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01 July 2019, Volume 39 Issue 7 Previous Issue    Next Issue

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Insiting on the two great principles of higher medical education and promoting the four returns of higher medical education Zhu Junyong 2019, 39 (7):  481-485.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.001 Abstract ( 58 )   PDF (794KB) ( 35 )   In the new epoch, the National Conference on Undergraduate Education in Colleges and Universities has put forward that the principle of “taking undergraduate education as the foundation” should be adhered to and the “four returns” should be promoted. This article elaborates on the promotion of “four returning” in higher medical education, which is based on the two principles that higher medical education is elite education and is also professional education. In order to return to common sense, it is requested that the cultivation of medical students' core values be emphasized, the requests for students' learning capacity be clarified, the output quality of talent training be strictly controlled, and students guided to be learning-based and concentrate on study. In order to return to one's duty, teachers need to be motivated to focus on teaching, be guided to achieve not only the good reputation of behavior and skills but also the excellence on medicine and education, become a guide for medical students to grow up healthily by devoting themselves to education. In order to return to the original self, it is necessary to strengthen the construction of school spirit, teaching spirit and study spirit, pay attention to the construction of campus culture, highlight the construction of teaching quality culture and to build a good education culture. In order to return to dreams, it is necessary to innovate in concepts, institutional mechanisms, organizational management and certification systems, promote the cooperation of medicine and education, deepen the comprehensive reform of medical education, and improve the quality of medical personnel training, which will lay profound foundations for achieving a higher medical education which meets the social needs and subsequently reach the goal of healthy China and China with rich resource of education. References | Related Articles | Metrics

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The organization and thinking of the 5th National Undergraduate Basic Medical Innovation Forum and Experimental Design Competition Luo Ziqiang, Qin Xiaoqun, He Xiaofan, Han Jianzhong, Tan Sipin, Zhang Xinping, Wang Kangkai 2019, 39 (7):  486-490.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.002 Abstract ( 44 )   PDF (799KB) ( 19 )   The National Basic Medical Innovation Forum and Experimental Design Competition is the most important national college student discipline competition in the basic medical learning stage of medical students. On the basis of brief introduction of previous competitions, this paper mainly introduces the characteristics and innovative work of the academic organization of the 5th National Basic Medical Innovation Forum and Experimental Design Competition, and further discusses how to better organize the competition and puts forward corresponding suggestions, continuing to enhance the academic influence of the competition and provide more for participants. References | Related Articles | Metrics

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Practice and reflection on the modularization of specialist training program Li Xiangrui, Hu Yazhou 2019, 39 (7):  491-494.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.003 Abstract ( 40 )   PDF (780KB) ( 19 )   This paper analysized the problems in the training of specialist physicians in China and recommended a “modular training”. Combine with experience of its application in the training of oncology specialists, the author explored the strategic significance of modularization training in the training of specialist doctors, providing a new pathway to facilitate the development and implementation of the training policies for specialist doctors. References | Related Articles | Metrics

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Research progress in job burnout of medical college teachers in China Zhang Jin, Cao Depin, Li Yanchao, Xu Jiaming 2019, 39 (7):  495-498.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.004 Abstract ( 68 )   PDF (782KB) ( 27 )   Based on the analysis and collation of the relevant literatures on teachers' job burnout in medical colleges and universities in China, this paper summarizes the main manifestations, degrees and influencing factors of job burnout in this field, and analyzes its causes from the aspects of teachers' professional nature, school organizational environment, individual intrinsic characteristics and social comprehensive factors. In view of this, the intervention strategies are put forward from the individual, school and social levels of teachers, and the direction of future exploration is prospected. It is of great significance to alleviate the burnout of medical college teachers, improve the physical and mental health of medical college teachers, improve their sense of professional achievement and improve the teaching quality in medical colleges and universities. References | Related Articles | Metrics

