Chinese Journal of Medical Education

Medical humanities: meaning, significance and education

Ke Yang, Li Fang

2024, 44 (12): 881-885. DOI: 10.3760/cma.j.cn115259-20240921-00989

Abstract ( 81 )

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The application of entrustable professional activities in the undergraduate medical education

Wang Weimin

2024, 44 (12): 886-889. DOI: 10.3760/cma.j.cn115259-20241008-01034

Abstract ( 58 )

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Competency-based medical education (CBME), as a characteristic of the third generation of medical education, has received considerable attention. Various countries have intensified their research efforts, successively proposing competency frameworks and Milestones for medical education, and suggesting the use of entrustable professional activities (EPAs) for resident training and competency evaluation. This review summarizes the competency frameworks and milestones in medical education, reviews the application of EPAs in postgraduate education, and focuses on the application of EPAs in the undergraduate education phase. It highlights the increasingly important role that EPAs are playing in curriculum design and competency evaluation at the undergraduate level. Appropriately designed EPA projects at the undergraduate level can facilitate medical students' learning in contextualized environments, enhance their professional competence, and strengthen the effective connection between undergraduate and postgraduate education. The introduction of core EPA projects at the undergraduate level is feasible and of great significance.

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Developing career pathways in health professions education and inspiring the advancement of health service: a review of the AMEE 2024 conference (part 1)

Wu Hongbin, Shen Ziyue, Xin Siyan

2024, 44 (12): 890-895. DOI: 10.3760/cma.j.cn115259-20241006-01029

Abstract ( 24 )

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Cultural connotation and reflection of the “bridge courses” in clinical medicine

Liu Mengtong, Shi Nan, Li Haichao

2024, 44 (12): 905-909. DOI: 10.3760/cma.j.cn115259-20231112-00474

Abstract ( 26 )

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Objective To review the educational cultural connotation of "bridge courses"of clinical medical education, so as to inform the organ-system integration courses reform. Methods From June 2018 to June 2021, 176 medical students of the eight-year clinical medicine major of Peking University Health Science Center, who were interns in Peking University First Hospital from 2015 to 2018, were enrolled in this study. After each level of students completed the learning task of "bridge courses", semi-structured one-to-one interview method was used to investigate their understanding and harvest of "bridge courses". Keywords of the answer content were extracted, word frequency analysis and co-word clustering analysis were used, and corresponding to the Canada medical education directions for specialists model. The frequency of different role competence involved in the content of students' answers was analyzed. Results The educational cultural connotation of "bridge courses"was concentrated in three parts: professional teaching culture, humanistic care culture and emotional connection culture. Among the students' answers about competence, 55.1%(97/176) were medical experts, 65.9%(116/176) were communicators, 21.6%(38/176) were professionals, 9.1%(16/176) were collaborators and 1.7%(3/176) were scholars. Conclusions "Bridge courses"educational culture connotation reflects in professional, humanistic and social aspects, and has important teaching value in competency-based medical education. The inheritance of "bridge course"educational culture will continue to be the foundation and driving force for medical college education, and provide support for eight-year curriculum in clinical medicine.

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The mediating effect of perceived stress between the overall well-being and academic self-efficacy of nursing undergraduates

Wang Yunan, Huai Panpan, Li Yao, Jin Ji, Hao Pei, Liu Zhaoyi

2024, 44 (12): 910-914. DOI: 10.3760/cma.j.cn115259-20230927-00312

Abstract ( 23 )

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Objective To understand the mediating effect of perceived stress between the overall well-being and academic self-efficacy of nursing undergraduates. Methods A total of 570 nursing undergraduates in three provincial medical colleges were recruited by random sampling and investigated by using the Chinese version of the perceived stress scale, the overall well-being scale and the academic self-efficacy scale. The mediating effect of perceived stress between the overall well-being and academic self-efficacy of nursing undergraduates was tested by Bootstrap. Results The scores of perceived stress, overall well-being and academic self-efficacy of nursing undergraduates were (18.20±8.04), (87.68±11.91) and (82.15±16.70). Perceived stress was significantly negatively correlated with overall well-being and academic self-efficacy(all P＜0.001). There was a significant positive correlation between overall well-being and academic self-efficacy. The perceived stress was mediated between overall well-being and academic self-efficacy. The direct and indirect effects of perceived stress on academic self-efficacy were 0.404 (P＜0.001) and 0.271 (P＜0.001), respectively. The mediating effect of perceived stress accounted for 40.15% of the total effect. Conclusions The perceived stress was partially mediated between overall well-being and academic self-efficacy. In order to strengthen nursing undergraduates' academic self-efficacy, educators should take a variety of measures to improve students' overall well-being, and reduce their perceived stress.

