Chinese Journal of Medical Education

Reflections on the transition of competency-based medical education in undergraduate and postgraduate medical education

Li Haichao

2025, 45 (5): 321-326. DOI: 10.3760/cma.j.cn115259-20241218-01330

Abstract ( 44 )

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The construction of the standardized residency training system in China is undergoing a strategic shift towards a more substantive and quality-driven development model, with further enhancing training quality emerging as a critical priority at this stage. This article analyzes international admission standards for postgraduate medical education(Medical Licensing Examination) and explores the implementation of competency-based medical education (CBME) within undergraduate medical curricula. This article identifies that there are two distinct admission pathways and associated criteria in China′s postgraduate medical education system. In most North American and European countries, there exists nationally unified examination linked to medical licensing requirements during the final year of medical school, thereby establishing seamless articulation with postgraduate medical education. The author proposes that integrating components of medical licensing examinations and implementing formative assessments during undergraduate medical education would significantly enhance the alignment between undergraduate and postgraduate medical training in China. This approach is deemed essential for cultivating high-quality healthcare professionals capable of meeting the strategic objectives of the Healthy China initiative.

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Exploration and practice in faculty development and promotion incentive mechanisms for standardized residency training

Chen Shuying, Guo Siyuan, Yin Ying, Yang Daya, Hu Wenjie, Jiang Liang, Feng Shaoting, Zhang Kunsong, Xiao Lihua, Liang Ling, Wang Xiaotao, Kuang Ming

2025, 45 (5): 327-331. DOI: 10.3760/cma.j.cn115259-20250219-00173

Abstract ( 23 )

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Faculty development is pivotal to the quality of standardized residency training (SRT). To achieve sustained improvement in SRT quality, it is crucial to strengthen faculty development and incentive mechanism, to enhance faculty competence in and intrinsic motivation for teaching. Since 2015, the First Affiliated Hospital of Sun Yat-sen University has implemented a tiered and categorized faculty development framework, which was facilitated by international cooperation, to improve faculty competence in clinical teaching. Simultaneously, promotion mechanisms such as ″minimum teaching credit″ and the ″excellence in teaching″ have been established to foster intrinsic motivation among faculty members. These efforts have yielded significant outcomes. A well-structured faculty team has been developed, with 1 181 persons trained in internationally certified training programs, 45 awarded the Associate Fellowship of AMEE, and 32 key instructors selected in the Clinical Educator Program, among whom 23 have obtained the Master degree of Health Professions Education. Faculty teaching competence have been significantly enhanced, accompanied by a paradigm shift in their educational philosophy. A total of 44 faculty members have been promoted to senior professional titles through the excellence in education mechanism, effectively stimulating enthusiasm and innovation of the early- and mid-career educators. Moreover, 12 distinctive ″specialized colleges″ have been established, and a competence-based training programs has been designed and implemented, effectively enhancing the clinical competencies of resident trainees.

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The evolution and characteristic of medical education assessment

Qi Xin

2025, 45 (5): 332-337. DOI: 10.3760/cma.j.cn115259-20240906-00930

Abstract ( 25 )

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Medical education assessment has gone through three stages: assessment of learning, assessment for learning, and assessment as learning. The focus of evaluation in each stage is respectively summative assessment, formative assessment, and programmatic assessment, which has led to the continuous evolution of evaluation models and connotations. The purpose of assessment has shifted from educational measurement to determine whether learners are qualified, to increasing educational effect and catalytic effect of assessment, and then integrating multiple assessment methods to systematically evaluate learners′ core competencies. It is necessary for medical education to keep up with the times and take advantage of the trend of artificial intelligence development to gradually improve the methods and practices of educational assessment, and accelerate the implementation and development of competency-based medical education.

