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    01 July 2024, Volume 44 Issue 7 Previous Issue    Next Issue

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    A review of the Flexner Report
    Li Xiuyuan, Zhai Haihun
    2024, 44 (7):  481-486.  DOI: 10.3760/cma.j.cn115259-20240116-00055
    Abstract ( 74 )   PDF (857KB) ( 87 )  
    The Flexner Report (hereinafter referred to as the report) is a landmark report in the history of American medical education. The report is usually only considered as a historical record of the development of medical education in the United States at the beginning of the 20th century. In fact, from the perspective of medical education theory, it is a classic educational document. The concept of medical education expounded in the report is an important embodiment of Flexner's view on medical education and it formed the theoretical basis for the reform of medical education in the United States in the early 20th century, which is also one of its major contributions. The contribution of the report to American medical education has become a consensus in the academic field. However, when we have understood the complete path of medical education reform, we can see that its contribution is not only limited to that time. This article attempts to summarize the medical education concepts expounded by Flexner in the report and strives to review the impact of the report more comprehensively in a longer period of time from a historical and developmental perspective, hoping to provide inspiration for the current medical education reform.
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    Implementation effects of work management program for young pediatric teachers serving as class teachers
    Deng Hongmei, Zhu Jing, Liu Enmei, Zhang Zhiyong, Pan Bo
    2024, 44 (7):  487-491.  DOI: 10.3760/cma.j.cn115259-20231206-00552
    Abstract ( 77 )   PDF (868KB) ( 53 )  
    Objective To explore the effectiveness of the implementation of the management plan for young pediatric teachers to concurrently serve as pediatric class teachers in pediatrics,providing reference for the implementation of the class teacher system in colleges and universities. Methods From November 2021 to November 2023, the Pediatric College of Chongqing Medical University formulated a management plan for young pediatric teachers to concurrently serve as pediatric class teachers ( referred to as the ″plan″) in accordance with relevant documents from the Ministry of Education. The plan was organized according to Miller's Pyramid and optimized using action research methods. The study subjects were 1 231 students from five grades of the five-year pediatric specialty of the Pediatric College of Chongqing Medical University and 54 young pediatric teachers who concurrently served as pediatric class teachers (referred to as ″class teachers″). The effectiveness of the plan was evaluated through assessments by students and teaching management departments, as well as self-assessments by the class teachers. Using descriptive statistical analysis to analyze relevant data. Results A total of 823 valid questionnaires were collected from students. The students'scores for the class teachers were (63.47±5.20) points (out of 70), the scorse from the teaching management department for the class teachers were (7.28±1.68) points (out of 10), and the class teachers' self-assessment scores were(16.67±1.74) points( out of 20) .The class teacher assessment scores were as follows: 8(14.8%) were excellent (95-100 points), 24 (44.4%) were good (85-94 points), 11 (20.4%) were average (75-84 points),6 (11.1%) were poor (60-74 points), and 5 (9.3%) were very poor (below 60 points). A total of 83.5% (687/823) of the students indicated that they were ″full of gains″, with the top three areas of student gain being guidance for postgraduate entrance examination [72.9% (600/823)], academic planning guidance [55.4% (456/823)], and psychological counseling [21.1% (174/823)]. The class teachers summarized four key points in their work: understanding the students' situation [100.0% (54/54)], gaining students' trust [83.3% (45/54)], guiding students to clarify their goals [77.8% (42/54)], and leading students to the clinical setting to perceive the value of the profession [74.1% (40/54)]. Conclusions This plan is conducive to student growth and is recognized by students;it helps young teachers improve thir educational teaching abilities and helps teaching management departments refine their management work;this plan can provide a reference for other colleges and universities to implement the class teacher system.
