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01 September 2021, Volume 41 Issue 9 Previous Issue    Next Issue

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Analysis of medical education policy texts in China from the perspective of policy tools Guo Haichen, Zhang Min, Li Qinglin, Zhang Shue, Cao Depin, Yang Libin 2021, 41 (9):  769-774.  DOI: 10.3760/cma.j.cn115259-20210223-00238 Abstract ( 211 )   PDF (877KB) ( 192 )   Medical education policy is the criteria document guiding the development of medical education in China. The choice and application of medical education policy tools have direct impact on implementation the policy. Taking the national medical education policy documents from January 1, 2003 to September 30, 2020 as the research object, using the content analysis method and grounded theory to evaluate following categories by “building analysis framework, sample selection, text unit coding, classification and data analysis”so to make an overall investigation on China's medical education policy from the aspects of policy release time and quantity, policy instruments and policy value characteristics. The results show that there are different medical education policy issuing departments releasing documents with poor legal effect and uneven value characteristics, the use of policy instruments is mainly complementary. Therefore, suggestions are put forward as follows: to clarify the main body of policy content, improve the medical education system with innovative strategy and flexibility in application of policy instruments, so to promote a balanced development of the value characteristics of medical education policy. References | Related Articles | Metrics

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The orientation and strategy of faculty development center in medical school of university Gao Qilong, Li Qin, Xu Lingxiao 2021, 41 (9):  775-779.  DOI: 10.3760/cma.j.cn115259-20201109-01556 Abstract ( 104 )   PDF (863KB) ( 86 )   Center for faculty development is a professional institution to improve teaching in universities and colleges, which is of great significance to realize the connotative development of high education in China. Medical education is a key component of high education. With the increasing attention paid to medical education in recent years, the promotion of teaching capacity building of medical teachers has become increasingly urgent. Some universities have organized the center of faculty development at medical school level. Based on literature review, this paper systematically summarizes the establishment, mission and objectives, functions of faculty development center at medical school in top universities and analyzes the challenges and strategies for future development. References | Related Articles | Metrics

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The introduction to integrated curriculum for clinical medicine program in Peking University Health Science Center Lu Man, Wang Jingchao, Liu Hong 2021, 41 (9):  780-784.  DOI: 10.3760/cma.j.cn115259-20210322-00382 Abstract ( 315 )   PDF (857KB) ( 320 )   Since 1990s medical schools in China have initiated curriculum integration at different coherence level, Peking University Health Science Center has been exploring curriculum integration since 2006 then implemented in 2020 with different models covering horizontal integration, vertical integration and spiral integration. This paper summarizes the characteristics of the integrated curriculum, the background, design and implementation of the curriculum in medical education, proposes the key points in the development of an integrated curriculum and some suggestions for providing experience as well as reference to be shared by other medical schools. References | Related Articles | Metrics

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The integrated curriculum remodeling in medical education from the perspective of medical students Chen Huizhu 2021, 41 (9):  785-788.  DOI: 10.3760/cma.j.cn115259-20210326-00416 Abstract ( 251 )   PDF (790KB) ( 218 )   It is an inevitable trend in medical education worldwide that medical students should gain a systematic and integrated knowledge package through their learning. In the fall of 2020, Peking University Health Science Center initiated a New Era organ-system oriented integrated curriculum to be implemented in undergraduates enrolled in 2019. Based on the pedagogy theories supporting the integrated curriculum development and the practice atPeking University Health Science Center, this paper proposed the challenges in curriculum implementation and suggestions for optimizing the curriculum from the perspective of learners. References | Related Articles | Metrics

