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01 January 2019, Volume 39 Issue 1 Previous Issue    Next Issue

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The application of portfolio on problem-based learning tutor training Liu Bing, Qi Dianjun 2019, 39 (1):  1-5.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.001 Abstract ( 35 )   PDF (821KB) ( 18 )   Objective To evaluate the effect and significance of portfolio on PBL tutor training.Methods 10 PBL tutors from the first affiliated hospital of China medical university were enrolled in this study and portfolio were used in PBL tutor training. Evaluation form of teaching reflection in PBL, evaluation form of teaching plans in PBL, evaluation form of PBL tutors performance, evaluation form of PBL cases and questionnaires of training demand of PBL tutors were used in teaching evaluation. SPSS 25 was used for data analysis.Results After the use of portfolio, teaching plans of PBL (from 72.13±6.94 up to78.10±7.89), teaching reflection in PBL (from 55.50±3.83 up to 66.20±4.25), PBL tutors performance (from 72.73±5.45 up to 80.17±5.97) and PBL cases (from 72.13±6.94 up to 78.10±7.89) were significantly improved(P<0.05).Conclusions Portfolio is an effective method in the training and evaluation offaculty who implement PBL. References | Related Articles | Metrics

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On the role of part-time head teacher in the training of postgraduates of clinical medicine professional degree Chen Shuang, Xu Lan, Wang Zhijun, Lu Yanhua, Jiang Yanmin 2019, 39 (1):  6-9.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.002 Abstract ( 18 )   PDF (884KB) ( 13 )   Recently, the training model of combination postgraduate education of clinical medicine professional degree with the standardized training of residents has been popularized in our country. Different institutions have actively explored the cultivation experience. In this paper, it was introduced the exploration of the system of part-time head teacher in the teaching hospital in order to solve the problems existing in the cultivation of the graduate students with master's degree in clinical medicine in Nanjing Medical University. Besides, it was summarized the head's role in enhancing ideological and political education for students and improving students' clinical skills, scientific capacity and humanistic literacy, etc. References | Related Articles | Metrics

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Analysis on effects and course demand of simulation operations specialists in medical simulation education Xu Zhenye, Xu Yanli, Wang Jiayu, Zhang Qi, Kuang Jie, Huang Liang, Mao Enqiang, Shi Ting 2019, 39 (1):  10-14.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.003 Abstract ( 38 )   PDF (807KB) ( 19 )   Objective To investigate the effect and function of the simulation operations specialists (SOS) in assist healthcare simulation courses. To provide reference for the construction of SOS and the development of healthcare simulation education in China.Methods Based on the data in Ruijin healthcare simulation center, 194 medical simulation instructors from 93 medical institutions or colleges in 26 cities were investigated to understand their knowledge and needs for SOS, and 19 SOSs from 9 medical colleges were also investigated to understand their actual work status and self-evaluation using cellphone online research method.Results Instructors have 5.5(2.0,9.5)years' teaching experience, but the simulation experience is only 1 (1.0,1.0) year. 70% instructors are not familiar with SOS, and 85.1%(165/194) need helping in simulated teaching aspects. But the application of SOS is lower than actual demand(χ2= 7.645, P <0.05). Assist and guidance the operation of equipments, preparation classroom, and assistance teaching plans are needed by instructors. 87.1% (169/194) instructors approved the importance of SOS and there was no difference between the groups less than 20 years' teaching experience (F=0.229, P>0.05). A discrepancy exists in SOSs' actual work and responsibility in theory. In all the 19 SOSs, only 4 SOSs have enough communication with instructors before and after courses, 15 SOSs felt workload is very heavy, 14 SOSs think there is lack of enough time or disturbed by other works, 13 SOSs need professional training and only 5 SOSs are satisfied with income while instructors thought SOS should get more salaries (χ2= 19.363, P<0.05).Conclusions As the important resource of the simulation center, SOS directly affects the service ability and teaching quality of the center. The professional qualification training should be promoted actively to improve the professional technical ability for different service demand and promote the communication and understanding between simulation course faculty and SOS. The ratio of SOS and the work demand should be evaluated and improved with increasing the investment of ancillary facility. Simultaneously the establishment of the sense of SOS staff's professional value should be paid more attention and the SOS team building should be seen as the core competence development of the simulation center. References | Related Articles | Metrics

