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01 August 2024, Volume 44 Issue 8 Previous Issue    Next Issue

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Exploratory practice of generative large language models in the construction of medical item banks Jiang Zhehan, Feng Shicong, Wang Weimin 2024, 44 (8):  561-569.  DOI: 10.3760/cma.j.cn115259-20240524-00520 Abstract ( 107 )   PDF (891KB) ( 96 )   Item development in healthcare profession education is time-consuming and heavily reliant on content experts. While large language models (LLMs) introduce a new approach to reduce the burdens, the output quality is largely contingent upon the prompt. This article aims to guide educators in effectively leveraging LLMs for item development, enhancing the quality through prompt engineering. Using ″postoperative bile leakage″ as an example, the paper demonstrates the effectiveness of various prompt engineering strategies, including Zero-shot, Few-shot, Chain of Thought (CoT), CoT with Self-Consistency (CoT-SC), and Tree of Thoughts (ToT). It is found that while Zero-shot and Few-shot methods are straightforward, they have certain limitations in terms of item diversity and depth. Conversely, prompt strategies incorporating ″Thought″ elements can navigate the LLMs through stages of drafting, refining, comparing, and finalizing, thereby elevating question quality. Although refining prompts indeed leads to notable improvements in question formulation efficacy, there remains substantial room for exploring and optimizing prompt formulations and strategies to further augment the quality of generated questions. The pursuit of advancing prompt engineering techniques holds the promise of significantly elevating the standards of question bank development within medical education. References | Related Articles | Metrics

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Bibliometric analysis of research hotspots and trends in medical education from the perspective of ″new medicine″ Wei Xiaotong, Wen Deliang 2024, 44 (8):  570-575.  DOI: 10.3760/cma.j.cn115259-20230728-00049 Abstract ( 92 )   PDF (888KB) ( 92 )   Objective To explore the research hotspots and trends in medical education from the perspective of “new medicine”. Methods From January 2018 to December 2022, relevant documents on ″medical education″ in the China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Database for Chinese Technical Periodicals were retrieved. Data analysis was conducted on three levels: macro (literature), meso (authors and institutions), and micro (topics) using CiteSpace and VOSviewer software. Results The number of publications on medical education research under the new medical disciplines construction was on the rise. Peking University and its affiliated hospitals rank first in terms of the number of publications, and the core collaboration teams remain relatively stable. Traditional core topics in the field include standardized residency training and clinical medical education, while emerging research themes such as online teaching, COVID-19 pandemic, and curriculum ideological and political education have also appeared. Conclusion Medical education is an important cornerstone of the development of health and medical personnel training. The construction of ″new medicine″ puts forward a new era mission for medical education. By outlining the new research ecology of medical education under the construction of ″new medicine″, this study provides evidence-based basis for the further development of medical education reform in the new era. References | Related Articles | Metrics

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A survey on academic and campus life of ethnic minority medical students in three medical colleges in Jiangsu Province Ding Hongmei, Yiliminuer Wumaierjiang, Wang Fang, Wang Ting 2024, 44 (8):  576-580.  DOI: 10.3760/cma.j.cn115259-20230814-00130 Abstract ( 35 )   PDF (813KB) ( 30 )   Objective To understand the academic and campus life of ethnic minority medical students and provide ideas for improving their training quality. Methods A self-administered questionnaire was used to survey 72 ethnic minority medical students from grade 2016 to 2020 at Nanjing Medical University, Nanjing University of Traditional Chinese Medicine, and Xuzhou Medical University in December 2021, and the results of the survey were analyzed with descriptive statistics. Results Learning difficulties were reported by 60(83.3%) students, of which 43(71.7%) attributing this to a lack of foundational knowledge. Additional specialized knowledge enhancement courses and professional skills training were desired by 53(73.6%) and 46(63.9%) students, respectively. Appropriate adjustments to training standards were supported by 53(73.6%) students. Special scholarships for ethnic minority students or policies favoring them in the evaluation of prizes and merits were considered beneficial for stimulating learning enthusiasm by 71(98.6%) students. Ethnic minority status was not seen as a negative impact on campus life by 70(97.2%) students, although cultural differences and living habits were challenging for 33(45.8%) and 32(44.4%) students, respectively. School initiatives to promote ethnic cultural integration were recognized as helpful by 41(56.9%) students. All students (100.0%) considered employment after graduation. Region and salary benefits were regarded as priority considerations for employment by 51(70.8%) and 54(75.0%) students, respectively. Conclusions Ethnic minority medical students generally encountered learning difficulties because of weak foundational knowledge. They aspired for the establishment of targeted professional enhancement courses and the implementation of educational preferential policies by the school. Although their ethnic minority status did not negatively impact their campus life, they still experienced challenges from cultural differences and lifestyle habits. Students benefited to a limited extent from campus ethnic integration initiatives. Following graduation, students tended to seek employment, with geographic location and salary benefits being the primary factors influencing their employment choices. References | Related Articles | Metrics

