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01 September 2024, Volume 44 Issue 9 Previous Issue    Next Issue

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Basic medical education WFME global standards for quality improvement (the 2020 revision) Issued by World Federation for Medical Education; Translated by Secretariat of Working Committee for the Accreditation of Medical Education, Ministry of Education of the People's Republic of China 2024, 44 (9):  641-649.  DOI: 10.3760/cma.j.cn115259-20231123-00589 Abstract ( 44 )   PDF (842KB) ( 26 )   The World Federation for Medical Education (WFME) published the first edition of the ″Global Standards for Quality Improvement in Basic Medical Education″ in 2003. The second edition was released in 2012, and a revision was made in 2015. The third edition of the ″Global Standards for Quality Improvement in Basic Medical Education″ was published in 2020. This new edition incorporates the latest trends in medical education, thoroughly reviews and adjusts existing standards, aiming to provide more inclusive and flexible guidance to accommodate the unique needs of different regions and institutions. The standards cover eight areas: mission and values, curriculum planning, assessment, students, faculty, educational resources, quality assurance, and management and administration, emphasizing continuous improvement in medical education quality. The updated standards emphasize that WFME's standards serve as guidance rather than requirements or directives. WFME allows each institution to develop its own basic standards based on specific circumstances, which will involve the design, implementation, management, and quality assurance of medical education and training, and can be adjusted as needed.WFME global standards will help the establishment of standards of each country or region. If existing standards are functioning well, there is no need to revise them solely because of the third edition. References | Related Articles | Metrics

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Reflections on research-oriented medical universities Wang Weiping 2024, 44 (9):  650-657.  Abstract ( 34 )   PDF (2282KB) ( 40 )   References | Related Articles | Metrics

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The mediating role of professional identity between medical students' perceived tension in the doctor-patient relationship and their willingness to practice medicine Zhou Jin, Zhang Lin, Cao Yiyin, Zhang Xiaoshuai, Zhang Yuanhang, Gao Lei 2024, 44 (9):  658-663.  DOI: 10.3760/cma.j.cn115259-20230919-00268 Abstract ( 43 )   PDF (830KB) ( 36 )   Objective This study aims to explore the mediating role of medical students' professional identity between their perception of tension in doctor-patient relationships and their willingness to pursue a medical career, so as to inform better training of medical professionals and stabilizing the professional team. Methods From December 2022 to March 2023, a cluster sampling method was used to enroll undergraduate students from the second to fifth year of the five-year clinical medicine program at a medical university in Heilongjiang Province. The study investigated their professional identity, perception of tension in doctor-patient relationships, and willingness to pursue a medical career. Data analysis was conducted using one-way ANOVA, independent sample t-tests, and Pearson correlation analysis. The PROCESS plugin in SPSS 26.0 was utilized to verify the pathways among medical students' professional identity, perception of tension in doctor-patient relationships, and willingness to practice medicine. Results The final analysis included 971 medical students. The scores for professional identity were (3.44±0.50), perception of tension in doctor-patient relationships were (2.94±0.62), and willingness to practice medicine were (2.47±0.54). The perception of tension in doctor-patient relationships had a negative predictive effect on the willingness to practice medicine (β=-0.17, P<0.001), and professional identity played a partial mediating role between the perception of tension in doctor-patient relationships and willingness to practice medicine (β=-0.03, P<0.001). Conclusions The study reveals that medical students' professional identity is at a moderately high level with room for further improvement. There is a negative correlation between medical students' perception of tension in doctor-patient relationships and their willingness to practice medicine. Professional identity has a mediating effect between the perception of tension in doctor-patient relationships and the willingness to practice medicine. References | Related Articles | Metrics

