Chinese Journal of Medical Education

Assessment content and validity of medical students′ selection tools in an international perspective

Zhong Yuxin, Wang Dan, Wu Hongbin

2025, 45 (6): 401-407. DOI: 10.3760/cma.j.cn115259-20240131-00112

Abstract ( 14 )

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A variety of selection tools are used in undergraduate medical education admissions processes internationally. Through literature review and information gathering, it is found that the most widely used types of selection tools are academic records, aptitude tests, references and personal statements, interviews and multiple mini-interviews, and situational judgement tests. From the perspective of evaluation content, these selection tools each have their own emphasis and can be summarized as tools for assessing cognitive and non-cognitive abilities. From the perspective of effectiveness, cognitive ability assessment tools are better predictors of students′ academic performance and clinical examination results after enrollment. On the other hand, non-cognitive ability assessment tools are more effective in predicting later professional behavior, attrition rates, and diversity within the physician community. Based on research conclusions and combined with local context, it is suggested that China should learn from diversified international selection and evaluation tools for medical students, strengthen research on medical student selection tools and prediction effects, and construct a more scientific and reasonable medical student selection and evaluation system.

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Study on learning outcomes and its influencing factors in the blended courses based on the community of inquiry framework

Sun Yumei, Zhou Qiang, Ji Xuan, Zhao Guodong

2025, 45 (6): 408-413. DOI: 10.3760/cma.j.cn115259-20240411-00384

Abstract ( 9 )

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Objective To analyze the influencing factors of learning outcomes in the blended courses, and its relationship with the learning outcomes through the Community of Inquiry Framework. Methods A convenient sampling method was employed to enroll 3 841 full-time nursing undergraduates from 11 domestic nursing colleges and universities utilizing blended teaching from October to November 2022. The survey collected students′ ratings on various elements of the community of inquiry framework, as well as their perceptions and evaluations of the blended teaching. Data were analyzed using paired t-tests, Pearson correlation analysis, and multiple stepwise regression analysis. Results Among 3 841 students, the total score of inquiry community was (4.14±0.5), and the dimension scores from high to low were teaching presence (4.28±0.63), cognitive presence (4.11±0.62) and social presence (3.97±0.65); the score of amount of homework., course difficulty, learning interest, learning gains, satisfaction with the curriculum and teachers were (2.93±0.75), (3.21±0.76), (3.40±0.78), (3.55±0.80), (4.24±0.71), (4.35±0.67), respectively. The Results of multiple stepwise regression analysis showed that the three presences of community of inquiry were the most important influencing factors of students′ learning outcomes, while students′ feelings of learning, different courses also have a certain impact on the learning outcomes (adjusted R²respectively were 0.159,0.183,0.569,0.621). Conclusions Blended teaching design is conducive to the formation of the community of inquiry, and students′ perception of the community of inquiry can effectively improve the learning outcomes. The community of inquiry frame provides theoretical support and practical guidance for high-quality blended teaching design, which is worthy of further promotion and exploration.

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Application of augmented reality-assisted functional magnetic resonance imaging fusion reconstruction in medical imaging teaching for clinical medicine interns

Yang Liu, Gao Xuan, Li Renpeng, Wang Jing

2025, 45 (6): 414-418. DOI: 10.3760/cma.j.cn115259-20231226-00625

Abstract ( 10 )