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Analysis of the current situation of oral genetics teaching in China Zhang Yanli, Duan Xiaohong 2021, 41 (9):  789-792.  DOI: 10.3760/cma.j.cn115259-20210317-00362 Abstract ( 86 )   PDF (796KB) ( 51 )   Objective To review the current education status of oral genetics in China for the initiation and promotion the course in future. Methods A questionnaire survey was conducted among 105 teachers who participated in the continuing education program of “Popularization and practice of Oral Genetics course” in 2020. Results Totally 30.0% (15/50) of the schools have offered the relevant courses or lectures. These 105 teachers directly participated in teaching practice and 64.8% (68/105) of them expected to open the course within five years. There were 72.4% (76/105) of teachers agreed that the course should be offered to undergraduates and postgraduates and 93.3% (98/105) preferred to the traditional theoretic teaching and case-based learning. Conclusions Consistent with expectation, the education status of oral genetics has been improved and entered a growing stage. More and more teachers expected to open the course in the near future. References | Related Articles | Metrics

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Research progress on academic burnout of medical students Xue Bowen, Luo Hong, Hu Zhiguo 2021, 41 (9):  793-798.  DOI: 10.3760/cma.j.cn115259-20210331-00437 Abstract ( 219 )   PDF (904KB) ( 175 )   Academic burnout is a common phenomenon among medical students. This paper summarizes the detection rate and distribution characteristics of academic burnout of medical students in China and in other countries, the factors of learners' side like learning attitude, psychological and physiological situation and environmental factors including family, school and social factors. This paper also summarizes psychology and other intervention methods for academic burnout of medical students. Finally, some suggestions are put forward on the future research of academic burnout of medical students in China, such as large sample survey, development process investigation, effective intervention and prevention. References | Related Articles | Metrics

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Investigation on cognition and anxiety status of trainees receiving standardized resident training for COVID-19 pandemic Huang Xiaohan, He Xie, Zhu Bingjing, Deng Caixia, Bian Shizhu, Li Yang, Luo Hu 2021, 41 (9):  799-802.  DOI: 10.3760/cma.j.cn115259-20201208-01690 Abstract ( 82 )   PDF (802KB) ( 76 )   Objective To understand the knowledge gain and psychological status of residents of standardized training program on the emerging coronavirus pneumonia (COVID-19), to provide a reference to the teaching departments of the school for development of methods to improve capacity building of trainees. Methods A questionnaire survey was implemented and.154 trainees from three hospitals affiliated to Army Medical University participated in this investigation by questionnaires star platform. Data was collected and analyzed by Excel and SPSS 22.0. Results It was found that 72.7% (112/154) of the trainees believed that the improvement of their awareness about COVID-19 pandemic and their personal protection skill was mainly learnt from training courses organized by the hospital in the early stage of the pandemic; 85.7% (132/154) of them believed that skill training significantly improved personal protection skills, and 95.5% (147/154) of them believed that it was very important to strengthen the training on these infectious diseases. The results also showed that 55.2% (85/154) of the trainees suffered from different degrees of anxiety. The incidence of moderate-to-severe anxiety was much lower among those who believed the pandemic was preventable(χ2=24.8, P＜0.05);Among the trainees who participated in skill training more than two times, the incidence of moderate-to-severe anxiety is lower than those who participated in the protection skill training less than 2 times( χ2=11.9, P＜0.05); The better the mastery of the new coronary pneumonia protection skill,the lower is the incidence of moderate-to-severe anxiety as compared to the individuals with poor knowledge(χ2=13.7, P＜0.05), while there was no significant correlation between the degree of education, grade, major and anxiety status. Conclusions In the early stage of the COVID-19 pandemic, most of the trainees receiving standardized resident training are not well trained with the protection skill against to deal with acute contagious diseases,thus the knowledge and skills training related to the COVID-19 pandemic organized by the hospital is necessary. Facing an emerging pandemic, the incidence of anxiety is high in resident training trainees and the teaching management department needs to pay attention to their mental health and provide necessary psychological support including personal consultation. References | Related Articles | Metrics