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Application of thematic experiential teaching in bioinformatics course learning for students majoring in basic medicine Li Miaoxin, Ding Tao 2024, 44 (9):  664-669.  DOI: 10.3760/cma.j.cn115259-20231019-00589 Abstract ( 49 )   PDF (856KB) ( 33 )   Objective To explore and evaluate the effectiveness of the thematic experiential teaching model in a bioinformatics course. Methods An experimental control study was employed. From April to June 2022, 39 students majoring in 5-Year Basic Medicine from the Zhongshan School of Medicine at Sun Yat-sen University, from the classes of 2018 and 2019, were selected as the study subjects. The 26 students from the class of 2019 were assigned to the experimental group, which employed the ″thematic experiential″ teaching model, while the 13 students from the class of 2018 were assigned to the control group, which used traditional teaching methods. Course teaching satisfaction evaluation questionnaires and academic performance of students were used for assessment. The questionnaire was filled out anonymously and voluntarily by 34 participants Statistical analyses were conducted using Fisher's exact test and rank-sum test. Results The proportion of 21 students in the class of 2019 who evaluated the course teaching effect as ″excellent″ was 76.2% (16/21), significantly higher than 7.7% (1/13) observed among the students from the class of 2018. The proportion of 2019 class students who found the course ″very rewarding″ was 61.9% (13/21), significantly higher than the 2018 class students' 15.4% (2/13). The proportion of 2019 class students who ″strongly agreed″ to recommend the course was 61.9% (13/21), significantly higher than the 2018 class students' 7.7% (1/13). The median of final exam scores for the 2019 class students was 87 points, higher than the 2018 class students' 81 points. All differences were statistically significant (P<0.05). Conclusions Implementing the thematic experiential teaching model in a bioinformatics course helps to stimulate students' interest in learning and enhances teaching effectiveness and satisfaction. References | Related Articles | Metrics

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The application of rich pictures in health professions education research Xu Xiaoming, Cheng Huaqin, Chen Weiying 2024, 44 (9):  670-676.  DOI: 10.3760/cma.j.cn115259-20231224-00613 Abstract ( 23 )   PDF (3125KB) ( 24 )   Objective To understand the connotation, development and application of rich pictures, and to encourage related practices among researchers in China. Methods To sort out and interpret the key literature on rich pictures, and to introduce the application of rich pictures in health professions education with examples. Results rich pictures are qualitative research approaches that have gained much attention in health professions education research in recent years. It can help researchers describe and understand complex issues from multiple perspectives as well as support in-depth communication among relevant participants. The research steps of rich pictures include research object selection and application strategy, data collection, data analysis, and report writing. The research process requires attention to equip individual participants' drawings with the broader meaning of explaining the research problem. Conclusions rich pictures have a unique research paradigm, including presenting scenarios corresponding to the research questions, triggering more in-depth interviews and discussions, exemplifying the results of the research. It will receive more attention from health professions educational research in China because of its unique advantages and characteristics. References | Related Articles | Metrics

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Analysis of research hotspots and trends about serious games in medical educationbased on the Web of Science Su Xiaoping, Xu Jingjuan, Liang Yongchun, Wu Zhishui 2024, 44 (9):  677-682.  DOI: 10.3760/cma.j.cn115259-20231007-00324 Abstract ( 27 )   PDF (1535KB) ( 30 )   Objective To analyze the research hotspots and trends of ″Serious Games″ (SG) in the field of medical education. Methods The core collection of the Web of Science (WOS) was searched for literature from January 1, 2004 to September 20, 2023. CiteSpace software was used to analyze the distribution characteristics, research hotspots, and trends in this field. Results A total of 1 026 articles meeting the search criteria were selected. The overall publication volume of research on SG in medical education shows an upward trend. The top 5 high-frequency keywords were medical education (161 times), ″serious games″ (136 times), virtual reality (86 times), medical students (76 times), and performance (75 times). The top 5 keyword clusters were medical education, human-computer interaction, incentive mechanisms, gamification, and virtual reality. Keywords that have emerged from January 1, 2020 to September 20, 2023, include game strategy, game design, technology, management, gamification, and game theory. Conclusions Research on SG in the field of medical education is increasingly valued. Human-computer interaction, gamification, and virtual reality are research hotspots, while game theory, game strategy, and game design are emerging trends. The research hotspots and trends show diverse characteristics, and further exploration is needed in the future. References | Related Articles | Metrics