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Current situation and training strategy of Chinese doctors' clinical research competency

Li Pei, Zhu Shengjie, Zhao Ning, Qiu Yue

2024, 44 (12): 915-919. DOI: 10.3760/cma.j.cn115259-20241011-01054

Abstract ( 25 )

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Amidst global trends and technological leaps, medical science is at a pivotal transformation, with innovation as its driving force. This study examines China's current status and challenges in cultivating clinical research capabilities, particularly in reducing dependency on foreign drugs, devices, and standards. It identifies key obstacles such as funding, resource disparity, flawed incentives, interdisciplinary hurdles, and continuing education gaps. To address these, the paper suggests optimization strategies including curriculum enhancement, establishing mentorship, adopting digital and targeted training approaches, and enhancing collaboration and international partnerships to boost clinical research and foster medical innovation in China.

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Application of team-based learning in the medical imaging internship of eight-year medical students

Guo Wei, He Qingyuan, Wang Xiaohua

2024, 44 (12): 920-923. DOI: 10.3760/cma.j.cn115259-20240325-00310

Abstract ( 17 )

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Objective To explore the effect of team-based learning (TBL) method in the medical imaging internship for eight-year medical students. Methods A controlled trial method was adopted. In March 2021 and December 2022, a total of 56 eight-year medical students were enrolled in 2018 and 2020 of Peking University Health Science Center who participated in the internship course in the Radiology Department of Peking University Third Hospital were selected as research subjects through convenience sampling. All students were randomly divided into experimental group(n=28) and control group (n=28) using the online tool random.org. The experimental group students used TBL teaching method, while the control group students used traditional teaching method. The knowledge acquisition ability, film reading reasoning ability and final exam and student satisfaction questionnaire survey were used to evaluate the teaching effect. The independent sample t-test or chi square test were used for statistical analyses. Results There was no significant difference in knowledge acquisition ability, film reading reasoning ability and final exam scores between students in the two teaching modes [For instance,the score of knowledge acquisition ability,(108.05±7.07) vs. (106.07±5.17),all P>0.05]. The students score of experimental group in group discussions and the effectiveness of peer learning were better than the control group [(102.35±4.11) vs. (96.37±7.03), P=0.006; (98.01±7.09) vs. (93.27±6.09), P=0.014], the differences were statistically significant (all P<0.05). Conclusions The application of TBL teaching method in medical imaging internship teaching can help to improve student participation and peer learning effect.

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Case-based learning combined with bedside teaching in critical care medicine

Cui Yan, Xie Keliang

2024, 44 (12): 924-928. DOI: 10.3760/cma.j.cn115259-20240503-00448

Abstract ( 14 )

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Case-based learning and bedside teaching are both important methods to cultivate clinical thinking and active learning ability of medical students. Under the traditional teaching mode, there is a problem that theoretical knowledge is out of touch with clinical practice in critical care medicine teaching. The Department of Critical Care Medicine of Tianjin Medical University General Hospital adopted the model of case-based learning combined with bedside teaching for 30 undergraduates majoring in anesthesiology in the five-year clinical medicine of grade 2020, built a clinical case library for undergraduate teaching of critical care medicine, designed 7 sessions of case-based learning integrated with core theoretical knowledge, two of which trained students' practical skills through simulated teaching and 2 times of bedside teaching were arranged. The course assessment results showed that the average score of students' regular performance was 88.63 points, the average score of the final exam was 77.53 points, and among them, the average score of the comprehensive case analysis questions was 32.93 points. The results of the questionnaire survey showed that 26 students (86.7%) believed that the case-based learning combined with bedside teaching model was helpful to deepen the understanding and application of theoretical knowledge; 29 (96.7%) believed that the teaching model was helpful to cultivate clinical thinking and the ability to solve clinical problem; 28 (93.3%) believed that this teaching model was helpful to enhance the ability of independent learning and communication and cooperation. Case-based learning combined with bedside teaching model is helpful to the undergraduate teaching of critical care medicine, which has been recognized by students and is worthy of further promotion.