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Objective To explore the application and effectiveness of augmented reality (AR)-assisted functional magnetic resonance imaging (fMRI) fusion reconstruction in medical imaging teaching for clinical medicine interns. Methods Forty interns majoring in five-year clinical medicine of the 2019 grade from Tongji Medical College of Huazhong University of Science and Technology were enrolled from June to August 2023. Participants were randomly divided into an experimental group (n=20) and a control group (n=20). The experimental group received medical imaging instruction utilizing an AR-assisted fMRI fusion reconstruction teaching model, whereas the control group received traditional medical imaging education. A self-designed questionnaire was used to evaluate students′ learning interest and cognitive load in both groups, with an additional acceptance survey of the AR-assisted teaching model for the experimental group. Independent sample t-test, chi-square test, pearson correlation analysis and descriptive statistical analysis were used to analyze the data. Results In terms of the degree of interest, the scores ofthe improvement of knowledge interest, the improvement of learning initiative, and the associative thinkingin the experimental group were (4.10±0.79), (3.85±0.75), and (3.95±1.05),respectively. They were all higher than those in the control group (3.35±0.61), (3.35±0.67), and (3.20±0.62). In terms of cognitive load, the scores of the difficulty of mastering three-dimensional imagination ability, the course easiness, and the course impression in the experimental group were (4.70±0.47), (4.35±0.49), and (4.05±0.89), respectively. They were all higher than those in the control group (2.70±0.47), (3.20±0.62), and (3.15±0.59). All differences were statistically significant (all P<0.05). In the experimental group, there were more positive correlations between learning interest and cognitive load (r=0.58-0.81, all P<0.05). Eighty percent of the interns in the experimental group were willing to accept the new AR assistance teaching model. Conclusions Compared with traditional teaching methods, the AR-assisted fMRI fusion reconstruction teaching significantly enhances students′ interest, reduces cognitive load, and achieves high acceptance among students, indicating its considerable value for medical imaging education.

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Research on influencing factors of medical students′ digital resilience based on qualitative analysis

Gan Yutian, Yang Xiaojing, Tian Yinan, Qin Xiaxia, Zhang Yilin, Zhang Shue, Cao Depin, Yang Libin

2025, 45 (6): 419-422. DOI: 10.3760/cma.j.cn115259-20241118-01191

Abstract ( 9 )

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Objective To understand the influencing factors of digital resilience among medical students and provide basis for strengthening digital resilience education in medical schools. Methods From June to August 2024, semi-structured interviews were conducted with 15 medical students from a medical school in Northeast China, and the Colaizzi analysis method was applied to analyze the interview data. Results Three themes and ten sub-themes were extracted: mental faculties (critical thinking, etc.); social support system (peer support, etc.); elements of the network ecology (cybersecurity policies, etc.). Conclusions Digital resilience of medical students is influenced by multiple factors. Medical schools should optimize digital intelligence in medical education and cultivate positive mental faculties among medical students; teachers, parents, and society need to make a joint effort to build a digital resilience education system, guide students to view digital challenges correctly, and promote the growth of medical students.

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Survey on the need and efficacy of artificial intelligence systems in enhancing young physicians′ ability to manage emergencies of hematemesis

Wang Kun, Hu Nan, Lu Haoping, Liu Wenzheng, Liu Zuojing

2025, 45 (6): 423-427. DOI: 10.3760/cma.j.cn115259-20231208-00563

Abstract ( 4 )

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Objective To investigate the need and efficacy of artificial intelligence (AI) systems in enhancing young physicians′ ability to manage emergencies of hematemesis. Methods A questionnaire survey was conducted among 77 young physicians undergoing standardized residency training and specialized physician training at Peking University Third Hospital in 2023. The survey assessed their experience in managing emergencies of hematemesis, identified key areas for competency improvement, and evaluated their willingness and satisfaction regarding AI-assisted systems. Descriptive statistics were used for data analysis. Results Young physicians demonstrated relatively high theoretical knowledge of acute hematemesis management but showed limited proficiency in practical details. For instance, the self-assessed score for awareness of initial emergency measures was (3.40±0.78), and only 40 (51.9%) young physicians had mastered the critical procedural details. Notably, 70 (90.9%) young physicians expressed willingness to use AI-assisted systems trained with expert knowledge. With real-time AI guidance, all young physicians successfully addressed clinical uncertainties in hematemesis management. Moreover, 75 (97.4%) young physicians reported that AI systems effectively enhanced their emergencies management skills. Conclusions Refining practical skills is a critical need for young physicians in managing hematemesis emergencies. AI-assisted systems can efficiently and instantaneously address these competency gaps, with high user acceptance and preliminary satisfaction among young physicians.

