.5±4.2) points, which was significantly higher than (77.2±5.1) points in the control group. In addition, there was a strong negative correlation between core cognitive confusion score and teaching effect (|r|≥0.78, P < 0.001), which confirmed the good construct validity of the system. Conclusions The BOPPPS-LLMs integrated teaching quality evaluation system is scientific, reliable and highly practical. It can accurately and comprehensively evaluate the teaching quality of TCM courses, and provide an empirical basis for the implementation of digital teaching quality evaluation systems in TCM higher education.

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A study on developing entrustable professional activities for renal pathologists

Jiang Lei, Liu Gang, Zheng Xizi, Yu Xiaojuan, Ren Yali, Wang Suxia, Qi Xin, Lyu Jicheng, Yang Li

2026, 46 (8): 622-627. DOI: 10.3760/cma.j.cn115259-20250806-00900

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Objective To establish specialty-specific Entrustable Professional Activities (EPAs) for renal pathologists. Methods From 2024 to 2025, preliminary EPA indicators were drafted through literature review. A modified Delphi method was employed, involving two rounds of expert consultation and one consultation meeting with 12 specialists to refine the EPA framework. Results Eleven EPA indicators with content descriptions were developed, alongside expected entrustment levels for different training stages. The expert authority coefficient was 0.89±0.09, with 100.0% response rates across consultations. Kendall′s W coefficients for consensus were 0.448 and 0.510, respectively. Conclusions The established EPA framework is comprehensive and applicable. The development process demonstrates methodological rigor and reliability, offering a simple and practical standardized tool for competency-based training and assessment in renal pathology.

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Application of generative large language models in improving the quality of basic medical science examination items

Liu Kan, Zheng Shuyuan, Wang Zhenyu, Liu Zidong, Yang Hai, Tian Tian

2026, 46 (8): 628-635. DOI: 10.3760/cma.j.cn115259-20250729-00842

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Objective To investigate the effectiveness of generative large language models (LLMs) in assisting the improvement of basic medical science examination item quality. Methods A total of 2 520 items from the ″Comprehensive Basic Medical Science Examination″ administered at Air Force Medical University from 2013 to 2024 were selected. Based on the correct response rate, discrimination index, and distractor selection rate, 64 problematic items were identified. Three sets of prompt engineering protocols were designed using the Tree of Thoughts framework, and 121 new items were generated through the ChatGPT-4o model. After manual refinement by an expert panel, 48 items were randomly selected and incorporated into an actual examination for field testing. The Wilcoxon signed-rank test was used to compare differences in correct response rates and discrimination indices, and Fisher′s exact test was used to compare differences in distractor selection rates. Results The mean correct response rate of the generated items increased from 0.218 1 to 0.444 2 (P<0.001), and the mean discrimination index increased from 0.082 1 to 0.146 9 (P=0.019). The abnormal distractor structure was significantly improved: the proportion of items with no distractor selection rate exceeding 30% increased from 27.1% (13/48) to 54.2% (26/48), and the proportion of items with no distractor selection rate below 5% decreased from 41.7% (20/48) to 33.3% (16/48), all differences were statistically significant (all P<0.05). A total of 72.7% (88/121) of the generated items required manual refinement, primarily involving option design deficiencies [44.3% (39/88)] and stem wording issues [30.7% (27/88)]. Conclusions LLMs demonstrate promising application potential in basic medical science item development. Standardized prompt engineering design combined with manual refinement processes can effectively improve item quality, although in-depth involvement of subject matter experts in quality control remains essential.

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Training model for cardiovascular surgeons at the University of Michigan and its implications

Fan Chengming, Yang Jinfu, Feng Hong

2026, 46 (8): 636-640. DOI: 10.3760/cma.j.cn115259-20251216-01634

Abstract ( 8 )

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Over the past two decades, the Integrated 6-year Cardiothoracic Surgical Residency Program (I-6) has emerged in the United States as a representative model characterized by early specialization, longitudinal training, and dedicated research development. By combining intensive clinical exposure with structured academic development, the program has maintained strong scholarly productivity and remained an established pathway for cardiovascular surgical residency training. The University of Michigan, one of the oldest research-intensive universities in the United States, is among the representative institutions implementing this model. Using document analysis and field observation, this article examines the cardiovascular surgery training model at the University of Michigan in terms of training objectives, pathway design, curriculum and rotations, teaching methods, assessment and quality assurance, clinical competence, and training outcomes.Its experience suggests that China should develop a context-appropriate training model for cardiovascular surgeons by aligning national healthcare needs, existing institutional frameworks, training pathways, and the constraints of training capacity.

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