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01 August 2019, Volume 39 Issue 8 Previous Issue    Next Issue

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Thoughts on the problems of high quality development of comprehensive university medical education in the new era Lyu Shaochun, Song Hanjun 2019, 39 (8):  561-565.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.001 Abstract ( 69 )   PDF (826KB) ( 38 )   In the new era,the situation of medical education in China has undergone significant and profound changes.Medical universities not only carry the historical mission of providing multidisciplinary talent support for the modernization of education,but also are endowed with the tasks and requirements of holding high quality medical education and promoting the construction of “healthy China”.Based on the above understanding,this paper interprets the connotation of high quality development of medical education in the new era,thinking about the current situation features of domestic medical education such as the multilateral exploration of management mode of comprehensive university medical education,and listing the main problems in medical education,discussing the ideas and countermeasures to solve these problems in the future,in order to achieve the goal of high quality development of medical education. References | Related Articles | Metrics

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Research on teaching improvement of resident standardized training based on process method Luo Linzhi, Zhang Shuyang, Pan Hui, Zhu Huijuan, Long Xiao, Xue Huadan, Shi Yuxi, Wei Yizhen, Zhao Jun, Chang Xing 2019, 39 (8):  566-569.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.002 Abstract ( 84 )   PDF (937KB) ( 32 )   Teaching evaluation is an important link in the improvement of resident standardized training.In the construction of residential training teaching improvement system,the process method can be fully used.Peking Union Medical College Hospital uses process method to improve residential education,strengthening the assessment,analyzing and improving process in past teaching practice,and building a plan-do-check-action (PDCA) quality cycle based on the process method.The hospital takes internal self-evaluation and external expert evaluation of implement situation,and uses strengths-weaknesses-opportunities-threats (SWOT) tools to analyze the results of residential education evaluation.Finally,based on SWOT analysis results,targeted improvement measures are put forward. References | Related Articles | Metrics

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Research and practice of rural doctors' free order oriented training mode Wen Maoxing 2019, 39 (8):  570-573.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.003 Abstract ( 41 )   PDF (762KB) ( 15 )   The shortage of rural doctors is a challenge in the construction of rural health service system.The way to train the tuition-free oriented rural doctors in a mode of “order-oriented training” by both local government and schools is effective to respond to this challenge.Xiangyang Polytechnic mode has conducted useful exploration and research in this regard in recent years.It has carried out industry research,formulated the personnel training program,actively raised funds to conduct joint enrollment and targeted cultivation,through methods including literature consultation,questionnaire surveys,expert discussions,etc.Therefore,a “mode with Xiangyang Polytechnic characteristics” to cultivate rural doctors was established,through which a number of special courses and special teaching materials were developed,and a group of rural doctors were trained,which made great contribution to poverty alleviation in the areas where they provide health-care service. References | Related Articles | Metrics

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Optimization of ecological elements in medical English teaching from the perspective of educational ecology Qi Hui, Feng Xin 2019, 39 (8):  574-580.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.004 Abstract ( 55 )   PDF (954KB) ( 15 )   Based on the theoretical model of Stevens language teaching process,this paper studies the ecological elements of medical English teaching and their relationship,and investigates the strategies for optimizing each element,from the perspective of educational ecology,in order to improve medical English teaching in medical universities,and to meet social needs for excellent physician education and training.The results show that policy made by both the government authority and the university,language teaching and education theories,teaching objectives,teaching methods,curriculum,teaching resources,construction of teaching staff,learner characteristics and education evaluation are all elements in medical English teaching ecological environment,and they are in complementary relation.Only with all elements optimized a sustainable medical English teaching ecology could be built and ultimately contribute to the cultivation of high-quality medical staff. References | Related Articles | Metrics

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Medical specialized English teaching for postgraduates in colleges and universities of traditional Chinese medicine from the perspective of students' learning needs Xiong Linxiao, Shi Jing, Zhao Xia 2019, 39 (8):  581-585.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.005 Abstract ( 41 )   PDF (831KB) ( 17 )   With accelerated globalization of traditional Chinese medicine (TCM),TCM colleges and universities are paying more and more attention to cultivate medical specialized English proficiency for postgraduates.This study investigated learning needs of postgraduate students in Beijing University of Chinese Medicine through questionnaires and interviews and discussed major implications on postgraduate medical specialized English teaching.The survey results were analyzed in five aspects:students' English proficiency,course selection reasons,learning content,teaching activities and requirement of teachers.It is recommended to set diversified English courses according to students' English proficiency,to enhance their ability in using medical terms based on their learning needs,to strengthen their initiative and enthusiasm of learning medical specialized English,and to increase training more qualified teachers instructing medical specialized English. References | Related Articles | Metrics