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A research on the satisfaction of students with the simulation pharmacy practical training and environment in relevant colleges and universities in Guizhou Province

Yang Junli, Chang Yue, Wang Wenju, Liao Xingjiang, Zhou Hanni, Wang Hongmei, Zhang Keren, Luo Xiaobo

2025, 45 (6): 428-432. DOI: 10.3760/cma.j.cn115259-20240312-00241

Abstract ( 6 )

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Objective To understand the satisfaction degree of practical training and environment of simulated pharmacy by college students in Guizhou Province, in order to inform the construction and application of simulated pharmacy. Methods A questionnaire survey was conducted in March 2023 among 653 undergraduate and junior college students from colleges and universities in Guizhou Province who had participated in the simulated pharmacy training. The self-designed questionnaire was used, and the survey Results were statistically analyzed using the rank sum test and multiple linear regression. Results The average score of students′ overall satisfaction with the training and environment of the simulated pharmacy was 4 (3, 4) points. The single class hour of the simulated pharmacy training and the inclusion of the drug management information system, the drug shelving process, the prescription dispensing process, and the drug selection and usage guidance process are not only the influencing factors of the satisfaction with the simulated pharmacy training (β values were 1.42, 1.18, 2.15, 1.93, and 2.32 respectively, all P<0.05), but also the influencing factors of the satisfaction with the simulated pharmacy environment (β values were 1.45, 1.78, 1.78, 2.16, and 2.38 respectively, all P<0.05). The satisfaction scores for single training sessions of 4 hours, 3 hours, and 2 hours were 36(30,38), 33(28,36), and 31(27,36) respectively, and there were statistical differences (P<0.05). Conclusions The students were basically satisfied with the simulated pharmacy training and its environment. The single training time was up to 4 class hours, and the simulated pharmacy was equipped with drug management information system, drug shelving, prescription dispensing and medication guidance environment, which can help to improve the students′ satisfaction.

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The application of Gibbs′ reflective cycle in the internship teaching of students majoring in rehabilitation therapy

Shen Ying, Song Yan, Sun Jianmiao, Liu Rui

2025, 45 (6): 433-437. DOI: 10.3760/cma.j.cn115259-20240204-00125

Abstract ( 4 )

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Objective To explore the effect of applying Gibbs′ reflective cycle in clinical teaching of students majoring in rehabilitation therapy. Methods Using the experimental control method, 88 students majoring in rehabilitation therapy from Shaanxi University of Chinese Medicine who practiced in the rehabilitation department of the second affiliated hospital of Air Force Military Medical University from September 2022 to December 2023 were enrolled, and randomly divided into experimental group and control group, with 44 students in each group. The experimental group adopted Gibbs′ reflective cycle teaching method, while the control group adopted the traditional teaching method. After the teaching, the two groups of students′ theoretical knowledge, practical ability, critical thinking ability, and evaluation of their respective teaching Methods were compared. T-test and χ²text were used for statistical analysis. Results The knowledge test scores and test scores of the experimental group were higher than those of the control group [(92.71±2.93) vs. (88.76±3.19), (92.65±3.32) vs. (88.63±4.00)], and all the difference were statistically significant (all P＜0.001). The scores of critical thinking ability and teaching evaluation score of the experimental group were higher than those of the control group [ (292.95±11.42) vs. (279.25±12.38), (44.59±2.76) vs. (40.59±3.06)], and all the differences between the two groups were statistically significant (all P<0.001). Conclusions Gibbs′ reflective cycle can improve the clinical knowledge and practical skills of students majoring in rehabilitation therapy, and has a positive effect on the formation of critical thinking ability, which is highly recognized by students.

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Optimization study of the residency training program specialty directory based on comparative analysis

Sun Jingwen, Liu Jing, Li Li, Wang Ying, Fang Caimei, Wu Zhenlong, Wang Jianliu

2025, 45 (6): 438-443. DOI: 10.3760/cma.j.cn115259-20240329-00330

Abstract ( 8 )