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Comparison on the evaluation conditions of teachers' professional titles in medical colleges and universities in China Song Yan, Jin Yanpeng, Gao Yu, Wang Shuoting, Zhi Shaoyu, Wu Haijiang 2024, 44 (8):  581-586.  DOI: 10.3760/cma.j.cn115259-20230926-00302 Abstract ( 47 )   PDF (855KB) ( 38 )   The professional title evaluation system of higher medical schools plays a pivotal role in the field of medical education. It not only dominates the training direction of medical talents, but also is a key mechanism to stimulate teachers' innovative ability. By collecting and sorting out the professional and technical post qualification evaluation documents of 21 higher medical schools, this study comprehensively analyzes and compares the requirements of the evaluation conditions, such as basic requirements, teaching, student guidance, teaching competitions, paper publication, scientific research projects, and unconventional promotion, which serves to inform the reform of the teacher title evaluation system in China's higher medical schools. References | Related Articles | Metrics

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Analysis of hotspots and development trends of research on clinical teacher in China Kong Fenghua, Dang Ningning, Wang Guowen 2024, 44 (8):  587-591.  DOI: 10.3760/cma.j.cn115259-20230925-00292 Abstract ( 51 )   PDF (941KB) ( 49 )   Objective To explore the hotspots and development trends of research on clinical teachers in China. Methods Research literature on clinical teacher as of July 31, 2023 were retrieved from CNKI, Wanfang, Weipu and SinoMed database and analyzed with CiteSpace software. Results A total of 803 papers fulfilling the search criteria were examined. The total number of research papers on clinical teachers was on the rise, but the research authors and institutions were relatively dispersed. The top five high-frequency keywords with cumulative frequency were clinical teaching (78 times), teaching ability (52 times), young teachers (47 times), medical education (34 times), medical students (33 times) and teaching staff (33 times). In recent years, the burst terms were affiliated hospitals, teaching performance, etc. Conclusions The research on clinical teachers in China is becoming increasingly active, focusing on the teaching development of clinical teachers. Young teachers are the most concerned group in clinical teacher research, and the assessment and evaluation of clinical teachers' teaching performance is the research trends, which needs to be further explored. References | Related Articles | Metrics

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Construction of a career development and support system for residents in a university-affiliated children's hospital Wu Hao, Ma Jiuyuan, Song Yimeng, Tan Hui, Wang Yating, Fan Ru, Chai Yiming, Zhou Wenhao, Wu Jingyan 2024, 44 (8):  592-596.  DOI: 10.3760/cma.j.cn115259-20230808-00101 Abstract ( 37 )   PDF (907KB) ( 24 )   Objective To explore the effect of constructing a career development and support system for pediatric residents to enhance their professional beliefs and to strengthen their career path. Methods Based on earlier research, literature review, and preliminary work, a provisional career development and support system was drafted. Seventeen experts from a university-affiliated children's hospital were invited to participate in Delphi study from June to July 2023. After two rounds of consultation, a career development and support system for pediatric resident physicians was finally formed. Results Two rounds of expert consultation resulted in a 100.0% questionnaire response rate, with expert authority coefficients of 0.894 and 0.868, respectively. The coordination coefficients of the two rounds of expert consultation were 0.212 and 0.269, respectively (χ2 values were 82.86 and 123.28, both P<0.001). The final support system includes 4 primary items, namely professionalism and beliefs, social support, teaching environment, and self-efficacy, as well as 22 secondary items. Conclusions The construction of the career development and support system for pediatric resident physicians may inform for the training of pediatric resident physicians, and provide a path for strengthening the career path of pediatric resident physicians. References | Related Articles | Metrics

