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01 February 2019, Volume 39 Issue 2 Previous Issue    Next Issue

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Quantitative and qualitative methods in medical education research Wu Hongbin, Wang Weimin 2019, 39 (2):  81-92.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.001 Abstract ( 116 )   PDF (934KB) ( 91 )   The reform and development of medical education should be supported by high-level medical education research. This paper reviews and introduces two research papers about the methods in medical education, which are published in the journal of medical teacher and these two papers have been regarded as the AMEE Guide. The purpose of this paper is to provide medical educators in China, especially those who are interested in and new to medical education research, with some references and a basic understanding of the methods of medical education research. Also, helps them to understand that how quantitative and qualitative methods contribute to the medical education evidence through different approaches and how to select the most appropriate approach according to the research questions. The main body of this paper includes six parts: research paradigm, research process, quantitative research design, qualitative research design, research object and sampling procedures, data collection and analysis. We thinks that the above six parts are of great reference and guiding significance for medical education research in China. References | Related Articles | Metrics

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Investigating and comparing attitudes toward death and hospice care in medical students of different major Xiao Wenli, Yu Ling, Li Bing, Yi Chun, Sun Xiaoning, Gao Jing 2019, 39 (2):  93-97.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.002 Abstract ( 85 )   PDF (806KB) ( 22 )   Objective To describe medical students' attitudes toward death and hospice care before internship, in order to provide the evidence for optimizing end-of-life care education at school.Methods The total of 191 baccalaureate students majored in Chinese medicine and nursing in Guangzhou University of Chinese Medicine just before clinical practice were investigated and compared using the Chinese version of the death attitude profile-revised (DAP-R) and the Chinese version of the frommelt attitude toward care of the dying scale-form B (FATCOD-B). Independent t-test and Pearson product-moment correlation were used to analyze the data.Results For students of Chinese medicine, the scores of the 5 dimensions of death attitude are neutral acceptance (3.95±0.55), approach acceptance (2.64±0.60), death avoidance (2.64±0.69), fear of death (2.59±0.61), and escape acceptance (2.45±0.72). The scores of nursing students are neutral acceptance (4.10±0.44), fear of death (2.76±0.71), death avoidance (2.59±0.71), approach acceptance (2.56±0.55), and escape acceptance (2.47±0.80). Neutral acceptance score of nursing students is statistically higher than students of Chinese medicine (t=-2.019,P=0.045). The total score of hospice care attitude of students majored in Chinese medicine and nursing are (103.98±7.63) and (109.66±9.06), and the score of nursing students is statistically higher (t=-4.678,P<0.001). The hospice care attitude score is negatively correlated with fear of death scores, and positively correlated with neutral acceptance score in medical students.Conclusions Despite nursing students' attitudes toward death and hospice care are superior to students of Chinese medicine, there is a big space to improve both groups of students. Therefore, it is imperative for medical colleges and universities to strengthen end-of-life care education, so as to help medical students improving their view of death and understanding of hospice care. References | Related Articles | Metrics

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Cognition of palliative care and its influencing factors among medical students Yang Xiyu, Pan Hui, Zhao Jun, Ning Xiaohong 2019, 39 (2):  98-104.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.003 Abstract ( 30 )   PDF (846KB) ( 12 )   Objective To explore the cognition of palliative care among medical students and analyze the correlative factors.Methods Students from different places were invited to do the home-based made questionnaire, questions include students' basic information, their attitudes toward death and knowledge about palliative care. Correlation analysis and rank sum test were used to analyze the influencing factors.Results The following medical students got a higher grade of cognition about palliative care: female(34.05±2.00), undergraduates candidates for masters (34.11±2.11), those postgraduates (34.07±2.04), those born in a large family (34.15±1.57), those had received education or training about death(34.34±1.81) and those had participated in voluntary activities(34.03±2.06). Also students in an atmosphere of talking about death at home is frank and open(34.01±1.99) and those had visited or cared for dying patients(34.11±2.00).Conclusions Medical students' cognition of palliative care varies because of personalexperience of death or education background which suggests that could supply palliative care education penetrating intoclinic practice. References | Related Articles | Metrics

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A survey of residents' attitude, ability and influencing factors of communication with patients Wang Zhuoyun, Wang Jing, Zhu Lei, Wang Xiuyan 2019, 39 (2):  105-111.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.004 Abstract ( 76 )   PDF (813KB) ( 29 )   Objective To know the residents' attitude, ability and influencing factors of communication with patients, and to help the residents to master doctor-patient communication skills.Methods There were 163 residents and graduate students (hereinafter referred to as residents) who participated in standardized training were selected from the Second Clinical College of Anhui Medical University. They were investigated by filling anonymous questionnaires and using the communication skills attitude scale (CSAS). To understand and assess the residents' attitudes towards doctor-patient communication skills, the ability of doctor-patient communication, and the factors that influence their communication attitudes and abilities.Results The two major factors that some residents think will affect the relationship between doctors and patients are mainly external image and personal cultivation. Nearly half of the residents believe that the current doctor-patient relationship is relatively tight. Most residents attribute the problem of doctor-patient communication problems to medical services. There is no time and effort for busy people. Positive attitude subscale (PAS) score (51.44±7.72); negative attitude subscale (NAS) score (34.99±7.75). The results of PAS univariate analysis showed that the difference in the scores of residents, whether they come from the “one child family”, whether they loved their majors, whether they were confident to become qualified doctors, and the level of interpersonal communication skills were statistically significant (all P<0.05).Conclusions Hospital administrators need to reduce the workload of residents, enhance their professional confidence, and help residents to master the ways and skills of interpersonal communication, to enhance the enthusiasm of residents to learn the communication between doctors and patients, and improve the ability of doctor-patient communication. References | Related Articles | Metrics