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Objective This study aims to analyze the standardized residency training (hereinafter referred to as residency training) specialty directory in China and propose optimization recommendations. Methods In 2021, a comparative analysis was conducted between China′s residency training specialty directory and other domestic medical-related directories. A questionnaire survey was also carried out involving 28 staff members from the science and education departments of health administration institutions in 17 provinces, 740 residency training managers from 443 residency training bases across 27 provinces (autonomous regions, municipalities), 15 586 residency training faculty members, 20 240 residents, and 86 experts from the Chinese Medical Doctor Association′s Professional Committee. The selection of the research Methods aimed to ensure the breadth and representativeness of the data. Literature analysis was used to define the research topic and key issues, while the survey questionnaire collected firsthand experiences and perspectives from residency training administrators, instructors, and resident physicians at various levels. This approach allowed for a comprehensive examination of the existing issues in China′s residency training catalog and potential improvements. Descriptive statistical analysis was applied to analyze the relevant data. The study identified existing issues and gathered suggestions for optimizing the residency training specialty directory through practical evaluation. Descriptive statistics were used to analyze relevant data. Results Based on a comparison of the directories and survey results, it was found that the current residency training program directory in China has several issues: certain specialties are inconsistent with other medical directories (e.g., Medical Genetics and Preventive Medicine), and some specialties (e.g., Surgery-Neurosurgery, Surgery-Cardiothoracic Surgery, Oral and Maxillofacial Surgery, and Prosthodontics) are overly specialized at an early stage. Conclusions The residency training directory should align with the professional directories of all stages of medical education, from training to practice. It is recommended to emphasize generalist competencies or broad specialty training in directory development and explore integrated residency and specialty training models for disciplines such as Radiology and Oncology.

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Quantitative evaluation of standardized residency training policy based on the PMC index model

Wu Danni, Xia Zhouyan, Zhu Binhai

2025, 45 (6): 444-449. DOI: 10.3760/cma.j.cn115259-20240720-00763

Abstract ( 5 )

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The standardized residency training policy is the core institutional guarantee for improving the quality of clinical training. Based on the Policy Modeling Consistency (PMC) model, this study constructed an evaluation framework with 9 primary variables and 41 secondary variables and conducted a multi-dimensional quantitative analysis of 15 residential training policies issued at the national level from 2013 to 2023. Through the evaluation of PMC index grading criteria (excellent: 8.00-9.00; good: 6.00-7.99; acceptable: 4.00-5.99; poor: 0-3.99), it was found that the average comprehensive score of the sample policies was 7.17 points, which was generally at a good level, including 3 excellent policies, 10 good policies, and 2 acceptable policies. The variables X6 (Policy Evaluation, 0.99) and X2 (Policy Timeliness, 0.89) scored highest6, while X8 (Policy Instruments) and X7 (Policy Support) showed notable weaknesses, with mean values of 0.67 and 0.69, respectively. China′s standardized residency training policy needs to focus on optimizing the structure of policy tools and strengthening demand-oriented policy tools and market incentive mechanisms, improving the mechanism for the introduction of special funds and social capital, and promoting multi-dimensional social investment; improving the cross-departmental coordination mechanism to systematically improve the effectiveness of policies and promote the high-quality development of the residential training system.

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The application of the ″disease-care″ dual-track mind map teaching rounds model in standardized residency training

Zhao Li, Zhang Xiaoyan, Sun Jihong, Chen Wenhui

2025, 45 (6): 450-455. DOI: 10.3760/cma.j.cn115259-20240424-00425

Abstract ( 3 )

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Teaching rounds are a crucial method for imparting medical knowledge and fostering clinical thinking. Mind map, as an effective teaching tool, has been widely adopted in teaching rounds. This study integrates the concepts of population medicine and the six-in-one health care concept of ″health promotion, prevention, diagnosis, control, treatment, and rehabilitation″ to propose a dual-track teaching round model based on mind map. This model clearly defines the ″disease track″ (including etiology, pathogenesis, location, symptoms, and course) and the ″care track″ (integrating prevention, diagnosis, control, treatment, and rehabilitation) within the mind map. A standardized template was designed to facilitate its application by attending physicians and residents during teaching rounds. We selected 18 Master′s degree graduate students in clinical medicine and 20 resident physicians (collectively referred to as resident physicians) rotating in the Lung Transplantation Department of China-Japan Friendship Hospital from May to December 2023 as the study participants. A total of 16 teaching rounds based on the ″disease-care″ dual-track mind map were conducted, amounting to 32 academic hours. The teaching effectiveness was evaluated through anonymous questionnaires after the completion of the teaching rounds. The Results demonstrated that all resident physicians rated ″excellent″ across 10 evaluation dimensions, mainly including ″mastery of clinical theoretical knowledge″, ″quality of teacher-student interaction″, ″level of motivation for clinical learning″ and ″development of clinical thinking ability″. In conclusion, the teaching rounds model based on the ″disease-care″ dual-track mind map contributes to the standardization and homogenization of teaching rounds, garnering widespread recognition from resident physicians and achieving favorable teaching outcomes.