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Application of WeChat learning platform combined with problem-based learning teaching model in gynecological refresher physician training Yang Mukun, Mao Lele, Wang Zijun, Bai Wenpei 2019, 39 (8):  586-589.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.006 Abstract ( 51 )   PDF (775KB) ( 25 )   Objective To evaluate the effect of WeChat learning platform combined with problem-based learning (PBL) teaching model in refresher physician training of gynecology.Methods A total of 63 refresher doctors who studied in Obstetrics and Gynecology Department of Beijing Shijitan Hospital were selected as observation group (PBL+ WeChat group,n=30) or control group (PBL group,n=33) randomly.Knowledge of abnormal uterine bleeding (AUB) and job competency score were used to evaluate the training effect.Results Compared with pre-training and post-training,the competency of PBL+WeChat group in clinical basic ability [5(4,5) vs 2(1,3)],medical professional quality and spirit [5(4,5)vs 4(3,4)],basic public health service ability [4(4,5) vs 3(2,4)] was significantly improved,with statistical significance (all P<0.05).AUB average knowledge points of PBL+ WeChat group were 76.00±19.41 which were significantly higher than 61.52±22.10 of PBL group (t=2.753,P=0.008).Conclusions WeChat learning platform combined with PBL teaching model can help to improve clinician's clinical skills and job competency. References | Related Articles | Metrics

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Application of case-based learning method in clinical practice education for medical imaging technology students Yuan Yuan, Deng Liping, Tang Hehan, Pan Xuelin, Li Yuming, Wang Ziwei, Qian Lingling, Li Zhenlin 2019, 39 (8):  590-593.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.007 Abstract ( 83 )   PDF (777KB) ( 41 )   Objective To explore the application of case-based learning method in the practice teaching for medical imaging technology undergraduates.Methods A total of 46 undergraduate interns from the 2015 four-year medical imaging technology of Sichuan University were recruited.They were divided into 2 groups:experimental group(23 persons) and control group(23 persons).Case-based learning method was used in experimental group,and the traditional lecture based learning method was used in control group.The theoretical-test scores,operational-test scores and questionnaire results of the two groups were compared.Results The subjective,total and operational scores of the experimental group were higher than those of the control group,with statistical significance [(28.29±2.18)vs (23.50±3.34),(74.17±6.79)vs(69.46±6.02),(75.75±5.37)vs(70.42±5.88),all P<0.05].The stimulation of subject interest,the mobilization of classroom atmosphere,the cultivation of clinical thinking,the exercise of self-study ability and the analysis of difficult problems were better than those of the control group.The differences were statistically significant [4 (3,4) vs 3 (2,3),4 (3,4) vs 2 (2,3),4 (3,4)vs 2 (2,3),4 (3,4) vs 2 (2,2),3 (3,4) vs 2 (2,3),all P<0.05].Conclusions Case-based learning method in the practice teaching of medical imaging technology may improve undergraduates'clinical analysis ability,practical operation ability,learning enthusiasm and self-learning ability. References | Related Articles | Metrics

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The teaching efficiency comparison between the combination of micro-course teaching with traditional teaching pattern and traditional teaching pattern in teaching of heart failure Li Yuxian, Huang Minjiang, Wang Chunfeng, He Xiaojin, Long Sha, Xu Guoyao, Cao Xiangyu, Jin Ling 2019, 39 (8):  594-597.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.008 Abstract ( 47 )   PDF (804KB) ( 29 )   Objective To reform the traditional teaching pattern of Heart Failure theory by evaluating the application efficiency in the teaching of heart failure,which is the combination of micro-course with traditional teaching pattern.Methods Totally 232 five-year undergraduate students of eight classes of 2015 from Hunan University of Medicine,who major in clinical medicine,were randomly divided into experimental group and control group,with 116 students in total for each group.Apply the new teaching pattern which combined micro-course with traditional teaching to the experimental group on the lectures of Heart Failure.On the other hand,the traditional teaching pattern was adopted to the control group.Use the theoretical test method to understand the learning situation of the two groups.Employ questionnaire survey method to reveal the experimental group students' evaluation to the new teaching pattern which combined micro-course with traditional teaching.Results The average scores of the experimental group(75.34±8.86) in classroom examination was higher than the control group(65.28±8.04).There was a statistical significance between the two groups(t=9.06,P<0.01).Questionnaire indicated that students from the experimental group evaluate that the new teaching pattern combined micro-course with traditional stimalated thier interests and improved their capacity solve problems,make the key points convenient to memorize and activate classroom teaching.Conclusions The new teaching pattern combined micro-course with traditional teaching adapted to the characteristics of heart failure,which is an efficient and practical teaching method to stimulate the students' learning motivation and improve the teaching quality. References | Related Articles | Metrics