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Clinical thinking cultivation in standardized residency training

Lan Xueli, Xiang Yang

2025, 45 (5): 338-343. DOI: 10.3760/cma.j.cn115259-20241114-01180

Abstract ( 23 )

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This paper integrates the principles of cognitive psychology and pedagogy into the teaching of clinical thinking, exploring the theoretical foundation, strategies, instructing elements and methods for cultivating clinical thinking during standardized training for resident doctors. The theoretical foundations of clinical thinking teaching include: Dual Process Theory, Metacognition Theory, and Constructivism. The teaching strategies for clinical thinking include: student-centered learning philosophy, spiral progression teaching model, debriefing and feedback in clinical thinking, and reflection-based metacognitive adjustment. The instructing elements encompass establishing a conceptual framework, enhancing information-gathering skills, developing diagnostic reasoning abilities, fostering diagnostic demonstration and verification capabilities, as well as promoting decision-making proficiency in diagnosis and treatment. By utilizing teaching rounds, case discussions, medical record writing and revision sessions along with Mini-clinical evaluation exercises (mini-CEX), this paper elucidates the aims, strategies employed in different educational activities related to residents′ clinical thinking training, while highlighting key aspects and potential challenges. Furthermore, attention is drawn to evaluating clinical thinking abilities effectively in instructional practices while stimulating residents′ intellectual potential; acknowledging the value inherent in traditional teaching approaches; as well as comprehending the essence of thoughtful instruction.

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Analysis of policy topics and their evolution in China′s higher medical education

Chen Haoyang, Liu Jianan, Duan Yanhan, Wang Sifan, Wu Haijiang, Zhang Xinping

2025, 45 (5): 344-349. DOI: 10.3760/cma.j.cn115259-20240305-00216

Abstract ( 12 )

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Objective Policy documents on higher medical education in China were systematically reviewed to identify key policy topics and analyze their evolutionary trajectories, thereby providing novel perspectives for policy research in this field. Methods A total of 159 representative policy texts spanning 1978-2023 were retrieved from the Peking University Fabao Database and official government archives. Latent dirichlet allocation (LDA) topic modeling was applied to extract latent topic structures. Core policy topics and their focal content were determined through systematic analysis of topic-specific keyword distributions and document-topic probability matrices. Results Fifteen potential policy themes were extracted by the LDA and ultimately classified into eight categories of policy themes: medical postgraduate education, grassroots medical workforce development, regulatory frameworks for medical education governance, quality assurance mechanisms in medical education, support systems for medical education infrastructure, ideological and political education in medical training, Traditional Chinese Medicine (TCM) talent cultivation, and standardized residency training programs. Each topic exhibited distinct temporal emphases across policy periods, reflecting evolving priorities. Conclusions China′s higher medical education policies are characterized by comprehensive and systematic topic coverage, addressing multi-tiered dimensions of medical workforce development. The evolution of topics demonstrates both phased progression and adaptive recalibration, indicating policy responsiveness to societal demands and systemic reforms.

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Overview of the China Medical Students Survey and its implementation progress

Yu Chen, Xie Ana, Wu Hongbin, Jin Yue, Wang Weimin

2025, 45 (5): 350-357. DOI: 10.3760/cma.j.cn115259-20240617-00612

Abstract ( 11 )

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On the basis of a series of investigations on student development both at home and abroad, this paper summarizes the present research situation of student development in the field of higher education and medical education in our country, and makes a detailed analysis of the current monitoring and investigation project on the China Medical Students Survey (CMSS), which collects data that is the largest in scale, the most authoritative and the most complete in the field. This paper systematically reports the research background, theoretical basis, design framework and content of this project, introduces in detail the structure and validity of the questionnaire for freshmen, college students and fresh graduates, and reviews the development of the project from 2019 to 2023. The CMSS provided a scientific basis for monitoring and evaluating the quality of medical education through the analysis of medical education data in a multidimensional, extended time period and across data sets,and bridges the gap in the field of high quality student development survey in the field of China′s higher education and medical education.

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A survey and analysis of the current status and influence factors of extracurricular research learning among undergraduates in the school of public health, southeast university

Ma Yue, Yang Ligang, Zhang Ting

2025, 45 (5): 358-363. DOI: 10.3760/cma.j.cn115259-20240328-00326

Abstract ( 9 )