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A study on the relationship between the perception of simulated learning immersion and clinical practice reflection ability of nursing interns Ma Junjie, Wei Yulian, Fang Xiaojie, Wang Shuo, Yuan Jie 2024, 44 (8):  597-601.  DOI: 10.3760/cma.j.cn115259-20230604-00560 Abstract ( 41 )   PDF (827KB) ( 30 )   Objective To investigate the current tendencies of the perception of simulated learning immersion and clinical practice reflection ability of nursing interns, to explore the relationship between them, so as toinform nursing interns' clinical practice reflection and improving the quality of nursing practice. Methods In March 2023, 243 nursing interns in the 2023 session of a tertiary first-class hospital in Shandong Province were investigated with general information questionnaire, the learning immersion scale in clinical simulation and the reflection on clinical practice questionnaire for nursing students. Pearson correlation analysis and multiple linear hierarchical regression analysis were used to analyze the data. Results The total score of 243 interns' simulated learning immersion perception was (47.62±13.66), and the average score of each dimension item from high to low was cognitive assimilation (3.23±0.92), emotional inclusion (3.19±0.95), focus (3.12±0.95), and acquired experience (3.10±1.01); The total score of clinical practice reflection ability was (106.86±23.35), and the average scores of each dimension item in descending order were: dynamic career development (2.98±0.68), reflective self-management (2.98±0.67), internal motivation source (2.97±0.68), professional ability (2.97±0.67), dynamic organizational atmosphere (2.96±0.67), and challenging clinical situation (2.95±0.68). The total score of simulated learning immersion perception and its scores in various dimensions were positively correlated with the total score of clinical practice reflection ability and its scores in all dimensions (r=0.51~0.63, all P<0.05). After controlling for demographic variables, the dimensions of perception of simulated learning immersion positively predicted clinical practice reflection ability (β =0.123~0.324, all P<0.05). Conclusions Nursing interns' perception of simulated learning immersion and clinical practice reflection ability were at medium level, and the former directly affect the latter. Clinical teachers should enrich the forms of clinical simulation teaching, enhance students' immersion perception in simulation learning, and thereby promote the cultivation of their clinical practice reflection ability. References | Related Articles | Metrics

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The application of diversified teaching methods in the clerkship teaching of Zhuang medical gynecology Lin Chujuan, Mao Baoman, Qin Zujie 2024, 44 (8):  602-606.  DOI: 10.3760/cma.j.cn115259-20230818-00143 Abstract ( 48 )   PDF (817KB) ( 43 )   Gynecology of Zhuang medicine is one of the important disciplines of ethnic medicine. In order to promote the development of gynecology teaching of Zhuang medicine, this paper takes as an example the clerkship teaching of five-year program students enrolled in 2019 of Zhuang medicine in Guangxi University of Traditional Chinese Medicine, expounds the design and implementation process of diversified teaching methods in gynecology of Zhuang medicine. The teaching effect was evaluated by pre-class preview record, clerkship report, teachers' evaluation of students and survey on students satisfaction with internship. The results showed that the excellent rate of pre-class preview record was 18.1%(19/105), and the pass rate was 71.4%(75/105). The excellent rate of probation report was 24.8%(26/105), and the pass rate was 68.6%(72/105). The excellent rate of teachers' evaluation was 34.3%(36/105), and the pass rate was 61.0%(64/105). A total of 581 valid questionnaires were collected from students during 6 internships, the recognition rate of students to the teaching method was 96.7%(562/581). The application of diversified teaching methods in the clerkship teaching of Zhuang medical gynecology helps to improve the overall educational quality, which has been recognized by students. References | Related Articles | Metrics