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    Comparison of student engagement between non-mainland and mainland medical students
    Pan Sanqiang, Li Hongying, Wu Fengming, Li Yanxue
    2024, 44 (7):  492-496.  DOI: 10.3760/cma.j.issn.1673-677X.2020.04.000
    Abstract ( 83 )   PDF (866KB) ( 48 )  
    Objective To compare the differences of student engagement between non-mainland students and mainland medical students, so as to inform future improvement of non-mainland students' academic development. Methods The China national survey of student engagement was used to evaluate the non-mainland and mainland medical students at Jinan University from November 2022 to December 2022. Results The level of academic challenge of non-mainland medical students (477.88±134.64) was significantly lower than that of mainland students (547.79±121.96). The total scores of the supportive campus environment of non-mainland students (489.02±119.82) were also significantly lower than those of mainland students (538.12±131.60)(all P<0.001). In terms of active cooperative learning level [(293.90±101.83) vs.(287.65±107.76)], student teacher interaction [(264.26±166.51) vs. (258.80±176.20)], and educational experience richness [(718.29±200.13) vs. (707.59±194.23)], there was no statistically significant difference in total scores between the two types of students (all P>0.05). Conclusions The levels of academic challenge and supportive campus environment for non-mainland students were lower than those of mailand students. It is necessary to strength the academic requirements of nan-mailand students, and improve their satisfaction, so as to promote their academic development and achieve better growth.
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    Current status of nursing scientific research projects in 67 medical universities in China from 2016 to 2020
    He Huan, Zhang Jian, Wu Chunyan, Wang Xiuli, Li Hongyu, Wang jing
    2024, 44 (7):  497-501.  DOI: 10.3760/cma.j.cn115259-20231219-00597
    Abstract ( 35 )   PDF (840KB) ( 22 )  
    Objective to analyze from 2016 to 2020, the country's 67 higher medical colleges scientific research project subject of nursing science. Methods from November 2021 to collect higher medical colleges and universities from 2016 to 2020 by the country's 67 nursing discipline project project, using descriptive statistics to project project situation and research fields were analyzed. Results the project topic to collect 2 490 items, project funding 58 286.22 million yuan; Among them, 53(2.1%) were national projects, 1 086(43.6%) were provincial projects, 118(4.7%) were municipal projects, and 1 233(49.5%) were nursing industry projects. Research studies such as the top five for interdisciplinary collaboration 1 084(43.5%), 358 items (14.4%) were aged care , 352 items (14.1%) were nursing management and education, 290 items (11.7%) were chronic disease nursing, and 189 items (7.6%) were clinical nursing. Conclusions Nursing scientific research projects are mainly concentrated in provincial and ministerial level and industry projects. The number of nursing research projects increased moderately. The distribution of nursing research funds in different colleges and regions was unbalanced. Nursing research center of gravity match the national requirements; The research focus of the ″Nursing +X″ crossover project shifted.
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    Application of a clinical education reflection training among head nursing preceptors
    Pan Jingjing, Zheng Meizhen, Chen Xiaofang
    2024, 44 (7):  502-506.  DOI: 10.3760/cma.j.cn115259-20230727-00037
    Abstract ( 41 )   PDF (867KB) ( 29 )  
    Clinical educational reflection is one reflecting in clinical education settings. Once clinical educational reflection ability enhanced,deeper inspection and exploration through certain educational experience can be expected,furthermore,clinical education quality will be more likely to be improved. A clinical educational reflection training experiment was implemented among the head nursing preceptors of the Third Affiliated Hospital of Southern Medical University,of which the process of training design and steps were elaborated. Educational reflectional diaries,questionnaires and group-focused semi-structure interviews were applied to analyze the training effect. It was shown that not only the training was approved by the head nursing preceptors ,but also the ability of their clinical educational reflection was indeed improved after training.
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    Integrating ideological and political education into clinical courses by targeting key learning points
    Zhang Wenjie, Chai Hua, Qing Ping
    2024, 44 (7):  507-512.  DOI: 10.3760/cma.j.cn115259-20230516-00505
    Abstract ( 73 )   PDF (853KB) ( 67 )  
    To enhance the integration of ideological and political within clinical courses and foster the internalization of educational objectives in the affective domain, West China School of Medicine of Sichuan University has been implementing a strategy that focuses on integrating ideological and political elements into clinical courses by targeting key learning points since 2019. This article outlines the teaching design, execution process, and strategies employed in our approach, and the effectiveness of this approach was assessed through questionnaire survey, academic performance and students' feedback. In March 2024, the questionnaire survey was conducted for senior students majoring in clinical medicine. The findings indicate that 89.8%(247/275) of the students recognized the integration of ideological and political elements in clinical courses, with 88.4%(243/275) perceiving it as seamless and not awkward, 88.4%(243/275) of the students reported that their goals of professional competency were clarified, 87.3%(240/275) reported their professional identity and career aspirations were reinforced, and 88.7%(244/275) reported that it meets the expectation of practicing medical professionalism in clinical settings. Overall, 87.3%(240/275) of the students expressed satisfaction with the integration of ideological and political elements into clinical courses. The cases of students' academic evaluation and subjective teaching evaluation show that some students have internalized such education. The results reflect that this approach is well-aligned with the nature of clinical courses and contributes to the fulfilment of educational objectives.