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Research on influencing factors of medical students' autonomous learning based on qualitative analysis Zhao Chenxi, Yang Libin, Zhu Liyan, Tian Jing, Li Qinglin, Wang Yanping, Cao Depin 2021, 41 (9):  803-806.  DOI: 10.3760/cma.j.cn115259-20210127-00131 Abstract ( 182 )   PDF (792KB) ( 162 )   Autonomous learning plays a very important role in the academic growth of medical students. This paper discusses the influencing factors of medical students' autonomous learning, so to provide a basis for improving students' autonomous learning capacity and teaching methods. The results show that the influencing factors of medical students' autonomous learning include learning motivation, learning interest, career planing, learning achievement, peer influence of dormitory, external environment and teachers. The influencing factors of medical students' autonomous learning are diverse. Medical colleges and universities can improve students' awareness and autonomous learning from three aspects: the establishment of guidance system, the construction of learning dormitory and the change of teachers' role orientation. References | Related Articles | Metrics

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Application of case-based learning in the teaching of medical microbiology Yang Yin, Guan Yuanzhi 2021, 41 (9):  807-809.  DOI: 10.3760/cma.j.cn115259-20210226-00256 Abstract ( 134 )   PDF (781KB) ( 134 )   Objective To explore the effect of a case-based learning method in the teaching of medical microbiology. Methods One hundred and sixty undergraduates from 8-year program of clinical medicine enrolled in 2016 and 2017 in Peking Union Medical College (PUMC) joined this research. Controlled trial method was applied in the study; 86 students from grade 2017 were assigned to the experimental group and 74 from grade 2016 to the control group. The experimental group was intervened with case-based learning, while traditional teaching was applied in the control group. Final exam analysis of both groups and anonymous questionnaires from the experimental group were used to evaluate the teaching effects. Results The scores of final exam of the experimental group and control group were (61.4±3.8) and (59.7±4.4) respectively(P＜0.05).The new teaching method was thought to be effective facilitation of basic knowledge into clinical use by 90.7%(78/86) students as well as stimulation of students' learning interests by 84.9%(73/86) students. Conclusions Case-based learning can support students' learning, promote the understanding of occupational application of knowledge in future and thus stimulating students' learning interests. References | Related Articles | Metrics

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Application of teaching clinic with reflective teaching during internship of obstetrics and gynecology Hou Yanru, Wu Yan, Wang Jianliu, Chen Zhe 2021, 41 (9):  810-813.  DOI: 10.3760/cma.j.cn115259-20210109-00043 Abstract ( 85 )   PDF (796KB) ( 82 )   In the background of observation practice as a mainstream, in order to promote the institution-based learning and professional development of medical students in a real clinical environment, the reflective teaching method was applied in the training at Obstetrics and Gynecology. By analyzing the survey data of 426 eight-year program students who participated in clerkship of Obstetrics and Gynecology in Peking University People's Hospital from 2010 to 2019, this paper expounds the process of clinical training in teaching clinic with reflective teaching methods. The author summarizes the effect of this method.The results showed that the score of the students' satisfaction with the teaching affairs was (96.00±3.38). It is suggested that the implementation of reflective teaching method in Obstetrics and Gynecology clerkship by eight-year program students has a good teaching effect. It provides students with learning opportunities to fully participate in clinical practice. References | Related Articles | Metrics