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Analysis and reflection on the medical humanities curriculum for five-year program of clinical medicine in China Zeng Yang, Yang Mianhua, Fan Guanhua, Lin Chun, Chen Zexin, Lin Changmin 2019, 39 (1):  15-18.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.004 Abstract ( 54 )   PDF (812KB) ( 32 )   Objective To analyze the differences of medical humanistic curriculum from 19 universities in 2003 and 33 universities in 2013, conclude the changes in China's medical humanistic education during 2003 to 2013 so as to give suggestions for the future development of medical humanistic education in China.Methods The data analysis method was used. The medical humanistic curriculum data in medical undergraduate of 5-year program from19 universities in 2003 and 33 universities in 2013 was collected and analyzed.Results Compared to the medical humanistic setting in 2003, in 2013 more medical humanistic curriculums were implemented; the curriculum spans were increased; the percentages of compulsory courses in the general curriculum were increased; formative assessment method was adopted and communication skills were practiced.Conclusions Compared to 2003,the concept of medical humanistic education in China has been strengthened, and some colleges and universities initiated medical humanistic education. In the future, the medical humanistic education also needs to integrate theory with practice, the combination of various teaching forms and the combination of multiple evaluation systems. References | Related Articles | Metrics

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Curriculum development in the combination of the standardized training of residents and the postgraduate education of candidates for professional degree Yu Jinrui, Wang Aihua, Jiao Liping, Ni Xin 2019, 39 (1):  19-21.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.005 Abstract ( 46 )   PDF (796KB) ( 16 )   Since 2012, the training of professional degree graduate students in our hospital has been combined with the standardized training of residents. Through the theoretical course scheme, the clinical rotation scheme, the clinical reasoning and clinical skill training program, the hospital has established a systematic and comprehensive training method. The total passing rate of the examination of practicing doctors' qualifications is 99.3%(142/143) in the past five years. The total passing rate of the pediatric resident qualification test is 98.8%(83/84) in the past four years, and the amount of published articles has increased significantly. Through this comprehensive system of three-in-one training, the graduate students have achieved a higher passing rate on the examination of practicing doctors' qualifications and the pediatric resident qualification test, and their ability on the scientific research has been steadily improved. The postgraduates who made standardized training of resident doctors have actually achieved pediatric professional knowledge and skills with the corresponding position competence. References | Related Articles | Metrics

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Hotspottracking of medical students' humanities quality education based on Citespace Wang Yameng, Jiao Mingli, Anastasia Gamburg, Li Yuze 2019, 39 (1):  22-26.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.006 Abstract ( 27 )   PDF (804KB) ( 13 )   Objective To visualize the English literature of medical students' humanities education in 1998-2018, and to explore the core research and hot-spot of medical students' humanities education.Methods Citespace was used to conduct quantitative and qualitative analysis of the research team, high-impact authors and high-impact journals of the medical science and humanities education in the Web of Science database.Results The United States is a country with the largest number of publications, accounting for 41.4%(516/1246) of the total number of publications in 20 years; the University of Toronto, Canada is the top one in terms of paper publication, up to 26; Fred Hafferty is the author with the highest number of articles cited, 196 times; Academic Medicine is the most cited journal, with a frequency of 841.Conclusions The research hotspots of medical students' humanities education in the past 20 years mainly include the basic connotation of medical humanities education, the understanding of the importance of medical students' humanities education, the optimization of humanities curriculum structure, and the establishment of professional medical humanities faculty. References | Related Articles | Metrics