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The application of utilizing portable laparoscopic surgery live streaming system as an auxiliary teaching tool in general surgery clinical internship teaching Men Zhiyu, Wang Xuchao, Jiang Linhua 2024, 44 (9):  683-687.  DOI: 10.3760/cma.j.cn115259-20230718-00011 Abstract ( 25 )   PDF (1073KB) ( 43 )   With the widespread adoption of minimally invasive technology, the importance of learning laparoscopic skills has become increasingly prominent. The conventional approach of on-site surgical observation for learning has several inherent limitations, such as limited space in the operating room and insufficient surgical explanations. To address these shortcomings, this study introduced a simple portable laparoscopic surgery live streaming system as an auxiliary tool for general surgical internship teaching. In addition to routine clinical internship activities such as handovers, ward rounds, dressing changes, and doctor-patient communication skills training, theoretical courses on laparoscopic surgery, live surgery streaming, surgery review sessions, and Q&A sessions were included. From February 2023 to June 2023, this innovative teaching method was applied to 30 preclinical students at the Department of Gastrointestinal Surgery,The First Affiliated Hospital of Soochow University. The teaching effectiveness was evaluated through knowledge assessments, skills assessments and subjective questionnaires. The results showed that the students who received the teaching method utilizing laparoscopy surgery live streaming achieved a pass rate of 100.0% (30/30) in both knowledge and skills assessments, with 96.7% (29/30) achieving good to excellent scores in knowledge assessments and 86.7% (26/30) obtaining good to excellent scores in skills assessments.Survey results indicated students' high satisfaction with utilizing the portable laparoscopic surgery live streaming system as an auxiliary teaching tool. Across 10 questions related to various dimensions of learning effectiveness, including understanding surgical content, enhancing learning engagement and interactivity, promoting active learning, improving learning flexibility, and overall effectiveness, 92.7% (278/300) of the responses had satisfaction ratings of ≥4 points, where 4 points represent the “satisfactory” level on a Likert five-level scale. In summary, the teaching effectiveness of utilizing the portable laparoscopic surgery live streaming system as an auxiliary teaching tool was commendable, accompanied by high student satisfaction. References | Related Articles | Metrics

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Exploration of an elective course for molecular biology techniques among medical undergraduates Zhang Weifang, Yi Xia, Ma Liwei, Zhou Xuehong, Wang Pu, Wu Xin, Ni Juhua 2024, 44 (9):  688-692.  DOI: 10.3760/cma.j.cn115259-20230710-00672 Abstract ( 36 )   PDF (852KB) ( 28 )   Undergraduates in various medical majors have an urgent need to learn the molecular biology techniques, which are essential for conducting bio medical research. However, the current experiment teaching for undergraduates cannot meet their learning needs. In this study we set up an elective course of molecular biology techniques (named Molecular Biology Techniques Learning Workshop) for undergraduates in Peking University, to explore a new model of molecular biology experiment teaching that seeks to meet the current needs of medical education. From 2020, a total of 33 undergraduates from multiple majors (including basic medicine, clinical medicine, and pharmacy et al) have selected the course. After three rounds, a questionnaire was distributed to evaluate the teaching effect. The course was praised and recommended by students, which was characterized by small class, active learning, spaced learning and peer-assisted learning. The elective course may meet the needs of medical undergraduates and has strong practical significance in cultivating students' experimental and scientific research skills. It can be used as a complementary form of molecular biology techniques teaching for undergraduates, or perhaps as one item of the early research ability training system, which may be worth promoting. References | Related Articles | Metrics