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Application of interactive case teaching in after-class learning of rehabilitation medicine for eight-year program medical students Zhao Xiaoyi, Shu Xuan, Chen Zhengwei, Chen Lixia 2021, 41 (9):  814-817.  DOI: 10.3760/cma.j.cn115259-20210329-00422 Abstract ( 99 )   PDF (798KB) ( 113 )   Objective To explore the application and effect of interactive case teaching in after-class learning of rehabilitation medicine for eight-year program undergraduates. Methods From March 2020 to October 2020,fifty five students of Grade 2014 in Peking Union Medical College were selected as the experimental group, while 55 students of Grade 2015 were selected as control group. After classes of basic theory, the experimental group received interactive case teaching as homework, while the control group completed their homework in traditional way. Results of assessment and questionnaire were used to evaluate learning outcomes. Results Both groups were qualified in the assessment. The survey showed that, compared to the students of control group, the capacity of communication, collaboration, patient care and life-long learning of students in experiment group was significantly higher [8.0(7.7,9.0)vs. 7.0(6.0,8.7),8.0(7.8,9.0)vs. 7.5(6.8,8.5),8.7(8.0,9.0)vs. 7.7(6.3,8.3)] with statistical significance (all P＜0.01). The experimental group also showed higher satisfaction score in the homework and the course [9(9, 10) vs. 9(8, 10), 9(8, 10) vs. 8(7, 9)] with statistical significance (all P＜0.05). Time consumption [(4.28±0.14) vs. (4.35±0.16) ]showed no difference(t=-0.3,P=0.764). Conclusions Interactive case teaching as a kind of after-class learning of rehabilitation medicine can significantly improve capacity building of eight-year program medical students with higher satisfaction. References | Related Articles | Metrics

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Innovation of teaching method and technology for undergraduate course of ophthalmology Yang Ning, Jin Siyan, Qin Hecong, Shi Lijun, Li Yutong, Zhao Jinsong 2021, 41 (9):  818-821.  DOI: 10.3760/cma.j.cn115259-20210310-00320 Abstract ( 122 )   PDF (838KB) ( 95 )   Eye health is a major medical and social issue. Understanding the diagnosis and treatment of major eye diseases is an essential capacity of medical. The current challenge is how to provide students with efficient ophthalmology knowledge in the over-packaged undergraduates' curriculum. This article reviews the innovative teaching method and educational technology in the world, including innovative teaching method of ophthalmology theory, assistant technology, and new methods for evaluation of ophthalmology's operational level. The purpose of this article is to allow ophthalmology educators to choose the appropriate method and technology applied in ophthalmology teaching within a limited time. References | Related Articles | Metrics

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The application of the Feynman Technique for practical teaching of prosthodontics Wang Xiaofei, Chen Qing, Sun Yanyan, Tong Weifeng, Niu Wenzhi 2021, 41 (9):  822-825.  DOI: 10.3760/cma.j.cn115259-20210204-00167 Abstract ( 1430 )   PDF (801KB) ( 718 )   Objective To evaluate the teaching effects of Feynman Technique for skill training of prosthodontics. Methods In May 2020, 45 students were selected from Xuzhou Medical University's 2017 undergraduates majoring in stomatology as the research objects, their scores of dental preparation and questionnaire results were analyzed and compared. Totally 45 senior students were randomly divided into three groups with 15 in each. Students of group A underwent the Feynman Technique, they were taught by tutors for teeth preparation firstly and then they taught the students in groups B and C. After the teaching work was over, the students in group A prepared teeth again, which was recorded as group A+. The results of the students' tooth preparation were evaluated by the digital system (DHC 220). The system evaluated the preparation results from the four groups as A, B, C, and A+ respectively. The questionnaire was distributed to students in 3 groups of A, B and C after completing the teaching experiment. The results of the questionnaire were tested by Kruskal-Wallis H to compare whether the results of 5 items between different groups were the same. The tooth preparation scores were analyzed by The Variance analysis and then compared between groups by LSD method. Results The scores of dental preparation in groups of A, B, C, and A+ was (74.6±4.7), (73.7±6.4), (74.1±6.4)and(84.4±5.3). Analysis of variance on the scores of tooth preparation showed that the scores of each group were not the same(F=6.088, P＜0.05). A+ group is significantly different from the other groups after the test of LSD (all P＜0.05). There was no significant difference in the results among the three groups A, B, and C (all P＞0.05). The Kruskal-Wallis H test results of the questionnaire showed that there were differences in the results of the two items between the groups which was item 2 “Whether the new learning method is helpful to improve the level of relevant theoretical knowledge”(χ2=15.724, P＜0.05) and item 4 “Does the new learning method improve your non-professional capacity?”(χ2=11.161, P＜0.05). Conclusions Feynman Technique has showed good teaching effects in the skill training of prosthodontics. References | Related Articles | Metrics