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Application of SPOC teaching mode with the digital renal pathology platform in nephrology clerkship for undergraduate students

Zhu Xuejing, Zhang Ke, Yuan Shuguang, Han Yachun, Xia Shiyu, Qi Zhiwen, Zhang Jie, Sun Lin, Liu Hong, Zhu Lanyan, Xiao Li

2024, 44 (12): 929-932. DOI: 10.3760/cma.j.cn115259-20240124-00090

Abstract ( 6 )

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Nephrology is an important part in clinical medicine, for which renal pathology plays an auxiliary role. Exploring suitable teaching methods to combine nephrology and renal pathology content is expected to improve the teaching effect. This study selected the nephrology knowledge required to mastered in the syllabus, collected the clinical and pathological data of typical cases by digital section scanning system, recorded teaching videos and uploaded them to the cloud to build an integrated platform of nephrology and renal pathology. The Small Private Online Course (SPOC) teaching based on the integrated platform was performed on 110 students majored in five-year clinical medicine of Grade 2018 in the Second Xiangya Hospital of Central South University. A follow-up test (10 points) and a questionnaire survey were used to evaluate the teaching effect. The experimental students scored well in the classroom test [10.0(9.0,10.0)]. The result showed that 98.2% (108/110) of students reckoned this teaching mode helps improve independent learning ability, 87.3% (96/110) of students reckoned it increases the interest in learning, and 100.0% (110/110) of students reckoned it helps to understand and consolidate the therapeutic knowledge and deepen memories. The SPOC teaching mode based on the integrated platform of nephrology and renal pathology is helpful to improve the learning ability and interest of undergraduate students of clinical medicine and enhance the effectiveness of nephrology internship teaching.

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Design, implementation and preliminary feedback on the innovative module of early clinical exposure course for eight-year medical students

Yu Fan, Wang Wei, Li Xin, Feng Lili, Yang Fan, Wang Xuedong, Wang Yanying, Liu Fang

2024, 44 (12): 933-937. DOI: 10.3760/cma.j.cn115259-20231016-00361

Abstract ( 9 )

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Objective To explore the design, implementation, and feedback of the innovative module "Whole Process of Medical Behavior"of the competency based early clinical exposure course for eight-year medical students. Methods A total of 68 undergraduate students of the 2022 clinical medicine eight year program from School of Medicine Tsinghua University and 10 clinical teachers were involved in the early clinical exposure course. "Whole Process of Medical Behavior"module was designed based on core competencies and needs assessment of the medical students. Both outpatient and inpatient clinical practice was observed. Rational module objectives were developed. Active teaching methods were adopted. Humanity education and system based practice were emphasized. The curriculum was preliminarily assessed by formal interviews with both clinical teachers and students and after-class summaries. Results Students believed that this module provided them with a preliminary understanding of medical behavior, clinical thinking, medical ethics, and systems-based practice. Clinical experience will be recalled and connected with future theretical learning, and help culture learning interest and self-directed learning ability. Compared with the previous extensive clinical early exposure courses, the teachers believed that the refined "Whole Process of Medical Behavior"module had detailed objectives, specific focuses, inevitably with more manpower demand. The module allowed in-depth student-student and teacher-student communication, and was expected to help develop core competency by stimulating interest, improving learning efficiency, and enhancing leadership. Conclusions The module "Whole Process of Medical Behavior"conforms to the goal of competency-oriented medical education, and can provide reference for the design of clinical exposure courses in medical colleges.