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Application comparison of animal skin and artificial skin in simulated training of clinical skills Wang Zuowei, Wang Lan, Liu Xiaoxu, Wang Peizhong, Yu Hao, Liu Deping 2019, 39 (8):  598-600.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.009 Abstract ( 37 )   PDF (1125KB) ( 11 )   Objective To evaluate the effect of animal skin and artificial skin in clinical suture skills training.Methods Forty-eight medical students who received standardized training were enrolled in this study.The students were asked to perform 3 suturing tasks on the animal skins or artificial skins:neat wound suture (station 1);irregular wound suture (station 2);deep tissue suture (station 3).The skill and general performance were assessed by the Objective structured assessment of technical skills (OSATS) scoring tool.The service lives of 10 animal skins and 10 artificial skins were investigated.Results In station 1,the scores were 14.8±2.1 in animal skins group and 14.6±1.8 in artificial skins group,there was no statistical difference between the two groups (P=0.666).In station 2,the scores were 13.9±1.9 in animal skins group and 12.1±2.1 in artificial skins group,and the score of animal skins group was significantly better than that of artificial skins group (P<0.01).In station 3,the scores were 12.8±2.0 in animal skins group and 11.4±2.1 in artificial skins group,and the score of animal skins group was better than that of artificial skins group (P=0.03).The service life of animal skin was (4.5±1.2)hours,and that of artificial skin was (13.5±2.6)hours.The difference was significant (P<0.01).Conclusions In neat wound,the suture skills training in animal skins and artificial skins have the same effect.In suture training of irregular wound and deep tissue,the animal skins are better than artificial skins. References | Related Articles | Metrics

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Studying on Mini-clinical examination exercise in standardized training of residents Hou Tiantian, Zhang Qin, Ma Yongjian, Niu Xiaochen, Zhang Yongqing, Wu Dawei, Zhang Lei, Qu Yi 2019, 39 (8):  601-604.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.010 Abstract ( 63 )   PDF (804KB) ( 17 )   Objective To compare and analyze the results before and after improvement of Mini-clinical examination exercise(Mini-CEX).To explore a more reliable evaluation method of Mini-CEX.Methods Mini-CEX data evaluation from January 2016 to December 2017 was included in this study.All data was divided into two groups based on the results of “before improvement” and “after improvement”.Distribution of scores and interquartile range were analyzed.Results A total of 1 354 sets were included in this study.Specifically,686 sets of score were in the “before improvement”,whereas 668 sets were in the “after improvement” group.The scores before improvement were distributed in full mark,while the scores after improvement were evenly distributed between 6 and 8 points.The interquartile range of the “after improvement” scores was different from the“before improvement”.Conclusions The interquartile range of the Mini-CEX before improvement was poor.The score distribution after improvement became wider.This can make the assessment closer to the real situation of the resident. References | Related Articles | Metrics

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Application of the case-based morning report in standarized residency training of general surgery Yang Jin, Wang Zhifei, Yu Xiaojun, Pan Danhong 2019, 39 (8):  605-609.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.011 Abstract ( 78 )   PDF (822KB) ( 53 )   Objective To explore the application effect of the case-based morning report in the standardized training of redidents in the department of general surgery.Methods The experimental control method was used in this research.Fourty-three resident in standardized resident training program from October 2016 to January 2018 in the gastroenteropancreatic division of general surgery of Zhejiang Provincial People's Hospital were recruited and were randomly divided into two groups.Twenty-two students participating in the case-based morning report defined as the experiment group,and Twenty-one students participating in the traditional shift group defined as the control group.After the training,the questionnaire survey results and the score of the theoretical test of the two groups were compared.And the teacher evaluation reports were also collected.Results The score of the theoretical test of the experiment group and the control group were (88.1±3.8) and (82.8±4.4) respectively,and the difference was statistically significant (t=4.26,P<0.01).The students in the experimental group showed that the case-based morning report had more significant effects on improving their ability of the patient record writing,illness evaluation,auxiliary result interpretation,clinical thinking and medical paper writing(all P<0.05).The scoresof experiment group were 9(8.0,9.0),7.5(7.0,8.0),8(7.0,9.0),8(8.0,9.0),6(4.0,7.3),5(3.0,6.0)respectively.The scores of the control group were 5(4.0,6.5),6(5.5,7.0),2(1.0,2.0),6(4.0,7.0),3(2.0,4.0),2(1.5,3.0) respectively.Scores of satisfaction of experimental group were significantly higher than those in the control group [8(7.8,9.0) vs 7(6.5,8.0),Z=2.83,P<0.01].The teacher's questionnaire survey showed that all teachers believed that case-based morning report would be helpful to train the students' clinical practice ability,and thought that case-based morning report would be helpful to better understand the students' learning outcome.Most of the teachers were satisfied with the case-based morning report.Conclusions The case-based morning report is helpful to train the clinical reasoning,skill and the competency of resident students.The teaching effect in the standardized training of general surgery are satisfactory and worth popularizing. References | Related Articles | Metrics