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    A practical study on knowledge graph empowering medical basic education
    Yu Li, Deng Weimin, Zhang Shijie, Mo Jing, Wen Ke, Yan Jingrui
    2024, 44 (7):  513-516.  DOI: 10.3760/cma.j.cn115259-20230729-00055
    Abstract ( 74 )   PDF (826KB) ( 92 )  
    Objective To study the effectiveness of the self-developed knowledge graph software platform empowering basic medical teaching for clinical students. Methods Under the guidance of the subject teachers, the platform was opened as an assisted learning tool to 259 clinical students of Grade 2020 in Tianjin Medical University for 6 months, from January 2022 to July 2022. The students of Grade 2020 were used as the experimental group, and 248 students of Grade 2018 who were in the same major and had not accessed the platform ever were enrolled as the control group. Results of the Comprehensive Examination of Basic Medical Education Stage, organized by Tianjin Medical University, were compared. Mann-Whitney U test was used for statistical analysis. Results The total score of the students in experimental group [84.0(79.7, 88.0)] was significantly higher than that of the students in control group [69.0(59.5, 78.0)]; with respect to questions based on logical reasoning, the score of the students in the experimental group [67.6(55.5, 79.7)] was higher than that of the students in the control group [61.1(54.3, 73.6)]. All differences were statistically significant (all P<0.05). Conclusions Knowledge graph can significantly help students improve their learning effectiveness and enhance their logical reasoning ability.
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    Meta-analysis of the effect of internet-based blended learning in domestic medical education
    Wang Xinyuan, Wei Chang, Wang Xinyu, Gong Linjing
    2024, 44 (7):  517-522.  DOI: 10.3760/cma.j.cn115259-20230919-00275
    Abstract ( 56 )   PDF (880KB) ( 45 )  
    Objective This study aimed to analysis the effect of internet-based blended medical education in China. Methods Electronic searches ofPubMed, Medline, Embase, Web of Science, Wanfang, CNKI, and VIP databases were performed. Studies published from January 1, 2000 to June 4, 2023 on the comparison between internet-based blended medical education and traditional medical education in China were included. Quality evaluation analysis and meta-analysis were conducted. Results A total of 77 studies consisting of 13 379 students met the inclusion and exclusion criteria. The quality evaluation results of the included studies are all grade B, with a certain risk of bias and publication bias. According to the different types of courses, the included studies were divided into four subgroups: medical basic courses, medical specialized courses, clinical medicine practice courses, and clinical nursing practice courses. The average improvements of the knowledge test score of blended learning group in each subgroup were 7.18 (95%CI=2.25~12.11, P<0.001), 5.73 (95%CI=3.76~7.71, P<0.001), 5.51 (95%CI=3.03~8.00, P<0.001), and 5.66 (95%CI=1.84~9.49, P<0.001), respectively. The average improvements of the skill test score of blended learning group in each subgroup were 3.22 (95%CI=-0.66~7.10, P=0.100), 5.45 (95%CI=3.60~7.31, P<0.001), 6.14 (95%CI=4.40~7.89, P<0.001), and 7.62 (95%CI=5.14~10.10, P<0.001), respectively. Conclusions Internet-based blended learning can significantly improve the knowledge and skill test scores of almost all kinds of medical courses and students.