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An empirical analysis of professionalism demonstration about standardized training physician from the perspective of chronic diseases patients Fan Guanhua, Yang Peng, Ye Wanbao, Chen Kangkang, Zhang Beien, Yang Mianhua 2019, 39 (2):  112-118.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.005 Abstract ( 41 )   PDF (1119KB) ( 123 )   Objective The identify the challenge and weakness in standardized training medical students and their clinical exposure are essential for capacity building of healthcare providers.Methods Select the patients with chronic diseases who have an interactive experience with the standardized training medical students as the subjects for investigation, this paper identifies the relevant factors affecting the professionalism demonstration of the standardized training medical students from the perspective of patients.Results The demonstration of care for patients by the resident physician is an independent factor affecting the patients' perception of the standardized training medical students' professionalism accomplishment. From the perspective of chronic diseases patients, waiting, diagnosis and therapy time, medical expenses, medical institution environment and insurance policy will affect the evaluation of the professionalism demonstration of the standardized training medical students, and the above factors will restrict the standardized training medical students' demonstration of professionalism. Patients in the central and western districts of China showed less expectation gap of professionalism than those in the eastern districts. There was no significant difference in the evaluation of professionalism demonstration of standardized training medical students by different gender patients. Aged patients prefer to visit public hospitals with more comprehensive coverage of health insurance policies and are more sensitive to the price of medicines in prescriptions for trained standardized training medical students.Conclusions For the clinical standardized training education, the evaluation of the professionalism of the medical students can form a formative evaluation in the professionalism developing process, which may help the standardized training medical students improve their professionalism sensitivity. References | Related Articles | Metrics

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Application of image-based learning method in ultrasound standardized residents training in the field ultrasound technology Zhao Bo, Chen Wen, Cui Ligang, Jiang Ling, Zhang Fan 2019, 39 (2):  119-122.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.006 Abstract ( 39 )   PDF (780KB) ( 9 )   Objective To explore the advantages and application value of “image-based learning” method in ultrasound technology for standardized residents training of radiologists.Methods There were 50 residents of other imaging departments who studied from 2010 to 2017 in the ultrasound department of Peking University Third Hospital of were divided into two groups: the control group and the experimental group.The experimental group was 25 doctors, the control group was 25 doctors. Image-based learning method was applied in the experimental group, while traditional teaching method was applied to the control group. By the end of the training,the training effect of image-based learning teaching method was evaluated by comparing the examination scores of the two groups after ultrasound training, and the satisfaction degree of image-based learning teaching method for experimental group was evaluated by questionnaire survey.Results The average examination score of experimental group after ultrasound training was significantly higher than that of the control group [(87.74±6.21) VS.(81.99±9.84),t=2.48,P＜0.05]. Meanwhile, 100.0%(25/25) in the experimental group believed that the image-based learning teaching method was helpful to consolidate the knowledge of ultrasound, stimulated learning interest and clinical reasoning capacity and facilitated the learning of ultrasound skills. 96.0% (24/25)in the experimental group agreed that the image-based learning teaching method was helpful to enhance self-learning ability and participation consciousness. Conclusions Image-based learning teaching method has a certain application value in the training of ultrasound skill of radiologists. References | Related Articles | Metrics

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Revision and application of EENT new nurses standardized training program Gui Chunyi, Sun Mei, Nie Wenjin, Hong Yili, Zhou Qi, Xi Shuxin, Wang Min 2019, 39 (2):  123-128.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.007 Abstract ( 65 )   PDF (784KB) ( 15 )   Objective To construct a standardized training program for EENT new nurses and verify the training effect.Methods Comparing the gaps between the training status for EENT new nurses and the requirements in the National Health Commission's “Training Program for New Nurses (Trial)”, expert discussions were organized to revise and construct the “Standardized Training Program for EENT New Nurses” and organize its implementation. To compare the differences between the new nurses trained by the new program and those trained by the traditional method by using experimental research methods.Results There was some gaps between the training status and the requirements, such as system formulation, rotation setting, curriculum content and training assessment methods. The revised training program may significantly improve the performance of new nurses in operation assessment and comprehensive practical skills.Conclusions The revised standardized training program for EENT new nurses is standardized and effective one, which fit the needs of EENT specialized hospitals. References | Related Articles | Metrics