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Investigation on professional identity of nursing undergraduates in four universities in Beijing area Qin Dan, Zhang Lichuan, Ma Xueqian, Zhang Tong, Wang Di, Yu Miao, Kou Leipeng, Han Xiaoxu, Lu Qian 2019, 39 (8):  610-615.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.012 Abstract ( 65 )   PDF (844KB) ( 24 )   Objective To investigate the professional identity of nursing undergraduates in Beijing area and analyze its influence factors,so as to provide references for improving the professional identity of nursing undergraduates in the future.Methods From March to May 2018,a total of 579 full-time nursing undergraduates in four universities in Beijing area were investigated by questionnaire,and the influence factors were analyzed.Results The total score of professional identity of undergraduate nursing students was 83.58±11.18.Only 35(6.0%)students were highly identified with their major.Converted to 0~100 score scale,the average scores of professional expectation,professional skills,professional understanding,professional values,professional will and professional emotion were 83.50,76.35,52.95,48.75,47.33 and 47.00 respectively.The factors influencing the professional identity of nursing undergraduates were their grades,whether or not they have relatives to engage in medical-related professions and the sources of professional intention.The above three factors could explain 15.7% of the total variation.Among them,the total score of professional identity of the fourth grade students was lower than that of the other three grades.The total score of professional identity of the students with relatives engaged in medical-related occupations was higher.The professional will of the students from themselves and their parents was higher than that of other students.Conclusions Nursing undergraduates' professional identity level is not high.The professional identity can be improved through the reform of nursing education,the improvement of clinical learning and working environment. References | Related Articles | Metrics

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Multi-disciplinary team nursing mode plus problem-based learning in the training of emergency nursing Zeng Zhu, Ding Yu 2019, 39 (8):  616-619.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.013 Abstract ( 43 )   PDF (774KB) ( 24 )   Objective To explore the learning outcome of multi-disciplinary team(MDT) plus problem-based learning(PBL) model in the training of emergency nursing.Methods A total of 270 students majoring in nursing enrolled in 2013,2014 and 2015 in Renmin Hospital,Wuhan University were selected as research objects,126 intership trainees selected from December 2016 to June 2017 as control group and 144 from July 2017 to February 2018 as experimental group.The control group used lecture-based learning methods and the experimental group used MDT mode combined with PBL.Results The experimental group theory test (36.96±2.56),emergencyassessment(35.44±2.28) and comperehensive ability assessment(18.48±1.06) were significantly higher than the control group(35.92±2.48),(34.05±2.16),(17.32±1.02).The trainees' satisfaction of in the experimental group (35.18±3.98) was significantly higher than that in the control group was(28.22±2.94).Conclusions MDT combined with PBL mode improve the students' achievement and comprehensive ability,and cultivate students' emergency capacity,so as to enhance the analysis and problem solving ability,to lay the foundation for the furure clinical work. References | Related Articles | Metrics

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The effects of the blended learning applied in the course of health assessment on rain classroom Jiang Zhaoquan, Zhou Shixue, Zhang Huijun 2019, 39 (8):  620-623.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.014 Abstract ( 41 )   PDF (775KB) ( 22 )   Objective To evaluate the effects of the blended learning applied in the course of Health assessment on rain classroom.Methods There were 120 undergraduate nursing students who were enrolled in 2017 from Jinzhou Medical University as the research subjects.The students were randomly divided into experimental group and control group with 60 in each.The experimental group adopted mixed teaching method based on rain classroom,while 60 students in control group adopted lecture-based learning.This paper evaluates the mixed teaching method based on rain classroom through the students' theoretical assessment results,self-learning ability scale and teaching effect satisfaction scale.Results The scores of theoretical assessment,autonomous learning ability and teaching satisfaction of students in the experimental group were (47.39±3.41),(90.23±10.38) and 95.0% (57/60),while those in the control group were (39.61±3.52),(70.45±11.41) and 68.3% (41/60) respectively.The scores of theoretical assessment,autonomous learning ability and teaching satisfaction of students in the experimental group were higher than those of the control group.There were statistically significant (all P <0.05).Conclusions The mixed teaching method based on rain classroom improves the students' capacity of theoretical assessment and of self-learning,and improves the students' learning satisfaction. References | Related Articles | Metrics