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Strengthening humanistic medical education in standardized residents training Luo Yinli, He Guodong 2019, 39 (1):  27-29.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.007 Abstract ( 75 )   PDF (759KB) ( 41 )   Every health care provider should realize it's particularly important to cultivate the residents with professional skills and noble humanistic spirit. Medical professional education and humanities education must be integrated perfectly, then it will facilitate progress in standardized training for residents and promote the level of healthcare services.This paper focus on the importance of training humanistic attitude in standardized training of residents, and the methodology of training including communication ability of doctors and improvement of faculty performance. References | Related Articles | Metrics

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Anxiety and depression state and their associated factors of eight-year program medical students at postgraduate stage Zhao Xiujuan, Zhu Fengxue, Zeng Li, Li Shu, An Youzhong 2019, 39 (1):  30-34.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.008 Abstract ( 34 )   PDF (814KB) ( 19 )   Objective To investigate the incidence of anxiety and depression in the eight-year program medical student at postgraduate stage, and to analyze the characteristics of anxiety and depression and their influencing factors.Methods Two hundred andthirteen eight-year program medical students at postgraduate stage in Peking University People's Hospital were analyzed by random sampling. Using respectively self-rating anxiety scale (SAS) and self-rating depression scale (SDS) to investigate the incidence of anxiety and depression, using adolescent self-rating life events checklist, social support rating scale and self-made questionnaire to analysis the influence factors of anxiety and depression.Results The incidence of anxiety in eight-year program medical students at postgraduate stage was 26.8%(57/213). Logistic regression analysis showed that the risk factors of the anxiety in eight-year program medical students at postgraduate stage included the students comes from the countryside (OR=3.860, 95%CI:1.656~8.997, P=0.002), professional dissatisfaction (OR=6.293, 95%CI:1.288~30.744, P=0.023), the more adolescent life events (OR=1.196, 95%CI:1.126~1.270, P<0.001), learning pressure (OR=1.489, 95%CI:1.295~1.713, P=0.009) and the less social support (OR=0.871, 95%CI:0.809~0.936, P<0.001). The incidence of depression in eight-year program medical students at postgraduate stage was 37.1%(79/213). Logistic regression analysis showed that the risk factors of the depression in eight-year program medical students at postgraduate stage included female (OR=2.495, 95%CI:1.095~5.683, P=0.03), the first and third years of graduate training (OR=2.770, 95%CI:1.174~6.536, P=0.02), the more adolescent life events (OR=1.232, 95%CI:1.141~1.329, P<0.001) and the less social support (OR=0.632, 95%CI:0.489~0.816, P<0.001).Conclusions The incidence of anxiety and depression are higher in eight-year program medical students at postgraduate stage. The students comes from the countryside, professional dissatisfaction, the more adolescent life events, learning pressure and the less social support are the risk factors of the anxiety in eight-year program medical students at postgraduate stage. Female, the first and third years of graduate training, the more adolescent life events and the less social support are the risk factors of the depression in eight-year program medical students at postgraduate stage. Universities and hospitals should give great insight to the anxiety and depression of the eight-year program medical students, and strengthen the psychological health education and counseling of these students, to improve their physical and mental health. References | Related Articles | Metrics

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The current situation and influencing factors of mental stress among medical postgraduate students Zhang Ruonan, Cao Depin, Ma Xing, Yang Libin 2019, 39 (1):  35-38.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.009 Abstract ( 126 )   PDF (785KB) ( 45 )   Objective To discuss the current situation of the postgraduate students' mental stress and its influencing factors, and to offer some suggestions that can be effective to relieve the mental stress, to provide a certain reference to the development of the training for the medical postgraduate students.Methods The mental stress scale, connor-davidson resilience scale(CD-RISC), positive and negative affect schedule (PANAS),self-compiled general information questionnaire were used to test the mental stress source and resilience, emotional state of 403 medical postgraduate students.Results The KMO value of the mental stress scale was 0.904, which could explain the total variation of 67.4%.The main mental stress source of medical postgraduate students is economic stress (3.33±0.77), followed by academic stress (2.88±0.68), employment and future stress (2.85±0.81). The resilience (2.32±0.58), professional satisfaction, the annual family income are positive to alleviate the medical postgraduate students' mental stress factors.Conclusions Medical postgraduate students' mental stress is influenced by many factors. School should have a targeted mental health education for medical postgraduate students. References | Related Articles | Metrics