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Survey on online learning satisfaction and analysis of influencing factors of different types of medical students during the COVID-19 pandemic Zhao Feng, Wang Jili, Zhu Xinli, Yao Guorong, Lu Zhongjie, Yan Senxiang 2021, 41 (9):  826-830.  DOI: 10.3760/cma.j.cn115259-20201116-01589 Abstract ( 110 )   PDF (814KB) ( 128 )   Objective To evaluate the learning satisfaction and find influencing factors on online learning in medical students from Zhejiang University during COVID-19 pandemic for improving the online learning. Methods From April to May 2020, 201 undergraduates, graduate candidates for master and doctor degree from Zhejiang University School of Medicine were investigated by questionnaire. Descriptive statistics, χ2 test and ordinal polytomous logistic regression were used in the analysis of results. Results It was found that 27.9% (56/201) and 40.3% (81/201) of students were very satisfied or relatively satisfied with online learning respectively. Ordinal polytomous logistic regression analysis showed that educational category and majors were independent factors affecting online learning satisfaction. The online learning satisfaction of candidates for professional master degree was 3.734 times higher than that of candidates for academic doctor degree (OR=3.734, P=0.049), while the satisfaction of candidates for academic master degree is 7.808 times higher than that of candidates for academic doctor degree (OR=7.808, P=0.004). Conclusions During COVID-19 pandemic, medical students are generally satisfied with online learning. Educational category is the key factor affecting their online learning satisfaction. Candidates for professional master degree, academic master degree show higher satisfaction with online learning, suggesting that online teaching should be adjusted according to different educational category, so as to further improve the learning outcomes of online teaching. References | Related Articles | Metrics

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Investigation of online teaching in pre-medical and basic medical phases during the prevention and control of COVID-19 pandemic Gu Feng, Li Yujing, Xue Shilin, Meng Chang, Qi Wenxiu, Yin Zhaodi, Li Meiyao 2021, 41 (9):  831-834.  DOI: 10.3760/cma.j.cn115259-20201218-01735 Abstract ( 75 )   PDF (800KB) ( 51 )   Objective To evaluate the online teaching for undergraduates at the pre-medical and basic medicine stage in Peking University Health Science Center during COVID-19 pandemic period and to provide reference for improving the quality of online teaching. Methods Self-designed questionnaire was used in this study. A total of 105 five-year program undergraduates of clinical medicine and eight year program of basic medicine at the education stages of pre-medicine and basic medicine and 10 teachers were selected from February 24 to March 1, 2020.The comparison between online teaching and traditional teaching in terms of strengthens and weakness was implemented. The data were analyzed by Fisher's exact test. Results Compared with the traditional teaching, 37.1% (39/105) of the students and 6 teachers considered that the effect of online teaching was equal to traditional teaching and 39.0% (41/105) of the students and 3 teachers thought that the teacher's in teaching plan document was 125% higher than that in traditional teaching and 35.2% (37/105), 19.1% (20/105), 4.8% (5/105) of the students and 3, 2 and 1 teachers thought that in online teaching environment, the classroom interaction decreased to 75%, 50% and 25% respectively. There was no significant difference between students and teachers in the evaluation of the adequacy of lesson preparation and the effect of classroom interaction (all P> 0.05). Teachers listed three advantages of online teaching as the feasibility of reviewing after class, the teaching time and place were more flexible and the students in different classes were able to join the course simultaneously; Teachers listed three difficulties of online teaching as barrier to implement the training of lab experiment, surgical operation and other clinical skills, the network is sometimes stuck, and students' learning situation were not able to be followed. There were 63.8% (67/105) of the students and 8 teachers thought that online teaching was a complementary pathway for traditional teaching at moment. Conclusions In the online teaching, the teachers are better prepared for the lesson, but the classroom interaction is not as good as that in traditional pathway. The current teaching mode should still be based on traditional pathway and online teaching function as a complementary technology to traditional teaching. References | Related Articles | Metrics