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Research on the current situation and optimization path of online teaching quality in Chinese universities from the perspective of teachers and students Jiang Hai, Kong Xiangjin, Meng Tingting, Yang Lijuan, Guan Youfei, Liu Weiwei 2024, 44 (8):  607-610.  DOI: 10.3760/cma.j.cn115259-20230928-00315 Abstract ( 36 )   PDF (802KB) ( 23 )   Objective To investigate the current state of online teaching in universities from the perspectives of teachers and students and propose optimization paths for improving the quality of online teaching in Chinese universities. Methods A self-designed questionnaire survey was conducted from March to September 2022 at Dalian Medical University, Dalian University of Technology, and Dalian University of Foreign Languages. The survey included 451 teachers and 1 805 students, and the results were analyzed by using descriptive statistics. Results A total of 258(57.2%) teachers and 1 239(68.6%) students held a supportive attitude towards online courses. 315(69.8%) teachers and 815(45.2%) students believed that ″full online live streaming″ is the most suitable form of online teaching. A total of 240(53.2%) teachers and 1 202(66.6%) students held a positive attitude towards the future normalization of online teaching in daily education. There were significant differences in opinions regarding the adjustment of online teaching plans: 345(76.5%) teachers believed ″adjustments are needed,″ while 949(52.6%) students believed ″adjustments are not needed.″ Conclusions Currently, both teachers and students hold supportive attitudes towards online teaching. Universities need to rationally analyze the advantages and disadvantages of online teaching, choose online teaching methods that highly match student needs and course characteristics, innovate course construction and design, and improve the online teaching quality evaluation system. References | Related Articles | Metrics

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The application of blended learning in basic life support training for retraining Ma Ruolin, Gu Haojie, Liu Shengjun, Shan Qiyuan, Chen Chi, Sun Xiaoliang, Kang Baoli, Xu Wei, Ding Min 2024, 44 (8):  611-614.  DOI: 10.3760/cma.j.cn115259-20230804-00088 Abstract ( 48 )   PDF (805KB) ( 48 )   Objective To explore the application effects of blended learning inbasic life support training for retraining trainees. Methods An experimental control method was used. A total of522 retraining trainees from East Hospital Affiliated to Tongji University who participated in the basic life support training were selected as the subjects, all of whom were hospital physicians. 265 retraining trainees who participated in the training from March to April 2023 were set as the experimental group, using blended learning mode; and 257 retraining trainees who participated in the training from March to April 2021 were set as the control groupusing blended learning mode. The teaching effectiveness were evaluated through the skill assessments of two groups of trainees and a questionnaire survey of trainees participating in blended learning mode. χ2-test and t-test were used for data analysis. Results The first-time pass rate of skill assessment among the experimental group trainees was higher than that of the control group trainees [90.6% (240/265) vs. 84.4% (217/257)](P=0.034). The survey results showed that the average score of the experimental group's liking for using blended learning mode for retraining was (4.73±0.64) points, and the average score of confidence in using basic life support in practice after receiving the course was (4.78±0.62) points. In addition, 96.6% (256/265) of the experimental group believed that adopting a blended teaching mode would facilitate more flexible learning, while 95.5% (253/265) believed that it would help to systematically master basic life support knowledge and skills. Conclusions The blended learning mode helps to improve the retraining trainees' pass rate of skills assessments in the training of basic life support. It has the advantage of allowing students to learn more flexibly and systematically to master knowledge and skills, and to enhances their confidence in using basic life support skills. References | Related Articles | Metrics