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Analysis of self-evaluation and tutor evaluation on the position competency of residents in Zhongnan Hospital of Wuhan University

Chen Jinyu, Zhang Cen, Ye Yanqing, He Li, Wang Shiyu

2024, 44 (12): 938-942. DOI: 10.3760/cma.j.cn115259-20230801-00076

Abstract ( 15 )

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Objective To explore the status of standardized residency training in Zhongnan Hospital of Wuhan University with competency-based medical education evaluation system, and to provide suggestions for improving the competency of residents. Methods In 2022, a questionnaire survey was conducted to evaluate the job competency of 185 resident physicians from the 2021 cohort, both at the time of admission and after six months of training. Both self-evaluations and evaluations by tutors were collected. Paired-sample t-tests and one-way ANOVA analysis were performed on the evaluation results. Results After six months of training, both the self-evaluation of the residents and the evaluations by their tutors showed significant improvement compared to their initial admission. For example, in terms of professionalism, the self-evaluation score of the residents increased to (4.31±0.76), higher than the initial score of (3.87±0.95); the evaluation score by tutors was (4.70±0.50), also higher than the initial score of (4.54±0.65), all P<0.001. After six months of training, the self-evaluation score for professionalism among residents was the highest [(4.31±0.76)], while the self-evaluation score for the healthcare system was the lowest [(3.15±1.07)]. Furthermore, after six months of training, there were no statistically significant differences in the self-evaluation results of job competency among resident physicians of different identities (all P>0.05). For instance, the self-evaluation scores for professionalism among residents recruited from society, those under the entrusted training of other institutions, professional master in clinical medicine, and residents within the same institution were (4.30±0.75), (4.28±0.80), (4.29±0.77), and (4.46±0.71), respectively. Conclusions Standardized residency training can improve the competency of residents. But at the same time, the weakness of medical quality assurance system, patient management and academic performance should be strengthened. Therefore, supervision, peer, patient evaluation and assessment results will be increased in the later stage to achieve a comprehensive evaluation and analysis of the residents and improve the residents competency.

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Resuscitation quality improvement program to improve the acquisition and retention of cardiopulmonary resuscitation skills for healthcare professionals in emergency department

Jiang Hui, Song Xiao, Zong Liang, Zhu Huadong, Liu Jihai, Shi Di

2024, 44 (12): 943-947. DOI: 10.3760/cma.j.cn115259-20230822-00153

Abstract ( 3 )

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Objective This study aims to evaluate the effectiveness of the resuscitation quality improvement (RQI) program in cardiopulmonary resuscitation (CPR) training for emergency department personnel. Methods From April 2021 to April 2022, a cohort of 149 healthcare professionals from the Emergency Department of Peking Union Medical College Hospital were enrolled in CPR training using the RQI program. Test scores of pre-training, post-training and four quarterly refresher training periods (Q1, Q2, Q3, Q4) were collected, questionnaires were also used to assess the training effects. Non-parametric Wilcoxon rank-sum tests were used for data analysis. Results There were statistical improvements in CPR test scores from pre- to post-training for adult compressions [64.5 (59.0) vs. 96.0 (15.0)], adult ventilation [42.5 (86.0) vs. 97.5 (14.0)], infant compressions [24.0 (73.0) vs. 94.0 (19.0)], and infant ventilation [28.5 (57.0) vs. 74.5 (46.0)](all P < 0.05). The adult compression scores for Q1, Q2, Q3, and Q4 were 97.0 (3.0), 98.0 (4.0), 97.0 (5.0), and 98.0 (4.0), respectively, and the infant compression scores were 98.0 (6.0), 98.0 (5.0), 99.0 (8.0), and 98.0 (5.0), respectively. The adult ventilation scores were 99.0 (3.0), 99.0 (3.0), 99.0 (7.0), and 99.0 (3.0), and the infant ventilation scores were 98.0 (7.0), 98.0 (8.0), 99.0 (5.0), and 99.0 (5.0), all with no statistical differences across the four quarters (all P>0.05). The participation rate was 99.3%(148/149) for Q1, 96.6%(144/149) for Q2, 94.6%(141/149) for Q3, and 91.9%(137/149) for Q4. The overall satisfaction rate was 89.1%(122/137). Conclusions The RQI program for CPR training in the emergency department was effective in enabling participants to acquire and maintain core skills, with high levels of course compliance and satisfaction. RQI could be an alternative approach for CPR training among emergency clinicians and nurses.