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The blending learning based on small private online course in histology Cao Bo, Yu Hongwei, Yang Zhiwen, Liu Donghua, Liu Chunjia, Lei Lei, Cao Depin 2019, 39 (1):  39-42.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.010 Abstract ( 37 )   PDF (784KB) ( 27 )   Objective To investigate the effect of the blending learning based on small private online course (SPOC) in histology.Methods 361 students from grade 2016 and 2017 undergraduate clinical medicine in Harbin Medical University were randomly selected and divided into experimental group and control group. The control group received traditional education, and the experimental group received the blending pathway of education based on SPOC. The learning outcome was evaluated through questionnaire survey and the exam result of students, and the panel discussion of the teachers.Results There was no significant difference between these two groups in test scores(P>0.05). According to the survey in students and teachers, the experimental group was better than the control group in stimulating interest in learning, improving critical thinking, communicating skill and the ability of solving problem(P<0.05). Satisfaction with blending learning based on SPOC reached 97%. Teachers thought it has a significant effect on improving the teacher-student relationship, teaching interests, and occupational pride.Conclusions The blending learning based on SPOC in histology was better than traditional teaching method in the teaching of histology. References | Related Articles | Metrics

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Application and evaluation of 3D printing mold in spinal deformity teaching among residents Wang Chao, Zhu Kai, Tao Hao, Wang Yan, Xiang Hongfei, Ma Xuexiao 2019, 39 (1):  43-46.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.011 Abstract ( 31 )   PDF (782KB) ( 20 )   Objective To evaluate the effect of 3D printing mold in resident teaching of spine deformity by combining Objective test and subjective evaluation.Methods The experimental control method was adopted. A total of 43 residents, who were enrolled in standardized training at the Affiliated Hospital of Qingdao University, were successively selected for this research. The experimental group received two lessons about spinal deformity in the first month at the spinal department, by using case-based learning (CBL) combined with 3D printing mold. The control group was taught with traditional CBL method at the similar time and by the same lecturers. After teaching, assessment forms were filled by residents to evaluate the effect of different teaching methods.Results For rating scales, experimental group showed higher score than control group in the aspects of pathologic characteristic, concepts and relevant measurements, anatomical structures and the principles of orthopedic surgery (all P<0.05), with no statistical difference in evaluation of the teachers (t=1.131,P>0.05).Objective test results were higher in the experimental group than in the control group (t=2.222,P<0.05). For scoring the degree of interest to the way that the residents were taught, experimental group showed higher score than control group (t=2.313,P<0.05).Conclusions 3D individualized printing mold can improve learning outcome while improving residents’ subjective teaching evaluation and make the learning interest. The method is valuable to popularize. References | Related Articles | Metrics

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Application of micro-lecture system based on BOPPPS model in clinical practice of neurology Zhu Yuyou, Wang Juan, Wang Li, Cheng Juan, Lyu Xinyi, Wang Guoping 2019, 39 (1):  47-51.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.012 Abstract ( 73 )   PDF (829KB) ( 55 )   Objective To explore the application of micro-lecture system based on BOPPPS model in clinical practice of neurology.Methods Sixty clinical medicine undergraduate students graded 2013 in Anhui Medical University were random divided into 2 groups, thirty students in both experimental group and control group. Micro-lecture system based on BOPPPS model teaching method was adopted in experimental group, while traditional teaching method was adopted in control group. The learning results of two different methods of teaching were valued by mini-clinical evaluation exercise evaluation, direct observation of procedural skills and questionnaire survey.Results ①The score of interviewing skills,physical examination skills, humanistic qualities, clinical judgment, communication skills, organization efficiency and overall clinical competence were higher in experimental group students, the difference was statistically significant (all P<0.05). ②There was no significant difference in the first item “demonstrates understanding of indications, relevant anatomy and technique” and “explains procedure/risks to patient, obtains informed consent” between the two groups, the scores of the other items were higher in experimental group students, the difference was statistically significant (all P<0.05). ③At the end of internship, the questionnaire showed that the students in the experimental group were more recognized for this new way of teaching.Conclusions Micro-lecture system based on BOPPPS model teaching methods achieved better results in the teaching of neurology. New teaching method was superior to traditional teaching method in improving students' comprehensive clinical competence. The new teaching method is need future research and promotion. References | Related Articles | Metrics