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Analysis of the effect of medical ethics teaching by a group of clinicians and humanistic teachers Wang Xiaoye, Han Tongyan, Zhang Shudong, Liu lei, Xie Guangkuan, Cong Yali 2019, 39 (7):  499-502.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.005 Abstract ( 36 )   PDF (817KB) ( 26 )   Objective To explore the teaching outcome of medical ethics course jointly by clinical teachers and humanities teachers. Methods A total of 286 students from eight-year curriculum enrolled from 2007 to 2013 in Health Science Center Peking University were selected for clinical practice in Peking University Third Hospital from May 2012 to May 2018, Four clinical teachers and two medical humanities teachers form medical ethics teaching team, Medical ethics is taught for two months a year in total 30 hours. Every year after the end of the course, the students'acceptance of medical ethics teaching team is investigated by questionnaire, and the teaching outcome is evaluated. Results There were 86.7% (248/286) students expressed their interest in medical ethics, 83.2% (238/286) students thought that the study of the medical ethics could adjust their clinical thinking, 78% (223/286) students also hoped to discuss further, 93.4% (267/286) students expressed their satisfaction with medical ethics, 54.9%(157/286)students thought the course of medical ethics should run through the stages of basic medicine science, clinical medicine and secondary discipline stage. Conclusions The physicians' participation in the teaching of medical humanities courses stimulate students' interest, Improve students' learning satisfaction. Medical ethics learning should run through all stages of medical learning. References | Related Articles | Metrics

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Application of narrative medicine in orthopaedic clinical clerkship teaching Liu Changwen, Lyu Zhi, Song Wenhui, Guan Haishan, Li Yuan, Huo Jiang 2019, 39 (7):  503-506.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.006 Abstract ( 61 )   PDF (788KB) ( 45 )   Objective To explore the role of narrative medicine teaching in orthopaedic clinical clerkship. Methods Totally 87 medical students of “5+3”integrative mode of grade 2013 of Shanxi Medical University were enrolled in the teaching of narrative medicine in orthopedics clinical clerkship. The empathy level of students before and after teaching was measured by Jefferson scale of empathy, and the students' approval of teaching were investigated through questionnaires. Results The score of empathy after teaching was (114.5±10.9), which was higher than that before teaching (101.2±12.0), the difference was statistically significant (t=21.83, P<0.05). The results of the questionnaire survey showed that 75.9% (66/87) had a strong interest in narrative medicine teaching, and 98.9% (86/87) suggested continuing the teaching. Conclusions The teaching of narrative medicine in orthopaedics clinical clerkship can improve students' empathy ability, and well accepted by the students'. References | Related Articles | Metrics

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The effect of teachers simulate standardized patients in psychiatric anchored practice teaching Zhang Ming, Chen Minhua, Zheng Liarong, Guan Nianhong, Gan Zhaoyu 2019, 39 (7):  507-512.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.007 Abstract ( 34 )   PDF (821KB) ( 20 )   Objective To explore the effects of teachers' simulation standardized patients in the psychiatric anchored practice teaching. Methods The five-year undergraduate intern trainees of clinical medicine at Sun Yat-sen University were randomly divided into three groups, the classic anchored teaching group (classic group, 34 students), improvement of anchored teaching group (modified group, 36 students),“teachers' simulation standardized patients” anchored group (TSSP group, 32 students), and use “psychiatric practice teaching quality of classroom assessment questionnaire” to evaluate the teaching effect. Results Classic group of autonomous learning factor points factor, teaching methods, teaching process, curriculum design factor of factor and scale total score were (21.47±1.42),(17.09±1.19),(21.44±1.54),(22.41±1.37),(82.41±2.90) respectively, modified group of autonomous learning factor points factor, teaching methods, teaching process, curriculum design factor of factor and scale total score were (21.83±1.50),(17.69±1.56),(22.25±1.75),(22.92±1.96),(84.69±3.85) respectively. TSSP group of autonomous learning factor points factor, teaching methods, teaching process, curriculum design factor of factor and scale total score were (23.03±1.62),(18.25±1.46),(23.66±1.21),(23.41±2.20),(88.34±3.01) respectively, the three groups were statistically significant in the autonomous learning (F=9.57, P<0.05), the teaching method (F=5.56, P<0.05), the teaching process (F=17.73, P<0.05) and total scores of scale (F=26.99, P<0.05). The TSSP group was superior to the modified group (P<0.05) in the comparison of scores of independent learning factors, teaching process factors and total scale scores. In terms of factors of independent learning, factors of teaching methods, factors of teaching process and total scores of the scale, TSSP group was superior to the classical group (all P<0.05).In addition, in terms of teaching process factors and total scores of the scale, the modified group was superior to the classical group (all P<0.05). Conclusions It is more effective to use “teachers simulate standardized patients” in anchorage teaching, which can be further popularized in psychiatric practice teaching. References | Related Articles | Metrics