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Progress and prospect on evaluation of political and virtuous awareness in medical curricula

Meng Fang, Wang Shilei, Xu Jicheng

2024, 44 (12): 948-952. DOI: 10.3760/cma.j.cn115259-20240111-00043

Abstract ( 24 )

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Objective To analyze the current situation of political and virtuous awareness education evaluation in medical curricula, so as to inform the development and promotion in this area. Methods Bibliometric method was used to analyze the annual number of documents, the authors, Journals and key words included in CNKI, Wanfang and VIP databases. Results A total of 380 articles were included, and the number of articles was on the rise. There were a lot of papers published in Health Vocational Education, China Continuing Medical Education, Education and Teaching Forum, Chinese Journal of Nursing Education, Continuing Medical Education. No core author team has been formed, and there were fewer inter-regional cooperation. There were 285(75.0%) papers based on a specific course, basic medical courses count for 98(34.4%) and professional courses count for 187(65.6%). The research focused on the evaluation of students' learning effect, the evaluation of teachers' teaching activities and construction of curriculum teaching evaluation system. Conclusions The evaluation of political and virtuous awareness in medical curricula developed rapidly and is gaining an increasing attention in China. However, improvements need to be focused on the quality of the research, the depth and breadth of the research are not enough, and the scientific merits of the construction of the evaluation index system needs to be improved. It is suggested that we should learn from the existing studies, to explore the evaluation paradigms in different medical professional courses, and further refine the research contents and increase the research depth, so as to promote scientific, three-dimensional and systematic research.

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Analysis of the performance in the professional level test and final assessment of standardized residency training in Heilongjiang Province

Wang Meijie, Zheng Nan, Liu Zhenhong, Zhang Ding, Zhu Nan, Liu Zhenhua

2024, 44 (12): 953-956. DOI: 10.3760/cma.j.cn115259-20230908-00223

Abstract ( 10 )

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Objective To analyze the professional level test and final assessment results of standardized residency training in Heilongjiang Province and to explore strategies and measures to enhance the management of this training program. Methods The professional level test and final assessment scores of 2 311 residents in Heilongjiang Province in 2022 were analyzed. Statistical methods such as the χ²test and variance analysis were employed to analyze the differences in professional knowledge assessment results among residents grouped by their professional level test scores across three tests. Additionally, comparisons were made regarding the differences in final assessment scores among different types of residents. Results The pass rates for the high-score groups in the three professional level tests were 98.33% (646/657), 97.80%(623/637), and 95.85%(600/626), respectively, while the pass rates for the low-score groups were 85.80%(544/6634), 87.03%(550/632), and 89.03%(568/638), respectively, all P<0.001. The scores for professional knowledge and clinical practice ability assessments in the final assessment for postgraduate students with a master's degree in clinical medicine were higher than those of ordinary residents [(426.10±15.78) vs. (421.26±17.81) for professional knowledge, and (91.53±5.52) vs. (89.30±5.71) for clinical practice ability, all P<0.001. Conclusions There may be a certain correlation between the professional level test scores and the results of the final assessment in standardized residency training. Differences exist in the training effectiveness between specialized master's degree students and ordinary residents. Efforts should be intensified in the management and training of ordinary residents, with an emphasis on enhancing clinical practice ability, to further improve the quality of residency training.

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Medical education model in the University Medical Center Groningen and its implications

Xu Xiaoming, Zhou Yan, Wu Hongbin, Chen Weiying

2024, 44 (12): 957-960. DOI: 10.3760/cma.j.cn115259-20231123-00515

Abstract ( 28 )

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The University of Groningen in the Netherlands is one of the top 100 universities globally, renowned worldwide for its excellent teaching quality and international reputation in medical education. Through on-site investigation and text analysis, this study provides a comprehensive review of the medical talent cultivation model at the University Medical Center Groningen (UMCG), spanning from undergraduate to postgraduate levels. UMCG's medical talent training objectives are competency-based, with a curriculum system centered on the patient, achieving systematic integration. The teaching approach involves small group learning communities, and formative assessments are employed to evaluate students' competency development. UMCG's medical talent cultivation model offers valuable insights and implications for the reform of medical education in China, particularly in terms of curriculum content, teaching methods, and evaluation approaches.

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