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A study on the influencing factors of self-efficacy among medical master candidates Zhu Rui, Jin Xin, Jia Jinzhong, Wen Mingyue, Zhu Quanrong, Lin Huangtao, Shi Peiyao, Liang Zhisheng, Xu Ming 2024, 44 (9):  693-697.  DOI: 10.3760/cma.j.cn115259-20230730-00058 Abstract ( 26 )   PDF (811KB) ( 26 )   Objective To analyze the influencing factors affecting the self-efficacy of medical master's degree students and to inform future improvement of the quality of online education. Methods A national survey on the educational satisfaction of recent medical graduate students was conducted from June to July 2022, in which 6 704 medical master's degree students from 49 institutions with online class experience were enrolled. The t-test and ANOVA were used to compare the differences in personal characteristics of self-efficacy, online learning engagement and external support self-assessment scores; and multiple linear stepwise regression was used to analyze the influencing factors of self-efficacy of medical master's degree students. Results The self-efficacy score of medical master's degree students was (3.81±0.96), the online learning engagement score was (4.00±0.95), and the external support score was (4.27±0.83). There was a positive correlation between self-efficacy, online learning engagement and external support of medical master's degree students (all P<0.001). Online learning engagement (β=0.53, P<0.001) and external support (β=0.16, P=0.008) were the influencing factors of self-efficacy among medical master's students. Conclusions The self-efficacy of medical master's degree students needs to be improved, and the online learning input of medical master's degree students can be promoted through the development of effective teaching measures, the enhancement of teacher-student interaction, and the provision of external support to improve self-efficacy, and then improve the quality of online education. References | Related Articles | Metrics

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Mediating role of research engagement between research self-efficacy and research satisfaction among postgraduate medical students Shi Peiyao, Wei Ruinan, Jia Jinzhong, Li Jingrui, Jiang Wei, Zhu Rui, Lei Xiaohua, Liang Zhisheng, Xu Ming 2024, 44 (9):  698-702.  DOI: 10.3760/cma.j.cn115259-20230801-00077 Abstract ( 33 )   PDF (846KB) ( 20 )   Objective To understand the current status of postgraduate medical students' research engagement, research self-efficacy and research satisfaction, and to investigate the mediating effect of research engagement between research self-efficacy and research satisfaction. Methods A cross-sectional survey was conducted with regards to the research engagement, research self-efficacy and research satisfaction among 9 919 fresh graduate medical students from 74 colleges and universities in China from June to July 2021, t-test or ANOVA was used to compare the differences between the characteristics of different populations. Pearson correlation analysis was used to explore the correlation of the three, and finally stratified regression analyses was utilized to explore the mediating effect of research engagement between research self-efficacy and research satisfaction. Results Graduate medical students' research engagement score was (3.68±0.91), research self-efficacy score was (3.58±0.92), and research satisfaction score was (3.70±0.99), research engagement was positively correlated with research self-efficacy (r=0.96, P<0.001), positively correlated with research satisfaction (r=0.76, P<0.001), research self-efficacy was positively correlated with research satisfaction (r=0.75, P<0.001), and research engagement played a partially mediating role between research self-efficacy and research self-efficacy (β=0.435, P<0.001). Conclusions Research engagement played a partially mediating role between research self-efficacy and research satisfaction. Institutions can improve research satisfaction by improving research efficiency, increasing research funding, cultivating medical postgraduate students' interest in research, and increasing medical postgraduate students' research self-efficacy and research engagement. References | Related Articles | Metrics