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Application of external auditory canal model combined with traditional teaching method in the training of endoscopic otologic surgery Zhuang Huiwen, Ren Hongmiao, Liu Min, Xiong Guanxia, Wu Xuan 2019, 39 (7):  513-515.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.008 Abstract ( 30 )   PDF (767KB) ( 18 )   Objective To explore the application of external auditory canal model combined with traditional teaching method for improving the teaching quality. Methods All 50 refresher doctors of sun yat-sen university were divided into experiment group and control group. Experiment group added an extra practice of external auditory canal model. The differences between the two groups in practice and subjective evaluation were analyzed. Results The trarnees in experiment group was significantly less than the control group in terms of the times of touching the external auditory canal [(2.52±0.65) vs (3.76±0.93)], the times of teachers' help [1(1,2) vs 2(2,2.75)] and the time of completion[(18.62±3.09) vs (24.08±4.05)] (all P<0.05). The experiment group was better than the control group in operation proficiency [(7.92±0.76) vs (6.88±0.98)] and teaching method evaluation [(9.80±0.41) vs (7.96±0.98)](all P<0.05). Conclusions External auditory canal model combined with traditional teaching has obvious advantages in the training of endoscopic otologic surgery. As an efficient teaching tool, it plays an important role in the training of trainees. References | Related Articles | Metrics

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Application effect of knowledge and skills competition in medical genetics teaching Song Hanjun, Ma Shuxia, Jin Yuelei, Zhang Jinbo 2019, 39 (7):  516-520.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.009 Abstract ( 21 )   PDF (803KB) ( 11 )   Objective To explore the application and effect of knowledge learning and skills competition of medical genetics. Methods A total of 182 students were selected from the 2015 clinical medicine major of Jiamusi University. Among them, class 1 and class 2 including 93 students were experimental groups, class 3 and 4 including 89 students were control groups. By the end of medical genetics course, medical genetics knowledge and skills competition was conducted in the experimental group. The student’s grades in the experimental group consisted of 60% of the final period and 40% of the routine scores. The routine grades consisted of usual attendance and classroom participation discussions (20%), experiment (10%), knowledge and skill competition (10%).By the end of the course, medical genetics knowledge and skills competition was not conducted in the control group. Both groups were evaluated by the same test paper. The student's grades in the control group consisted of 60% of the final period and 40% of the routine scores. The peacetime grades consisted of usual attendance and classroom participation discussions (20%), experiment (20%). The assessment form informs the students in the first class and allows the students to take appropriate learning methods. The teaching effect is evaluated by the two sides of the questionnaire and by the examination results. Results The average score of the experimental group was significantly higher than that of the control group (t=4.47, P<0.01), but the percentage of students who fail to pass the test, there was no statistically significant (χ2=1.04, P>0.05). The results of questionnaire survey showed that most of the students in the experimental group were recognized for medical genetics knowledge and skills competition, experimental group is higher than the control group ( all P<0.01) in the active learning skills of this course; experimental group is higher than the control group ( all P<0.01) in the development of comprehensive ability. Conclusions The development of knowledge and skills competition in medical genetics can stimulate students’ love for the course, cultivate their ability self-learning, clinical thinking and clinical practice. References | Related Articles | Metrics

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Study on the application of mind mapping combined with PDCA cycle teaching in emergency nursing practice Yuan Na, Wu Xueying, Qin Wei, Yang Sha, Wang Ying, Zong Yan, Wang Ping, Yang Qin 2019, 39 (7):  521-524.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.010 Abstract ( 60 )   PDF (788KB) ( 31 )   Objective T o evaluate the application of mind mapping combined with PDCA cycle teaching in emergency nursing practice, so as to provide basis for improving the quality of nursing practice teaching. Methods A total of 120 undergraduate nursing students working in the emergency department of the Second Affiliated Hospital of Dalian Medical University from July 2016 to April 2018 were selected as the research subjects, and they were randomly divided into experimental group and control group, with 60 students in each group. The experimental group adopted the mind map combined with PDCA cycle teaching to find the problems in emergency nursing practice through PDCA, and solved the problems with the clear context of mind map. The students in the control group adopted conventional clinical teaching. The satisfaction, training outcome and improvement of clinical reasoning of the two groups of students were compared. Results After continuous quality improvement, the experimental group students' satisfaction with teaching methods was 100.0%(60/60), the satisfaction with teachers' attitude was 93.3%(56/60), the control group students' satisfaction with teaching methods was 80.0%(48/60), the satisfaction with teachers' attitude was 76.7%(46/60), the difference was statistically significant (χ2=13.333, 6.536, all P<0.05). The excellent rate of theoretical achievement and the excellent rate of skill operation examination in the experimental group are higher than those in the control group, and the differences are statistically significant (χ2=6.988,4.415, all P<0.05); The total score of clinical thinking ability and scores of all dimensions of experimental group students are higher than those of control group students (t=-2.975, -4.573, -7.371, -5.702, all P<0.05). Conclusions The application of mind mapping combined with PDCA cycle teaching in emergency nursing practice can effectively improve the satisfaction of trainee, and improve the excellent rate of trainees' theoretical knowledge and operation skills, and improve their clinical reasoning. References | Related Articles | Metrics