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    Application of fully immersive virtual technology-based simulation in cesarean section training
    Li Wei, Ma Siyuan, Bao Xiaozhong, Wang Sibin
    2024, 44 (7):  523-526.  DOI: 10.3760/cma.j.cn115259-20230801-00067
    Abstract ( 52 )   PDF (819KB) ( 49 )  
    Objective To explore the effect of fully immersive virtual reality (VR) technology in the teaching of cesarean section (CS) surgery. Methods From September 2 to 17, 2021, 13 undergraduate students of clinical medicine major of Southern Medical University and 4 junior residents of Nanfang Hospital of Southern Medical University were enrolled (hereinafter referred to as trainees). In the teaching of CS surgery, VR software was used to train the trainees, and the built-in scoring system of the VR software was used to assess the accuracy and completion time of the trainees in completing the CS surgical operation, and a questionnaire was used to investigate the trainees' satisfaction with the training. The t-test was used to compare the differences between the two groups. Results The scores of trainees completing CS surgical operation before and after the training were (52.94±19.06) and (85.47±3.39), and the operation time was (21.66±8.85) and (12.37±1.58) minutes, respectively, and the differences were statistically significant (all P<0.05). The results of the questionnaire survey showed that 16 out of 17 trainees believed that VR technology was beneficial for mastering the key points of surgical skills, enhancing clinical confidence, and hoped to incorporate VR technology into the routine skills training. Conclusions Fully immersive VR based for teaching CS surgery helps to improve trainees' mastery of the CS procedure, shorten operation time, and is generally recognized by trainees.
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    Application of AR teaching assistant system based on naked eye 3D technology in medical imaging for undergraduates
    Ma Li'na, Peng Rui, Xu Jingji, Wei Shengnan, Zheng Minwen, Huang Yayu, Ren Jing
    2024, 44 (7):  527-531.  DOI: 10.3760/cma.j.cn115259-20230607-00575
    Abstract ( 42 )   PDF (873KB) ( 40 )  
    Objective To explore the application of naked eye 3D Augmented Reality (AR) teaching assistant system in medical imaging for undergraduates. Methods From 2023 to 2024, medical imaging teaching research were carried out among the fourth-year students of the eight-year clinical medicine major of 2018 and 2019 grades in Air Force Medical University through experimental control methods. Fifty-two students from the 2019 grade were assigned to the study group, and the AR teaching auxiliary system based on naked-eye 3D technology were used for teaching, while 50 students from the 2018 grade were assigned to the control group and taught through traditional teaching methods. Course assessment and questionnaire survey were used to evaluate the teaching effect of medical imaging among the two groups of students. T-test and Mann-Whitney U test were used to analyze the data. Results The knowledge examination, practical skills testing and total scores of the experimental group were higher than those of the control group [(62.1±3.1) vs. (59.8±3.4), (22.9±2.4) vs. (21.1±2.6), (85.0±4.6) vs. (80.9±6.0), all P<0.05]. The Likert scores in interest, satisfaction, participation, learning effect and ease of understanding of students in the naked eye 3D AR assisted teaching group were all higher than those in the control group [5.0 (1.0) vs 4.0 (2.0), 5.0 (1.0) vs 4.0 (2.0), 5.0 (1.0) vs 3.5 (1.0), 5.0 (1.0) vs 4.0 (2.0), 5.0 (1.0) vs 4.0 (1.0), all P<0.05], and scores of the convenience of using the naked eye 3D AR medical imaging teaching assistance system APP and willingness to continue to use the software were high in the experimental group [both were 5.0 (1.0)]. Conclusions AR teaching assistance system based on naked eye 3D technology is a new and efficient teaching model for medical imaging for undergraduates. Compared with traditional teaching methods, it helps to improve students' learning interest, increase teaching interaction, improve teaching effect, and has a good application prospect.
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    A survey on the application status of standardized patients in medical education
    Wang Lijuan, Wang Qiaoling, Zhang Miao, Li Juanjuan, Xiao Wenyi, Ge Yurong
    2024, 44 (7):  532-535.  DOI: 10.3760/cma.j.cn115259-20230628-00632
    Abstract ( 60 )   PDF (860KB) ( 47 )  
    Objective To understand the current situation of the application of standardized patients (SPs) in the field of medical education and analyze the obstacles in the process of implementation, so as to inform further promoting the use of SPs in medical education. Methods From December 2019 to February 2020, 79 medical universities offering five-year and long-term clinical medicine programs with clear contact information were selected as research subjects, and questionnaires and informed consent forms were sent by Email. Numerical data were analyzed by cross-table chi-square test or Fisher exact test. Results This survey received valid questionnaires from 64 colleges and universities, 37 (57.8%) applied SPs in medical education, and 27(42.2%) had training departments for SPs. The main methods of training were situational exercises, teaching demonstrations, watching videos and on-the-spot observation. Among 37 colleges and universities, SPs were mainly used in medical history collection [29(78.4%)], Objective Structured Clinical Exams [28(75.7%)], doctor-patient communication [27(73.0%)] and physical examination teaching [23(62.2%)] respectively. Moreover, 27(73.0%), 26(70.3%) and 11(29.7%) colleges and universities respectively evaluated the quality of SPs through teacher feedback, student feedback and self-made evaluation forms. Lastly, 27(73.0%) and 17(45.9%) colleges and universities respectively believed that there were unstable teams and lack of unified and standardized quality evaluation standards and course training in SPs. Conclusions SPs are widely used in medical education in China, and attention has been paid to doctor-patient communication. It is expected for SPs to participate in teaching in improving doctor-patient relationship. In the future, it is necessary to overcome a series of obstacles and further promote the use of SPs to improve the communication skills of medical students.