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Exploration of the application of virtual simulation technology combined with problem-based learning in neurology internship and practice Chen Junhan, Li Yujing, Chen Weicheng, Cai Kaiyu, Lyu Wenqi, Chen Xiangrong, Lin Zhenzhen 2021, 41 (9):  835-838.  DOI: 10.3760/cma.j.cn115259-20201221-01749 Abstract ( 160 )   PDF (836KB) ( 321 )   Clinical internship and practice are key stages for medical students to apply theory to clinical practice and therefore shift their roles from students to doctors gradually. Taking neurological diseases as an example, this paper analyzes the current situation of traditional medical education, proposes a new educational mode which combined virtual simulation technology with problem-based learning, and objectively analyzes the advantages of this new model in training process of clinical internship at different level, furthermore, provides experience and references for promotion of this training method in medical education. References | Related Articles | Metrics

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Investigation and analysis of requirement of medical function experiment training by students with different specialties Jia Shi, Cong Xin, Liu Cheng, Kang Jihong, Zheng Ming, Wang Jinyu, Wu Liling 2021, 41 (9):  839-844.  DOI: 10.3760/cma.j.cn115259-20201126-01635 Abstract ( 53 )   PDF (871KB) ( 39 )   Objective To explore the more scientific and effective methods of medical function experiment course through investigating and analyzing the requirements and suggestions from students of different specialties. Methods A questionnaire was designed to investigate requirements and suggestions from 925 undergraduate students in many items covering their experience before, during and after the training course of medical function experiment. Chi-square tests were applied to statistical analysis of each option. Results Concerning the expectation of training time length, the proportions of students who chose 21 to 30 minutes were 43.6%(199/456) and 39.1%(75/192) by students of clinical medicine and of basic medicine respectively , which were higher than students of preventive medicine [20.9%(14/67)]. Meanwhile, the results showed that 92.7%(178/192) basic medicine students would prefer teachers to explain more detailed and profound experimental principles and this percentage was higher than that of other students. During animal experiments, more students of clinical medicine [88.8%(405/456)] and of basic medicine 88.0%(169/192) were willing to deal with potential problems by themselves under teacher's instructions than students of preventive medicine [70.2%(47/67)]. More clinical and basic medicine students favored an independent learning manner than students from other majors, the scores were(1.48±1.60)and(1.56±1.74)respectively, which were higher than preventive medicine (0.97±1.27)(all P<0.0083). Conclusions Based on the feedback, it is necessary for us to flexibly adjust training strategy for creating a specific and smart system to teach experiment course and improving the training outcomes. References | Related Articles | Metrics

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A quantitative method to evaluate the capacity of medical graduates' cognition on ethical issues Liang Hao, He Lingyu, Zhang Xinqing 2021, 41 (9):  845-848.  DOI: 10.3760/cma.j.cn115259-20210105-00014 Abstract ( 65 )   PDF (802KB) ( 40 )   Objective To explore the method of case analysis combined with quantitative analysis to evaluate the capacity of medical graduates in recognizing and analyzing ethical issues. Methods Based on the ethical issues presented in stem cell therapy from clinical case,the questionnaire was distributed to 176 graduates enrolled in 2019 in Peking Union Medical College and the influencing factors of the questionnaire scores were analyzed with a self-designed scale. Results The general result was well. 89.8% (158/176) graduate students recognized the problems like inadequate informed consent from patients, unacceptable risk-benefit ratio, lack of responsibility, but 50.1%(90/176) of students failed to evaluate the weakness linking to ethical principles and just 35.2%(62/176) of them fully demonstrated informed consent status of patients. The multivariate logistic analysis showed thatfemale students are 3.36 times than male students to fully discuss the informed consent (OR=3.36,95%CI was 1.27 to 8.88). Conclusions Most graduates can recognize ethical issues, while the capacity of analysis need to be improved especially for male students in terms of gaining informed consent. Method of quantitative research in case analysis may evaluate the ethical capacity of graduates and provide scientific evidences for improving ethical education. References | Related Articles | Metrics