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Research on the influencing mechanisms of quality assurance factors in the standardized residency training in Jiangsu Province

Xia Zhouyan, Wu Danni, Zhu Binhai

2025, 45 (6): 456-460. DOI: 10.3760/cma.j.cn115259-20240902-00911

Abstract ( 7 )

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Objective To explore the influence mechanisms of assurance factors within Jiangsu Province′s Standardized residency training (SRT) on training quality, and to inform future optimization of the management framework of Standardized residency training. Methods A questionnaire-based study was conducted from April to June 2024. Using stratified random cluster sampling, 543 residents from 13 prefecture-level cities in Jiangsu Province were selected to assess the current status of SRT assurance factors and training quality. Factor analysis was conducted to identify critical components of the assurance factors, followed by structural equation modeling (SEM) to analyze their impact pathways on training quality. Bootstrap testing was applied to examine the mediating role of residents′ learning engagement between safeguarding factors and training outcomes. Results Exploratory factor analysis (EFA) revealed three core safeguarding dimensions: structural safeguards, process safeguards, and pedagogical safeguards. SEM demonstrated that structural assurance (β=0.340), process assurance (β=0.155), and teaching assurance (β=0.261) all have significant positive effects on training quality (all P<0.05). Mediation analysis showed: Partial mediation by learning engagement for structural safeguards (indirect effect: 48.3%); Full mediation for process safeguards (indirect effect: 84.7%); No mediation observed for pedagogical safeguards. Conclusions Optimizing residency training requires prioritized structural assurance (such as resource allocation), refined process management (such as salary and benefits), enhanced teaching quality (such as teacher training), and activation of learning engagement mechanisms, offering evidence-based policy pathways for sustainable quality improvement.

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Survey on the status of the doctors returning to work of the job-transfer-to-pediatrics′ training in Beijing from 2017 to 2022

Li Xia, Jiao Liping, Gu Yi, Wang Yujia, Lyu Lingyun, Feng Lei, Wang Aihua

2025, 45 (6): 461-465. DOI: 10.3760/cma.j.cn115259-20240325-00308

Abstract ( 4 )

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Objective To investigate the status of doctors returning to work of the job-transfer-to-pediatrics′ training in Beijing, and to explore the long-term effective mode of the transfer training, provide policy and management basis for the government and relevant medical institutions. Methods The study used a self-designed electronic questionnaire to investigate 108 trainees participating in the 2017-2022 job-transfer-to-pediatrics′ training program in Beijing between November and December 2023. Numerical data was analyzed by frequency and constitute ratio to investigate practice situation, work conditions, training effectiveness evaluation and ongoing demands. Results 108 valid questionnaires were collected. The overall satisfaction rate of the training work was 90.7% (98/108). Specifically, 86 trainees (79.6%) believed it was necessary to continue receiving training on pediatric knowledge, 50 trainees (46.3%) expected to establish a close medical alliance with the training unit, 87 trainees (80.6%) supported the construction of the green referral channel. In addition, 72 trainees (66.7%) added pediatrics on the basis of the original scope of practice, 23 trainees (21.3%) switched to pediatrics, the success rate of transfer of non-pediatric students was 88.8% (95/107). Moreover, 80 trainees (74.1%) were engaged in children′s medical services after returning to work. Conclusions The job-transfer-to-pediatrics′ training has achieved initial results. But there is still a need to strengthen transfer training policies and institutional guarantees, value and stabilize the team of primary pediatricians, establish long-term effective mechanisms to consolidate training effects, and promote the sustainable development of children′s medical services in primary hospitals.

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SWOT analysis and strategic study on resident physicians applying for professional master′s degree with equivalent academic qualifications

Chen Qian, Gong Yitong, Fan Fan, Yao Qiuping, Zhao Ping, Zou Liqin

2025, 45 (6): 466-470. DOI: 10.3760/cma.j.cn115259-20240304-00205

Abstract ( 4 )