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    An investigation and analysis of the teaching needs and effects of a research methodologycourse for medical postgraduate students at a Military Academy
    Sai Xiaoyong, Deng Jiayi, Li Qiongxuan, Li Chunyan, Wang Qiao, Luan Hengyu
    2024, 44 (7):  536-540.  DOI: 10.3760/cma.j.cn115259-20230808-00104
    Abstract ( 48 )   PDF (876KB) ( 33 )  
    Objective To understand the teaching needs and effectiveness of a medical research methodology course for medical graduate students and to explore suitable teaching methods for them. Methods A cross-sectional questionnaire survey was conducted in December 2021 on 160 graduate students from a military school enrolled in 2021. The survey covered knowledge, attitude, beliefs, andpractices (KABP) regarding the methodology course, the necessity of course content, satisfaction,and the need for changes in class hours, as well as factors affecting teaching effectiveness.Comparisons of continuous influencing factors were made using t-tests or rank-sum tests, ratecomparisons were made using χ2 tests or exact probability methods, categorical variables were analyzed using multivariate logistic regression models, and continuous variables were analyzed using multivariate linear regression models.Results The survey analysis revealed that more than 95.0% of the students were satisfied with the teaching. Furthermore, 104 students (65.0%) believedthat class hours should be increased, with older students expressing a greater need. Suggestions from students included the following:95 students (59.4%) supported separate courses for epidemiology and medical statistics, with a tendency for students with more publications sinceenrollment to favor separate courses. In addition, 117 students (73.1%) hoped to increase large cohort study platforms, 116 students (72.5%) suggested the need for computer room configurations, 138 students (86.3%) proposed enhancing multimedia teaching conditions, 30 students (18.8%) recommended increasing the number of case studies and practical teaching hours, 135 students (84.4%) advised implementing bilingual teaching, and 131 students (81.9%) recommended incorporating more literature review in the teaching process. Conclusions The overall evaluation of the clinical research methodology course by medical graduate students is positive. Most students support multimedia teaching, bilingual teaching, and the inclusion of literature reviews. Teaching conditions and methods should be continuously improved and adjusted to meet the actual needs of the students.
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    Analysis of the results of final assessment in standardized residency training in Beijing
    Wang Na, Liu Lei, Chen Lifen, Zhu Guangyi, Chang Dan, Xie Zi, Guan Lei, Tai Weiping, Zhang Yongming
    2024, 44 (7):  541-545.  DOI: 10.3760/cma.j.cn115259-20231120-00504
    Abstract ( 67 )   PDF (840KB) ( 52 )  
    Objective To analyze the final assessment results and related factors of standardized residency training in four training bases in Beijing and to propose suggestions for future improvement. Methods From September to November 2023, the final assessment results of 1007 resident physicians in clinical medicine and dentistry who entered the 4 training bases from 2018 to 2022 were enrolled. Basic information and results of proficiency tests, the final assessment results and related factors were collected and analyzed using methods such as χ2 test, logistic regression, and ROC curve. Results From 2020 to 2023, 864(85.8%) of the 1007 residents passed the final assessment for the first time, of which 915(90.9%) and 949(94.2%) passed the knowledge assessment and the practice assessment, respectively. Logistic regression analysis results show that the final examination pass rates for the surgery major(OR=3.92, 95% CI: 1.77~8.68), internal medicine and neurology major(OR=3.54, 95% CI: 1.77~7.06), and medical imaging major(OR=3.64, 95% CI: 1.69~7.85)were lower than those for “other” majors. Doctoral graduate students(OR=0.35, 95% CI: 0.20~0.63) have a higher final examination pass rate than undergraduate students. The higher the national percentile score in the annual clinic competency test (OR=0.96, 95% CI: 0.96~0.98), the higher the final examination pass rate. Conclusions The pass rate of final assessment in standardized residency training in our study was not high, the related factors were educational background, training major, and the national percentile of the annual clinic competency test. Residency training bases should develop training programs based on the individual characteristics of resident physicians to meet the requirements for standardized training.