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Practice and exploration of on-and-off line blended teaching and process management in the cultivationof professional medical graduates Zhou Fuling, Yu Jianing, Shang Yufeng, Wang Qian, Liu Yin, He Jing, Zhang Xian, Zhou Yi, Chen Fei 2021, 41 (9):  849-853.  DOI: 10.3760/cma.j.cn115259-20210122-00104 Abstract ( 113 )   PDF (955KB) ( 120 )   The goal of training of professional medical graduates is high-level talents with both scientific research capacity and clinical skills. Optimizing the training system is the issue of solicitude by people engaged in high education. During the pandemic of emerging coronavirus, infection, online teaching has played a pivotal role in medical education. In addition, the shortcomings of simple target management mode are increasingly found; therefore process management mode is developed and applied to practice. This article clarifies the application and evaluation methodology of online and offline hybrid teaching in the training of graduate students majoring in hematology, describes the application of online and offline hybrid teaching during the pandemic and the post-pandemic period, and analyzes the practice of process management in the training of graduate students majoring in clinical medicine. References | Related Articles | Metrics

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Study and construction strategy of online learning resource evaluation based on learning effect Shu Hui, Wu Xiuming, Leng Yanbing, Mao Ang, Chen Weizhong 2021, 41 (9):  854-858.  DOI: 10.3760/cma.j.cn115259-20201215-01716 Abstract ( 147 )   PDF (849KB) ( 110 )   Objective Based on the perspective of learners' learning effects, construct an online learning resource evaluation system to evaluate online course resources, and provide reasonable suggestions for improving the application effectiveness and construction level of online learning resources. Methods Taking the course resources in the online learning platform of a medical college in Chengdu as the research object, this paper constructed the evaluation index system, weight design and scoring standard of online course resources through Delphi method, collected the information related to the provision of course resources, the utilization of course resources and the learning effect of learners, and formed the scoring according to the standards. Results The score of learning effect evaluation of course resources was (7.5±0.9) points.There were statistically significant differences in learning effect scores among different course types (F=14.12, P<0.01), among which the scores of provincial excellent online course, university-level excellent online course and university-level general online course were [20(10,23)], [17(14,21)] and [14(5,20)] respectively. Conclusions Improving the quality of online course resources and optimizing the utilization of resources are effective ways to promote the construction of high-quality online learning resources and improve the learning effect. References | Related Articles | Metrics

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American medical education reformation guided by Flexner Report at the beginning of 20th century and its inspiration Yao Zelin, Ding Qing 2021, 41 (9):  859-864.  DOI: 10.3760/cma.j.cn115259-20210324-00400 Abstract ( 184 )   PDF (872KB) ( 160 )   Before the 20th century, medical education in the United States was quite confusing without entrance standards, lack of quality control in the education process, and standardized license system. Flexner Report released in 1910 started the dramatic changes in medical education in America, including development of standards of entrance and length of schooling, academic accreditation of faculty in medical schools, equipping laboratories and teaching hospitals, and changing fund sources of medical schools. These reforms had greatly improved the quality of medical education, promoted the professionalization of medicine, and turned doctors into an elite profession. However, it had also resulted in some problems, such as the barrier to lower-class people to obtain formal medical services. China should learn from the reformation of medical education in the USA, solve the problems of medical education system, school system, financial support, teaching staff and curriculum system, and provide guarantee for the health of the whole people. References | Related Articles | Metrics