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Analysis of the results of the second stage clinical comprehensive skills examination of clinical physician certification test by the students from Peking University Health Science Center Ma Junhong, Wang Jingchao, Zhou Yufei, Liu Hong 2019, 39 (8):  624-629.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.015 Abstract ( 34 )   PDF (810KB) ( 26 )   Objective To analyze and to evaluate the second stage clinical comprehensive skills examination results of clinical physician certification test by the students from Peking University Health Science Center.Methods Totally 188 students from Peking University Health Science Center have obtained valid results in the second stage of examination of clinical practitioners certification test in 2018.Those examination results were selected as the study subjects.SPSS 19.0 was used to test the internal consistency reliability,structural validity and criterion validity of the students' clinical comprehensive skill scores,and to analyze the differences among different groups of examinees.Results The average scores of the 188 students from 1~6 test stations of the clinical comprehensive skills examination were 9.81,13.67,12.72,7.25,16.56 and 16.94 respectively,with a total average score of 77.45.The internal consistency reliability Cronbach's alpha coefficient was 0.379 in the six test stations.The correlation coefficient between the scores of each examination station and the total scores of clinical comprehensive skills were 0.392~0.529.Spearman correlation coefficient r=0.320 between the results of the second and third stations.The correlation coefficient between the total scores of the first four stations of clinical comprehensive skills in the second stage examination and the scores of case analysis in the graduation examination was 0.286.The correlation coefficient between the total score of the 5th and 6th stations and the skill operation score of the graduation examination was 0.187.The correlation coefficient between the total score of clinical comprehensive skills in the second stage examination and the total score of clinical skills in the graduation examination was 0.347.There are slight differences in the examination results of different categories of students.Conclusions The reliability and validity of the second stage clinical comprehensive skills examination results of clinical practitioners certification in Peking University Health Science Center in 2018 are only mediocre and so further scientific analysis and rational design are needed.The university should strengthen the training of clinical reasoning and clinical skills of medical students. References | Related Articles | Metrics

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Application of information-based clinical thinking simulation training and assessment system in the evaluation of clinical thinking ability of students majoring in clinical medicine Huang Hua, Ma Yuan, Wang Ning, Gao Xingya 2019, 39 (8):  630-634.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.016 Abstract ( 102 )   PDF (828KB) ( 32 )   Objective To take objective structured clinical examination (OSCE) as an example to explore the application of online virtual diagnosis and treatment platform in the evaluation of clinical thinking ability of medical students.Methods Based on the study on the connotation of clinical thinking ability,an OSCE assessment scheme was constructed,and an information-based clinical thinking simulation training and assessment system was used,and totally 692 students were assessed.Results The difficulty coefficient of the four test sites was 0.34~0.55 (average 0.48),the difference was 0.01~0.53,the reliability was 0.72,and the validity was 0.74.The platform was easy to operate to implement assessment.Conclusions The application of online virtual diagnosis and treatment platform in OSCE can objectively and effectively evaluate the clinical reasoning of medical students. References | Related Articles | Metrics

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Implications of the breast oncology fellowship in the United States of America to China Zhang Xiang, Yin Xuedong 2019, 39 (8):  635-640.  DOI: 10.3760/cma.j.issn.1673-677X.2019.08.017 Abstract ( 34 )   PDF (756KB) ( 32 )   Specialist training is the only way to support the development of disciplines and the training of specialists.At present,the United States has established a relatively complete training system for tumor specialists covering all cancers,especially the breast specialists.The American Society of Surgical Oncology has approved 46 medical centers as training bases to help surgeons grow into breast specialists.In this article,a detailed introduction of the breast oncology fellowship training system in the United States of America is presented which includes its objects and requirements.It is very valuable and meaningful to depict an entire system of foreign fellowship training for one reason that a domestic fellowship training about breast can be built up based on their experience and medical resource in our country. References | Related Articles | Metrics