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Analysis of the application of early clinical clerkship among low grade nursing undergraduates Yao Xiuyu, Zhang Xin, Qin Xuelian, Sheng Yu, Zhang Hui 2019, 39 (1):  52-55.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.013 Abstract ( 21 )   PDF (783KB) ( 11 )   Objective To explore the suitability and application effect of early clinical clerkship by low grade nursing undergraduates.Methods This study used questionnaire survey and interview. An early clinical clerkship program was developed and conducted among 89 undergraduates of first-year nursing students at Peking Union Medical College. Then students' skill scores and theoretical scores were tested; students' clinical learning conditions were surveyed by self-compiled clinical learning evaluation scales; students' views on the early clinical clerkship were interviewed by reflective interview.Results Students' skill scores and theoretical scores were fairly well; the clinical learning score was satisfied with (87.8±3.7) points. Questionnaire survey and reflective interview showed that students had high level of interest in nursing major, and most students were willing to communicate with patients and provide help.Conclusions The early clinical clerkship is well adapted and feasible in low grade nursing undergraduates. To a certain extent, it can improve the learning outcomes, help the establishment of nursing professionalism, and cultivate the professional emotion. Other nursing educators can use early clinical clerkship according to their own situations. References | Related Articles | Metrics

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Discussion for the training method of laparoscopic surgical technique Xin Cheng, Hong Yonggang, Liu Qizhi, Gong Haifeng, Hao Liqiang, Zhang Wei 2019, 39 (1):  56-59.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.014 Abstract ( 37 )   PDF (812KB) ( 19 )   Laparoscopic surgery has become one of mature surgical procedures in gastrointestinal surgery. Laparoscopic surgery requires good spatial positioning skills, hand-eye coordination skills and operation skills. Traditional laparotomy training methods can no longer satisfy the training requirements of laparoscopic surgery. This paper presented a training method of stepped laparoscopic surgical technique combined with simulated training, animal experiment and clinical practice. The simulation training was divided into 3 stages: primary simulation training, intermediate simulation training and advanced simulation training. The conclusion is that, the training method improved the essential operation skills of the trainees and shorten the training cycle, thus to provide some evidencebased support to implement laparoscopic surgery technical training in other institutions. References | Related Articles | Metrics

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A preliminary investigation of trainees' basic knowledge on palliative medicine in resident standardized training Wang Hao, Zeng Yanying, Wang Hong, Zhan Yiyang 2019, 39 (1):  60-63.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.015 Abstract ( 39 )   PDF (792KB) ( 11 )   Objective To get a preliminary understanding of trainees' knowledge on palliative medicine's basic concepts in resident standardized training (referred to as “training”) and propose suggestions for improvement.Methods Using self-made questionnaire, 263 residents' standardized training trainees were investigated and conducted data summary in the First Affiliated Hospital of Nanjing Medical University from 2015 to 2017 by “questionnaire star” in their wechat group.Through the investigation targeted at basic concepts of palliative medicine and the professional attitude.Results The residents of 49.0%(129/263) had a flawed understanding of the basic concepts of palliative medicine, and there was no significant difference between different age groups, different academic qualifications and different training time (χ2test with all P>0.100). Only 34.2%(90/263) agree that medical staff should play an “authoritative role” in palliative medicine. Assuming that they are in the end of lives, 65.4%(172/263)、80.2%(211/263) and 31.9%(84/263) of those are willing to take the initiative to implement palliative treatment for themselves, their families and patients, and the difference was significant (χ2=133.240,P<0.05). Only 28.1%(74/263) of the respondents think that the time is ripe for our country to promote palliative medicine and only 50.2%(132/263) are confident in the implementation of palliative care in our country.Conclusions There is a lack of palliative medicine education in the current medical education system now and this is one of the important reasons that affect the palliative medicine in mainland China. Therefore, the implementation of palliative medicine education in the medical education system needs to be popularized, strengthened and standardized. References | Related Articles | Metrics