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Investigation on the core competitive capacity of clinical medical graduates in Taishan Medical University Zhao Qian, Yuan Li, Lyu Sikai, Li Wenxiu, Wang Qian, Liu Chengyan 2019, 39 (2):  129-132.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.008 Abstract ( 37 )   PDF (752KB) ( 8 )   Objective To evaluate clinical medical graduates' core competences from year 2010 to 2015 in Taishan Medical University, so as to provide reference and advice for personnel training system.Methods The research questionnaire was designed to medical graduates independently and fully justified by the employers including 102 heads of hospital-level business,102 heads of personnel department,102 heads and 244 doctors of department from 102 public hospitals in Shandong Province. The statistical analysis was conducted to understand its evaluation on the core competitive ability of clinical medicine graduates in Taishan Medical University from year 2010 to 2015.Results Employers are highly competent at vocational ability and ideological quality of graduates in Taishan Medical University. However, Employers evaluate that scientific literacy is still acceptable and workplace performance is not perfect.Conclusions Higher medical education should integrate resources inside and outside the school, enhancing the vocational ability, promoting scientific research innovation quality and professionalism based on a more comprehensive understanding of real learning as well as training outcomes of students. References | Related Articles | Metrics

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Application effect of virtual bronchoscopy in bronchoscopy operation test Tang Chunli, Zhou Ziqing, Chen Yu, Zhong Changhao, Chen Xiaobo, Liu Yuping, Li Shiyue 2019, 39 (2):  133-139.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.009 Abstract ( 64 )   PDF (871KB) ( 13 )   Objective To evaluate the application effect of virtual bronchoscopy in bronchoscopy operation test.Methods This study used experimental control method. Thirty participants who have completed 3 months of basic bronchoscopy training course in The First Affiliated Hospital of Guangzhou Medical University were divided into two groups randomly. Experimental group were tested by virtual bronchoscopy, and control group were tested by clinical patients (with prior consent). The test scores and the time used for test of the two groups were analyzed.Results The test score of the experimental group was (64.8±7.2) points, the test score of the control group was (67.6±8.4) points, and the difference was not statistically significant(t=-1.39,P=0.16). The time used for test in experimental group was (611.8±43.9) seconds, the time used for test in control group was (602.1±23.3) seconds, and the difference was not statistically significant(t=0.22,P=0.82).Conclusions The virtual bronchoscopy is reliable for bronchoscopy operation test in test scores and in the time used for test. In the future, we can try to apply more virtual bronchoscopy in bronchoscopy operation test, and thus provide some references for other institutions to carry out bronchoscopy operation test. References | Related Articles | Metrics

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Comparative study on continuing medical education system in BRICs Ma Zhen, Tong Chi, Zhu Binhai, Zhang Yanwen, Wang Xiongguo, Bi Xiaoming 2019, 39 (2):  140-146.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.010 Abstract ( 34 )   PDF (805KB) ( 20 )   Through the comparative study of continuing medical education systems in BRICS countries, the theory of institutional change in economics was introduced into the field of continuing medical education. Using North's theory of institutional change to reform and improve the current continuing medical education system, it is clear from the perspective of national theory that the state should act as a supplier of the system, add new state statutory specialized management institutions, promote the implementation of the registration system of doctors and continuing medical education, and build a large data tube for continuing medical education in China. Based on the perspective of property rights theory, the rights and obligations of professions, units and individuals in the work of continuing medical education should be sorted out, and the credit system of continuing education should be implemented. References | Related Articles | Metrics

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Implications of French medical education system to China Hu Dan, Liu Meicen, Wang Yisi, Liu Xiaoyun 2019, 39 (2):  147-152.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.011 Abstract ( 101 )   PDF (813KB) ( 46 )   After series of reforms, China's medical education system has made significant achievement, but is still facing many challenges. To further improve China's current medical education system, to establish a health professionals' training system tailored to China's context, and to promote its sustainable development, this study systematically reviewed literature on the medical education system in France. The study focus on the remodeling and implementation process of medical college education and continuing medical education in France, and on the comparisons of differences in the medical education process between China and France. Finally, some scientific and feasible suggestions are put forward to improve China's medical education system. References | Related Articles | Metrics

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The enlightenment of psychosomatic competence training for doctors in western countries Huang Lei, Cheng Liming, Cui Haisong, Zhang Ying, Guan Xiaofeng, Zhao Xudong 2019, 39 (2):  153-160.  DOI: 10.3760/cma.j.issn.1673-677X.2019.02.012 Abstract ( 48 )   PDF (845KB) ( 18 )   The importance of “bio-psycho-social” model and problems related to psychosomatic medicine have been paid attention to, which puts forward new requirements for physicians in the field of psychosomatic medicine. The training experience from western countries will provide enlightenment for China. This study introduced the origin and two typical clinical practice models of psychosomatic medicine as well as the relationships between psychosomatic medicine and other disciplines; proposed to draw lessons of psychosomatic medicine competence training in western countries represented by Germany and the United States so as to create our training system after localization revision. References | Related Articles | Metrics