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Objective To investigateand analysis medical students′ cognition and evaluation of and participation in extracurricular research and its influencing factors, and to provide empirical evidence for optimising the design of extracurricular research and promoting the improvement of students′ comprehensive ability. Methods A cross-sectional questionnaire survey using cluster sampling method was conducted in July 2023 with 223 undergraduate students majoring in Preventive Medicine and Labor and Social Securityfrom the School of Public Health, Southeast University, class of 2018~2022 as the study population. The questionnaire was designed by the research team and distributed through the Questionnaire Star platform.The survey content mainly included basic information, extracurricular research cognition and evaluation, participation, motivation, among others. Cognition and evaluation of extracurricular research andthe main reasons and considerations of students from different grades and majors to participate in extracurricular research were analysed by Mann-Whitney U test and χ²test. Logistic regression model was used to analyse the influencing factors of whether to choose a certain extracurricular research activity. Results The Likert scores in understanding, necessity, satisfaction, and learning outcomes of extracurricular research oflower grade students were all lower than those in the higher grade[(2.46±0.71) vs.(2.95±0.59), (3.00±0.76) vs.(3.33±0.64), (2.46±0.84) vs.(2.76±0.79), (3.11±0.73) vs.(3.41±0.55), all P<0.05]. Extracurricular research generally affects the first classroom. There were differences in the types of extracurricular research activities tended to be chosen by different grades, the factors prioritised, and the motivation to participate in the programme across different majors (P<0.05). Gender, grade level, and motivation influenc the choice of specific activity types. Personal interest had a greater influence on the choice of self-employment.Conclusions Medical students generally have a positive cognition and evaluation of extracurricular research, but the cognition of lower-grade students is not optimistic. Factors such as gender, grade, professional background and participation motivation influence the choice of activities.Institutions should strengthen the popularity and guidance of extracurricular research activities in the lower grades, establish an all-round and multi-level extracurricular research system, strengthen the guidance and practice opportunities for independent entrepreneurship education, and increase the time for students to learn independently, so as to optimise the mode of extracurricular research, and stimulate the enthusiasm of students′ participation and creative inspiration.

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Exploration and practice of the talent cultivation system for clinical pharmacy

Zhang Wei, Zang Hongmei, Xie Xuefeng, Wu Fanrong, Lyu Xiongwen, Li Jun

2025, 45 (5): 364-369. DOI: 10.3760/cma.j.cn115259-20240229-00194

Abstract ( 12 )

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As medical models evolved, clinical pharmacy education also needed to keep abreast of the times and adapt to new medical and patient needs. This study explored the cultivation model for clinical pharmacy talents, analyzed the core connotation of ″understand medicine and pharmacy″ and constructed a clinical pharmacy talent development system that encompasses ″platform + module″ curricula, practical teaching involving ″basic experimentation - comprehensive practice - innovative training″, a ″dual-qualified″ teaching staff, diversified teaching methods, and a ″six-in-one″ student evaluation mechanism. The outcomes of teaching practice showed that the cultivation system based on the concept of ″understand medicine and pharmacy″ facilitated program development and talent nurturing, laying a foundation for cultivating high-level clinical pharmacy talents who can meet the health needs of the people.

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Research on influencing factors of medical students′ death attitudes

Yang Xiaojing, Gan Yutian, Duan Xinyu, Lu Feng, Wang Jianye, Zhao Lijie, Zhang Shue, Cao Depin

2025, 45 (5): 370-374. DOI: 10.3760/cma.j.cn115259-20241030-01126

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To scientifically identify factors influencing death attitudes of medical students, and provide a basis for further carrying out life education for medical students in medical universities. From June to August 2024, 15 medical students enrolled in a medical university were used to collect data using semi-structured interviews to diagnose and identify the factors influencing medical students′ attitudes towards death through the phenomenological Colaizzi′s 7-step data analysis method. The analysis and extracted the influencing factors of medical students′ death attitudes include three main genera, embodied factors, situational factors, and interaction factors. Embodied factors include self-conscious physical and mental health, self-control, and positive psychological emotions. Situational factors include traditional culture, campus cultural atmosphere, online media environment, the experience of the death of friends or relatives around the individual. Interaction factors include teacher-student interaction within the school, individual-family interaction, and individual-peer interaction. The death attitude of medical students is formed by multiple and complex factors. Higher medical schools should pay attention to the actual needs of medical students, integrate excellent traditional culture into life education programs, create a good campus cultural atmosphere, and encourage medical students to participate in life-related academic activities.