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Analysis of instructors homogenization of residents from different sources in a residency institution Zeng Qingqi, Liu Jing, Gao Jie, Zhou Tao, Cui Yue, Wang Jianliu 2019, 39 (1):  64-68.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.016 Abstract ( 17 )   PDF (797KB) ( 13 )   Objective To understand the status of residents' evaluation of the instructors, and analyze whether the residents from different sources enjoyed homogenized teaching faculty during the residency training program.Methods 375 residents who had transferred training departments between November 2017 to April 2018 were investigated by a instructor evaluation scale.Results 265 instructors received scores with a mean of 97.7 and a median of 100. The differences between evaluations given by 4 groups of residents were not statistically significant, regardless of their dimensions or overall evaluation. The instructors' scores were not related to their gender, age, and education level, but they were influenced by their professional titles.Conclusions Residents from different institution received indiscriminate guidance from instructors during the training process. It is necessary to strengthen training for instructors of residents to improve the standardization teaching method and adequacy of teaching activities. References | Related Articles | Metrics

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The application of incident learning in education of radiation oncology physicists Yang Ruijie, Sun Haitao, Zhang Xile, Li Jun, Pan Yuxi, Sheng Hongguo, Wang Junjie 2019, 39 (1):  69-72.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.017 Abstract ( 27 )   PDF (812KB) ( 10 )   Incident learning is a vivid and effective teaching method, in which students learn and discuss the reported incidents under the guidance of teachers. In this paper, we investigate the feasibility, implementation and effectiveness of incident learning for the radiation oncology physicists' education, based on six-year clinical education practice, from establishing the database, learning the knowledge, concept and workflow, implementing incident learning to radiation oncology physicists' education. Our experience demonstrated that incident learning is an effective approach of education for radiation oncology physicists. It can be used for the training of theoretical learning, practical skills, and clinical reasoning. References | Related Articles | Metrics

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A study on the current status of rural doctors in Huaihua and Jishou in Hunan province Wu Kun 2019, 39 (1):  73-77.  DOI: 10.3760/cma.j.issn.1673-677X.2019.01.018 Abstract ( 19 )   PDF (836KB) ( 9 )   Objective To understand the basic situation and service satisfaction of rural doctors in two cities of Huaihua and Jishou in Hunan province.Methods A questionnaire survey was conducted among 428 rural doctors from 152 townships (villages) in two cities of Huaihua and Jishou.Results The rural doctor's education situation: Secondary school education accounted for 61.7%(264/428). There are rural doctor card, but no medical education accounted for23.8%(102/428). 27.3%(117/428) of doctors (assistants) were licensed by doctors, 72.7%(311/428) of which were rural doctors. Age over 60 years old accounted for17.5%(75/428). As a doctor occupation 11 years to 30 years accounted for63.3%(271/428), accounted for more than 30 years of practice17.8%(76/428). Monthly income of 1000 yuan to 3000 yuan accounted for 58.9%(252/428), more than 4000 yuan accounted for only 5.4%(23/428). More than 3 training sessions each year accounted for 10.8%(46/428), and 13.1%(56/428) of those who did not participate in training accounted for. Through convenient sampling survey, villagers are satisfied with the service provided by rural doctors. The highest satisfaction is the service attitude, while the lowest satisfaction is the disease solution.Conclusions The clinical capacity of rural doctors in Huaihua and Jishou is higher than that required by the state. It is suggested that the government should strengthen the training of rural doctors and improve their practical ability. References | Related Articles | Metrics