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    Application of the modified Peyton's approach in the standardized training of prosthodontics residents
    Men Qinglin, Zhou Xianhua, Zhang Wenjing, Wang Wei
    2024, 44 (7):  546-549.  DOI: 10.3760/cma.j.cn115259-20230511-00485
    Abstract ( 59 )   PDF (822KB) ( 48 )  
    Objective To explore the effect of modified Peyton's approach in the standardized training of prosthodontics residents. Methods The residents of grade 2019 and grade 2020 trained in the general dentistry of Stomatology Affiliated Hospital of Xuzhou Medical University were selected as the research objects, and the experimental control method was adopted. Twenty residents of 2020 were set as the experimental group, and the improved Peyton teaching method was adopted; twenty residents of the same department of 2019 were set as the control group, and the traditional teaching method was adopted. In order to evaluate the teaching effect of the two groups, the basic theory and clinical skills were assessed and the questionnaire survey was conducted within one month after the teaching was completed. The t test was used for comparison between measurement data, and the χ2 test was used for comparison between counting data. Results Comparison of assessment results, The basic theoretical scores (41.45±0.94), skill operation scores (41.75±1.12) and total scores (83.10±1.65) in the experimental group were higher than those in the control group [(39.90±1.39), (38.45±2.14), (78.25±2.24)]. There were statistical differences (all P<0.05). The results of questionnaire survey showed that the scores of operation ability (2.80±0.52) and learning interest and initiative (3.00±0.65) scores in experimental group were higher than those in control group [(2.26±0.55) , (2.35±0.89) ].There were statistical differences (all P<0.05). Conclusions The improved Peyton's teaching method is helpful to consolidate the theoretical knowledge and enhance the clinical operation ability, and improve the training effect of prosthodontics residents.
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    Current status and future development of national continuing medical education programs
    Chen Li, Du Zhiqin, Jing Shuqing
    2024, 44 (7):  550-553.  DOI: 10.3760/cma.j.cn115259-20231017-00366
    Abstract ( 41 )   PDF (1222KB) ( 34 )  
    The national continuing medical education programs, established and developed for 27 years, play a significant role in talent cultivation for the health and wellness sector in China. This study introduces the historical evolution and development overview of these programs, analyses the number, subject distribution, geographical distribution, training attendance and credits awarded of programs in the year 2022. The results show that in 2022, there were a total of 22 790 programs from 31 provinces and Xinjiang Production and Construction Corps, covering 24 secondary subjects and 89 tertiary disciplines, with a total of 1 972 project applicant units, 10.8 million training attendances, and a total of 53 million continuing medical education credits awarded. As the number of programs continues to rise, routine management becomes more complex and difficult, and problems such as insufficient overall planning and unbalanced development of disciplines and geographic areas continue to emerge. Top-down overall planning is recommended that enables a diversity of continuing medical education activities, to adjust and improve the management and service of programs, so as to promote the sustainable development of programs in the new era.
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    Australian health rule-of-law talent cultivation system and enlightenment
    Chen Yongyi, Su Chengyin, Meng Yanchen
    2024, 44 (7):  554-558.  DOI: 10.3760/cma.j.cn115259-20230908-00222
    Abstract ( 24 )   PDF (871KB) ( 30 )  
    Australia has rich experience in cultivating health rule-of-law talents. The University of Sydney and the University of Melbourne are highly representative of the cultivation system of health law talents, and have established reasonable health law curriculum systems, interdisciplinary health law teaching and research platforms and high-quality teaching staff, and have made significant contributions to the training of health law talents in Australia by using rich teaching content and flexible teaching methods. Taking Australia as a model, it is recommended that China strengthen health law education at the undergraduate level, highlight the superior disciplinary characteristics of each university at the postgraduate level, and innovate flexible and diversified teaching methods for health law.
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