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With the issuance of the opinions on deepening clinical medical talent training coordination between medical education and healthcare, the training of resident doctors with equivalent academic qualifications applying for a Master′s degree in clinical medicine (hereinafter referred to as postgraduate training with equivalent academic qualifications) has gradually begun, but there are significant problems in the quality of training. This study adopted a quantitative research method in July 2023 to conduct a current situation investigation on 275 resident physicians applying for a master′s degree by equivalent academic qualifications at Southwest Hospital of Army Medical University. Data were collected through a self-designed structured questionnaire and analyzed using Excel 2021. Currently, the proportions of those who have passed the National English Test, the National Comprehensive Subject Test, and all degree courses are 69.82% (192/275), 62.91% (173/275), and 72.00% (198/275) respectively, but only 10.18% (28/275) have been awarded a master′s degree. 76.73% (211/275) of the respondents believe that the greatest gain from the equivalent academic qualifications during residency training is the improvement of research capabilities, while 65.46% (180/275) consider the main problem to be the prominent contradiction between work and study, as well as insufficient attention from the university and supervisors. Based on literature review and the current situation investigation results, a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis was conducted. The advantages and opportunities mainly include the improvement of the equivalent academic qualifications system, the shortening of the medical talent training cycle, and the equivalent academic qualifications for master′s degree application becoming an important way for medical talent training. The disadvantages and threats mainly include the need for improvement in the management model, the urgent need to enhance the training quality, and the difficulty in adjusting the training model. The study proposed strategies such as building a multi-department collaborative and efficient teaching management mechanism, implementing a full-process educational and teaching quality monitoring mechanism, and continuously reforming and innovating the training model, with the aim of promoting the quality and efficiency of master′s degree application by equivalent academic qualifications during residency training.

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Analysis of the curriculum system for doctor of medicine training in four American medical schools

Xie Zhen, Hou Jianlin, Zhang Xiaomin, Xie Ana

2025, 45 (6): 471-475. DOI: 10.3760/cma.j.cn115259-20240614-00605

Abstract ( 6 )

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The curriculum system is regarded as a pivotal component of medical education. To systematically investigate the curriculum frameworks of leading American medical institutions and derive insights for advancing medical education reform in China, the doctor of medicine (MD) curriculum systems from four prominent American medical schools(Harvard Medical School, Johns Hopkins University School of Medicine, University of Michigan Medical School, and Mayo Clinic) were examined. A comprehensive analysis was conducted focusing on their curricular structures across three distinct phases: pre-clerkship, clerkship, and post-clerkship. During the pre-clerkship stage, integrated curricula organized through organ system-based modular approaches are predominantly implemented, with particular emphasis being placed on early clinical exposure for students. The clerkship phase is characterized by the adoption of longitudinal integrated clerkship models, through which the integration of theoretical knowledge with clinical competencies is systematically reinforced, along with the harmonization of medical expertise and humanistic care principles. In the post-clerkship stage, priority is given to the enhancement of professional medical ethics and the cultivation of scientific research capabilities, while diversified academic pathways and career development opportunities are provided. These institutional practices——encompassing curriculum integration methodologies, longitudinal integrated clerkship, medical humanities curriculum design, interdisciplinary collaboration skill development, and professional competency cultivation are proposed to be strategically adapted to China′s educational context. Through such localized implementation, the establishment of an optimized medical education framework is anticipated, ultimately contributing to the advancement of high-quality medical talent cultivation.

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Insights from Brown University′s MLMS program for narrative medicine in China

Chen Xiaotong, Yu Fang, Shen Yan, Ling Jianrong, Liu Yingchao

2025, 45 (6): 476-480. DOI: 10.3760/cma.j.cn115259-20240516-00489

Abstract ( 4 )

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Narrative medicine, which combines narrative literature and medicine, contributes to the effective implementation of medical humanities. To promote the practice of narrative medicine in China′s undergraduate education, this study examines Brown University, the first Ivy League university in the United States to incorporate narrative medicine into compulsory undergraduate course; and systematically analyzes its narrative medicine practice project, ″my life, my story″ (MLMS). The MLMS project consists of three main components: patient life story interviews, reflective writing and team reports. Its key features include a short implementation cycle, strong operability, and adaptability to preclinical courses, elective courses and clinical clerkships. The project′s effectiveness has been empirically validated. The MLMS project demonstrates that narrative medicine education is not confined to the classroom; medical students′ empathy can be enhanced through reflective writing; independent learning ability is a key factor in practicing narrative medicine. Additionally, training localized instructors is crucial for successfully implementing narrative medicine education in China.

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