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A study on the satisfaction and its influencing factors of master's students' academic scholarship policy Hu Xinyue, Zhai Shuangqing, Zhang Yaping, Ye Tongle, Yuan Na, Xue Pei, Jiao Nan 2024, 44 (8):  615-619.  DOI: 10.3760/cma.j.cn115259-20230802-00078 Abstract ( 42 )   PDF (821KB) ( 29 )   Objective To investigate the satisfaction with the academic scholarship policy for master's students and its influencing factors, to inform how to better stimulating postgraduates' learning motivation and improving the effectiveness of policy implementation. Methods From April to May 2023, using convenient sampling, 701 master's students from Beijing University of Chinese Medicine were enrolled to take part in a satisfaction questionnaire survey on the academic scholarship policy. Information on their general background, satisfaction with the entire process of academic scholarship selection, and overall satisfaction were collected. Descriptive statistics, t-tests, analysis of variance, and multiple linear regression were used to analyze the satisfaction of master's students with the academic scholarship policy and its influencing factors. Results The satisfaction scores of master's students with the overall academic scholarship policy, policy content formulation, policy implementation process, and policy implementation effects were (3.54±0.99), (3.71±0.96), (3.89±0.93), and (3.84±1.03) respectively. Satisfaction with the overall coverage of academic scholarships[ (3.40±1.35) ]and the setting of amounts for each grade [(3.50±1.24) ]was lower. Multiple linear regression results showed that the type of degree, scholarship level, annual family income, and degree of policy understanding were influencing factors on the overall satisfaction of master's students with the academic scholarship policy (β values were 0.103, 0.235, 0.129, and 0.093 respectively, all P＜0.05). Conclusions Master's students' satisfaction with the academic scholarship policy is at an above-average level, but their satisfaction is low in terms of the coverage of academic scholarships and the rationality of the setup for grade and amount. It is necessary to further improve the academic scholarship policy by broadening the sources of funds, and by setting a reasonable coverage and grade amount for academic scholarships. There are differences in the satisfaction of master's students with the academic scholarship policy among different degree types, scholarship levels, average annual family income, and policy understanding. Subsequent implementations of the academic scholarship policy should pay more attention to professional graduate students, postgraduates who have not received scholarships, and postgraduates from low-income families, while also enhancing the publicity of the academic scholarship policy. References | Related Articles | Metrics

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Application of teaching supervision in educational ward rounds for resident Chen Jinyu, He Li, Wang Shiyu, Li Li, Zhang Cen, Shen Liqiong, Ye Yanqing 2024, 44 (8):  620-623.  DOI: 10.3760/cma.j.cn115259-20230519-00515 Abstract ( 63 )   PDF (806KB) ( 54 )   Objective To investigate the effects of teaching supervision on educational ward rounds for residents in Zhongnan Hospital of Wuhan University in 2022, and to inform future quality improvement. Methods The results of 99 teachers' supervision in three educational ward rounds in 2022 were collected. Data were analyzed using χ2 test. Results In 2022, the excellent rates of the second and third rounds of educational ward rounds supervision were higher than that of the first round [the first round 48.5%(16/33) vs. the second round 75.8%(25/33) vs. the third round 72.7%(24/33), all P<0.05]. There was no significant difference in the excellence rates among different departments [non-surgical departments 70.4%(38/54) vs. surgical departments 60.0%(27/45), all P＞0.05]. The excellent rates of ward rounds supervision of chief physicians and associate chief physicians were higher than that of attending physicians [chief physicians 79.2%(19/24) vs. associate chief physicians 70.7%(29/41) vs. attending physicians 50.0%(17/34), all P<0.05]. Conclusions Teaching supervision has played an important role in promoting the quality of educational ward rounds. There are differences in the excellent rates of teaching supervision among physicians with different professional titles. Further optimization of the teaching ward rounds should be carried out to promote the continuous improvement of teaching quality. References | Related Articles | Metrics