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Comparative studies on the master of occupational therapy education in mainland, Hongkong and Taiwan area of China Hu Nan, Pan Cuihuan, Liu Yuanwen, Fu Zhen, Jiang Rongrong, Chen Yan, Fan Maohua, Ye Zhengmao 2019, 39 (7):  525-530.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.011 Abstract ( 42 )   PDF (849KB) ( 25 )   Hongkong and Taiwan area have relatively mature experience in the master of occupational therapy education.Based on the analysis and comparison of the enrollment system, training objectives, curriculum design, teaching mode, awarding degrees and assessment methods in mainland, Hongkong and Taiwan of China, several policy recommendations were made, in order to improve the master of occupational therapy education in mainland China. References | Related Articles | Metrics

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Application of CDIO based new tutorial system in dental resident standardized training for creation ability Li Shue, Yao Yao, Xiong Min, Sun Haitao, Geng Jinhuan, Wu Yan, Chen Lili 2019, 39 (7):  531-534.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.012 Abstract ( 51 )   PDF (785KB) ( 39 )   Objective T o explore the new tutorial system based on C(conceive), D(design), I(implement) and O(operate) (CDIO) applied in dental resident standardization for creation ability. Methods Residents from Department of Stomatology, Union Hospital, Tongji Medical College, HUST starting training in 2016 and 2017 that were chosen with 16 in experimental group and 16 in control group. CDIO based tutorial system and regular administration were applied separately to evaluate ability of study, creation and operation by questionnaire and exams. Results There was no statistically significant on the total score of study ability assessment between experiment group (201.06±9.77) and the control one (189.63±21.32) (t=1.95,P=0.06). However, the score on time administration and information processing of experimental group was significantly higher than that in control group[(26.69±3.07) vs (23.94±3.66)][(26.43±2.73) vs (23.25±3.28)][(t=2.30,P=0.03),(t=3.15,P=0.01)]. Innovation ability in experimental group (48.13±8.14) was significantly higher than that of control group (40.56±1.36) (t=3.67, P<0.01). There were no statistically significant between groups in theory and operation score (all P>0.05). Conclusions This model may improve the innovation capacity of trainees. References | Related Articles | Metrics

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Application of direct observation of procedural skills as formative evaluation in surgical residency training Liu Bing, Qi Dianjun 2019, 39 (7):  535-538.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.013 Abstract ( 50 )   PDF (826KB) ( 40 )   Objective T o discuss the effect of direct observation of procedural skills (DOPS) as formative evaluation in surgical residency training. Methods A total of 64 students in surgery residency training were randomly assigned to the experimental group (n=32) and the control group (n=32) . The clinical skill training of the control group was conducted by the traditional teaching method. DOPS was used in the experimental group as the formative evaluation. Both groups are trained by same group of teachers. After 2 month rotation, theoretical examination, medical record writing evaluation, Mini-CEX and clinical skill operation test were applied to evaluate the learning outcomes. SPSS 22.0 software was used for statistical analysis. Results The scores of clinical skill operation test of the experimental group (82.31±4.40) was higher than that of the control group (78.22±6.95), it showed statistically significant (t=-2.817,P<0.05). The scores of Mini-CEX of the experimental group (6.59±0.56) was higher than that of the control group (6.13±0.49), it showed statistically significant (t=-3.558,P<0.05). There was no statistically significant between the theoretical examination scores of the experimental group (80.31±7.51) and the control group (79.09±7.27) (t=-0.660,P>0.05). There was no statistically significant between the experimental group's medical record writing scores (79.68±7.54) and the control group (77.63±7.47) (t=-2.817, P>0.05). Conclusions DOPS as formative evaluation in the surgical residency training definitely increase the score of mini-CEX and clinical skill operation test, and improve the teaching outcome. References | Related Articles | Metrics