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Application of real patients in competency assessment of standardized training for dermatology residents Xie Yadian, Shen Liqiong, Wu Xuejingzi, Jiang Si 2024, 44 (9):  703-706.  DOI: 10.3760/cma.j.cn115259-20230711-00005 Abstract ( 29 )   PDF (792KB) ( 29 )   Objective To explore the feasibility of applying real patients in the clinical skills assessment of standardized training for dermatological residents, so as to inform the formulation of examination plans in the future. Methods In May 2023, 30 examinees who took part in the examination of dermatology graduation clinical skills in the examination center of Zhongnan Hospital of Wuhan University were enrolled in the study. A self-made questionnaire was used to investigate the examinees' satisfaction with the establishment of the examination station and the feelings of receiving real patients, and the assessment results were recorded. Results The median scores of all aspects in the satisfaction questionnaire for residents' examinations were all above 80% of the total score, with the lowest score given to the item ″reasonable duration of examination stations″ [3.0(2.0)]. The score for residents' assessment of the cooperation level of real patients was 10.0(1.5). The assessment results for treating patients at the examination stations were excellent, with the score of (85.75±3.80) for the 30 residents. Conclusions Examinees are highly satisfied with the national residency training program and graduation skills assessment in dermatology, but the time setting of receiving patients can be further optimized. It is feasible to use real patients in dermatology end-of-training skills assessment, and examinees have high recognition for real patients to participate in the assessment. References | Related Articles | Metrics

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Construction of a competency-based assessment index system for the completion of neurosurgery specialist training Lin Guozhong , Liu Bin , Ma Changcheng , Wang Guan, Li Aiwei, Chang Qing, Pang Chaonan, Yang Jun 2024, 44 (9):  707-712.  DOI: 10.3760/cma.j.cn115259-20230629-00637 Abstract ( 32 )   PDF (855KB) ( 47 )   Objective To explore the establishment of an index system suitable for the assessment of neurosurgery specialists' standardized training completion. Methods The assessment indicators for neurosurgery specialists' standardized training completion was initially screened through literature research. A preliminary index system was established based on the Milestone system. Expert correspondence were carried out using the Delphi method to revise and score the assessment indicators. Results Two rounds of correspondence were conducted with 15 experts and 2 specialty physician standardized training administrators from three tertiary grade A comprehensive hospitals. After modification by experts, an assessment index system was ultimately formed. Six first-level indicators (professional ethics, knowledge and skills, lifelong learning, communication and cooperation, patient care, teaching and research), 18 second-level indicators, and 66 third-level indicators were included in this index system. The weights of each first-level indicator were determined to be professional ethics 16.62%, knowledge and skills 18.43%, lifelong learning 16.49%, communication and cooperation 16.66%, patient care 16.43%, and teaching and research 15.37%. The Cronbach's alpha coefficient of the expert correspondence was 0.985, and the content validity index was 0.940. Conclusions The constructed assessment index system for the completion of neurosurgery specialist standardized training was found to be scientifically and systematically reflective of the content that needs to be examined for the completion of standardized training for neurosurgery specialists and inform the assessment of standardized training completion for neurosurgery specialists. References | Related Articles | Metrics

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The 12 reports issued by the General Medical Council and the transition of medical education in the UK Zhang Pei, Zhai Haihun 2024, 44 (9):  713-720.  DOI: 10.3760/cma.j.cn115259-20240220-00153 Abstract ( 30 )   PDF (896KB) ( 21 )   Objective This study aims to uncover the development in the United Kingdom and the role of the General Medical Council (GMC) through analysis of 12 reports issued by the GMC. Methods This study employed qualitative research methods including thematic analysis and content analysis. Utilizing the word frequency and coding analysis functions of Nvivo14 software, the study identifies the developmental stages and core themes of British medical education in each stage. Results Since 1858, UK medical education has undergone three stages. The characteristics of these three stages are examination-oriented, curriculum integration-oriented, and outcome-oriented reforms. Each stage has brought corresponding changes in educational objectives, content, methods, and evaluation. Conclusions Amid global transformations in the model of medical education, non-profit organizations like the General Medical Council (GMC) have become increasingly influential in shaping the field. Countries should pay attention to and make good use of the power of non-profit organizations to promote the reform and development of medical education in the future. References | Related Articles | Metrics