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Application of blended learning method in the teaching of clinical nutrition for resident physicians Ou Peng, Gong Cai, Liu Shiping, Tang Hanfen, Huang Fansu, Liu Shuang , Yuan Ting 2024, 44 (8):  624-628.  DOI: 10.3760/cma.j.cn115259-20240321-00285 Abstract ( 56 )   PDF (854KB) ( 53 )   Nutritional therapy is an important component of comprehensive clinical diagnosis and treatment. Strengthening clinical nutrition education can help resident physicians improve their level of nutrition diagnosis and treatment. This study introduced a hybrid teaching method that combines online and offline teaching into the teaching of clinical nutrition for 437 resident physicians, and observed its application effect. For all resident physicians in our hospital in 2023, the basic knowledge classroom of clinical nutrition was set up through online teaching, and combined with offline case-based clinical nutrition diagnosis and treatment teaching classroom as an example, the teaching design and implementation process of blended learning in resident physician clinical nutrition teaching were elaborated. The basic knowledge mastery of resident physicians was compared before and after training through knowledge test. The effectiveness of teaching was evaluated by comparing indicators such as nutritional risk screening rate and 24-hour nutritional risk screening rate to understand the nutritional diagnosis and treatment of resident physicians before and after training. The results showed among the 437 resident physicians who participated in the training, the qualification rate of clinical nutrition basic knowledge significantly improved after training from 18.8% (82/437) to 100.0% (437/437). The nutritional risk screening rate of hospitalized patients increased from 30.5% (9 181/30 103) to 91.3% (28 329/31 029), and the nutritional risk screening rate within 24 hours increased from 20.1% (6 051/30 103) to 36.8% (11 419/31 029). The qualified rate of nutritional risk screening increased from 51.2% (4 475/8 740) to 84.9% (7 420/8 740). The evaluation rate increased from 3.2% (968/30 103) to 9.9% (3 072/31 029), and all differences were statistically significant (all P<0.001).The questionnaire survey results showed that the satisfaction rating of resident physicians with blended learning was (4.85±0.36) points, and the satisfaction rating of blended learning in improving clinical nutrition diagnosis and treatment level was (4.82±0.39) points. It can be seen that the application of blended learning in the clinical nutrition teaching of resident physicians helps them to master clinical nutrition knowledge and improve their practical abilities of clinical nutrition diagnosis and treatment. References | Related Articles | Metrics

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Construction of the evaluation index system of political and virtuous awareness education for medical master students from the perspective of “Three-dimensional Education” Li Xiaomin, Zhang Wenyu, Duan Yifei, Luo Xiaojuan, Yu Qianhui, Zhang Li, Luo Xinle 2024, 44 (8):  629-633.  DOI: 10.3760/cma.j.cn115259-20240305-00211 Abstract ( 46 )   PDF (821KB) ( 30 )   Objective This study aims to construct an evaluation index system for political and virtuous awareness education of postgraduate medical students based on the concepts of educating of all personnel, in all aspects, and for the whole process (referred to as ″three-dimensional education″). Methods From December 2023 to February 2024, The evaluation index system was determined by literature analysis and combining with the training characteristics of medical master students. Two rounds of correspondence were conducted among 28 experts by Delphi method, and the index weights were calculated by analytic hierarchy process. Results The effective questionnaire recovery rates of the two rounds of expert correspondence were 87.5% and 100.0%, respectively. The authority coefficient of the first round ranged from 0.80 to 0.90, the authority coefficient of the second round ranged from 0.90 to 0.94, and the variation coefficient of each index of the second round ranged from 0.13 to 0.24. Kendall coordination coefficient W values range from 0.17 to 0.32 (all P<0.001). An evaluation index system of political and virtuous awareness for medical master students including 4 first-level indicators, 11 second-level indicators and 37 third-level indicators is constructed. Conclusions The evaluation index system is comprehensive, scientific and feasible, and provides a high informative value for the evaluation of the effect of political and virtuous awareness education for medical master students. References | Related Articles | Metrics

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The development of professional identity research in medical education based on Web of Science Xin Siyan, Ma Xuanxuan, Chen Lihua, Wu Haijiang, Wu Hongbin 2024, 44 (8):  634-640.  DOI: 10.3760/cma.j.cn115259-20230630-00647 Abstract ( 55 )   PDF (1979KB) ( 42 )   Objective To understand the development of professional identity research in the context of international medical education. Methods HistCite was used for bibliometrics analysis based on Web of Science core collection database, and Pajek was used for master path analysis of citation time series map. Results The research on professional identity in the field of international medical education was on the rise year by year, and it entered a relatively active period since 2014. In this field, United States was far ahead in the number of papers published while Canadian research had higher academic value. There were some highly influential research institutions such as University of California San Francisco, University of Toronto and McGill University in Canada, as well as a group of famous scholars such as Yvonne Steinert, Richard L Cruess, Sylvia R Cruess from McGill University in Canada. Some source journals had a higher influence on the topic of professional identity in the field of international medical education, such as Academic Medicine in the United States, BMC Medical Education and Medical Education in the United Kingdom. Conclusions The research on professional identity is increasingly active, but the measurement of professional identity in practice still needs to be further explored. There is still a big gap between the research in China and the developed countries in the world. China should carry out more in-depth research on the impact mechanism of professional identity. References | Related Articles | Metrics