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Reliability and validity of the Chinese version of Self-Assessment of Clinical Reasoning and Reflection in nursing undergraduates Yu Jie, Wang Jialin, Wang Mingyu, Guo Aimin, Kang Xiaofeng 2019, 39 (7):  539-544.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.014 Abstract ( 187 )   PDF (867KB) ( 102 )   Objective T o test the reliability and validity of Chinese version of Self-Assessment of Clinical Reasoning and Reflection (SACRR). Methods Totally 228 undergraduates majoring in four-year nursing from 2014 to 2016 in Peking Union Medical College were tested by Chinese version of SACRR. Two weeks later, 30 subjects were selected to fill in Chinese version of SACRR again and test the retest reliability. The data of reliability and validity were analyzed by SPSS 22.0 software. Results The Cronbach's α of the SACRR was 0.754, and the total scale retest reliability was 0.785.The content validity of the scale (S-CVI/Ave) was 0.98. Four factors were extracted by using Exploratory Factor Analysis: Information System, Analysis of Problems, Finding Truth and Reflective Ability, the cumulative variance contribution rate was 57.336%.In this study, the scores measured by Chinese Version of Critical Thinking Disposition Inventory (CTVI-CV) were used as the existing criteria for validity testing.The criterion-related validity test showed that the content of Chinese version of SACRR was significantly correlated with the three dimensions of CTDI-CV: truth-seeking, systematic ability and self-confidence, Pearson correlation coefficient was 0.215, 0.172, 0.343 (all P<0.05). Conclusions Chinese version of SACRR has good reliability and validity, which provides a reference for evaluating the clinical reasoning ability of nursing students in the future. References | Related Articles | Metrics

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Application of multisource assessment and feedback in medical education Liu Yuenan, Yang Wenbo, Ye Zhewei, Shao Zengwu, Wang Hong, Yang Cao, Huang Wei 2019, 39 (7):  545-549.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.015 Abstract ( 33 )   PDF (852KB) ( 26 )   Multisource assessment and feedback (MSAF) is a formative evaluation method based on questionnaire survey, which has been widely used in medical education in recent years. This review discussed MSAF probing in medical education and feasibility analysis emphatically. The basic procedures of incorporating MSAF into medical education evaluation were analyzed in detail. Finally, it pointed out that how to design an objective and comprehensive questionnaire, how to set up a special research team to improve feasibility of MSAF and how to collect an efficient feedback were the main challenges that needed to be studied when MSAF was included in the medical education assessment system. References | Related Articles | Metrics

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Construction of network examination system and its application in graduation examination of clinical medical students Chen Chen, Chen Lifen 2019, 39 (7):  550-552.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.016 Abstract ( 17 )   PDF (762KB) ( 13 )   As a new examination model, network examination system has been more and more used in medical examination. This paper analyzed the background and necessity of network examination, elaborated the construction of software and hardware platform, function realization and practical application of network examination system for graduation examination for clinical degree, pointed out the advantages of network examination, and summarized the practical significance of network examination system for graduation examination of medical students. References | Related Articles | Metrics

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Analysis and reflection on the examination achievement of community health practice for five-year program students major in clinical medicine Ji Yan, Yan Chunze, Sun Yange, Ding Jing 2019, 39 (7):  553-558.  DOI: 10.3760/cma.j.issn.1673-677X.2019.07.017 Abstract ( 35 )   PDF (858KB) ( 24 )   Objective Analyze the examination achievement of community health practice of five-year program students major in clinical medicine in Capital Medical University, and provide reference for accumulating experience in improving the quality of undergraduate community health practice. Methods Analyses the scores of general medical theory test, health education test and problem-oriented medical record writing of 171 five-year program students major in clinical medicine from the Capital Medical University who practiced at Yuetan Community Health Service Center from 2014 to 2018. Results The pass rate of the general medical theory was 100.0%, and the scores were basically in accordance with the normal distribution. The average score was (71.04±8.29). The examination content includes chronic non-communicable diseases, knowledge about general medical and preventive health care. The difficulty of the test paper was 0.64~0.81, the reliability was 0.56~0.70, and the discrimination degree was 0.14~0.22. The average score of health education test was (85.10±15.83) and the average score of problem-oriented medical record writing was (93.59±5.05).The excellent rate of the general medical theory, health education test and problem-oriented medical record was 31.6% (54/171)、95.4% (163/171)、100.0% (171/171). For the results of the general medicine theory examination, the excellent rate of the students practiced in 2015 was the highest (81.8%), next was the students practiced in 2018 (43.2%), the different between the two was statistically significant (χ2=5.944, P<0.05). Conclusions The pass rate and excellent and good rate of community health practice for five-year program students major in clinical medicine were higher. It is necessary to improve the quality of community health practice by strengthening the construction of test questions, paying attention to concept teaching and reforming assessment methods to further improve the quality of community health practice. References | Related Articles | Metrics