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Exploration of summer-initiated research program on the cultivation of scientific research capacities of medical students

Lu Man, Wang Jingchao, Yuan Lijia, Liu Hong

2025, 45 (5): 375-378. DOI: 10.3760/cma.j.cn115259-20240403-00344

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Strengthening the cultivation of undergraduate scientific research abilities is a trend in medical education. This paper introduced the design and practice of summer-initiated research program in Peking University Health Science Center, which enrolled 171 students of the summer-initiated research program in 2023, compared and analyzed the students′ evaluation of their own scientific research capacities before and after the program, and sorted out the students′ experience and suggestions. After participating in the summer-initiated research program, the students have significantly improved their understanding of scientific research ethics [ (3.94±0.91) vs. (3.77±1.01)], capacities of literature review [(4.02±0.78) vs. (3.81±1.02)], selection of research methods [ (3.22±1.00) vs. (3.03±1.02)], statistics and analysis of research data [ (3.53±1.02) vs. (3.37±1.03)] and writing research reports [ (3.72±0.98) vs. (3.44±0.97)], with statistical significance. Summer-initiated research program is a feasible and effective way of cultivating the research abilities of medical undergraduates.

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The mediating role of learning strategies for undergraduate students of traditional Chinese medicine between their professional identity and academic achievements

Hu Xinyue, Zhai Shuangqing, Yuan Na, Ye Tongle, Jiao Nan

2025, 45 (5): 379-383. DOI: 10.3760/cma.j.cn115259-20240204-00128

Abstract ( 9 )

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Objective To explore the mediating role of learning strategies among undergraduate students majoring in Chinese medicine between their professional identity and academic achievement. Methods A questionnaire survey was conducted. From November to December 2023, a convenient sampling method was used to select 1 194 undergraduate students majoring in Chinese medicine from 9 universities and colleges nationwide as survey respondents. Their level of professional identity, use of learning strategies, academic achievement, and the relationships among these variables were investigated. Descriptive statistics, t-tests, analysis of variance (ANOVA), Pearson correlation analysis, and other methods used to analyze the data. Results The scores for academic achievement, professional identity, and learning strategies among undergraduate students were 3.38±0.68, 3.88±0.73, and 3.40±0.73, respectively. Professional identity was positively correlated with both learning strategies and academic achievement, r values were 0.616 and 0.576, respectively, both P<0.05.The academic achievement scores are as follows: male students scored (3.44±0.74), female students scored (3.36±0.65), students with a traditional Chinese medicine family background scored (3.56±0.76), those with a Western medicine family background scored (3.48±0.68), and those without a medical family background scored (3.35±0.66). The differences in academic achievement among students of different genders and different family backgrounds are statistically significant (all P<0.05). The mediating effect of learning strategies between professional identity and academic achievement is significant, with an effect value of 0.357, accounting for 67.0% of the total effect of professional identity on academic achievement. Conclusions The overall levels of professional identity, learning strategies, and academic achievement among undergraduate students majoring in Chinese medicine are above average, but students′ academic achievement needs improvement. Differences exist in academic achievement among students, highlighting the need for personalized guidance. Learning strategies play a crucial mediating role between professional identity and academic achievement, suggesting that the cultivation of Chinese medicine students should achieve a comprehensive effect of enhancing both professional identity and the use of learning strategies.

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Bibliometric analysis of doctoral dissertations in the field of stomatology in China from 2003 to 2023

Cao Guifen, Liu Chuanxia, Fang Wen, Duan Xiaoni, Li Wen

2025, 45 (5): 384-389. DOI: 10.3760/cma.j.cn115259-20241224-01351

Abstract ( 10 )

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Objective To dissect the characteristics and prevalent research topics within Chinese doctoral dissertations in the field of stomatology from 2003 to 2023, offering insights for the nurturing of future dental doctoral candidates. Methods Utilizing bibliometric analysis, doctoral dissertations in the field of stomatology researchfrom 2003 to 2023 were sourced from the China National Knowledge Infrastructure (CNKI) and Wanfang Database Knowledge Service Platform in November 2024. Statistical analysis was performed on data such as authorship, publication volume, affiliated institutions and colleges, and dissertation keywords. CiteSpace software was used to conduct visual analysis of the keywords. Results A total of 2 721 doctoral dissertations in stomatology from 91 institutions and colleges were retrieved. Dissertations from the top 10 institutions constituted 69.8% (1 898/2 721) of the total. There were 959 thesis advisors, with 30 guiding≥20 dissertations, representing 29.7% (807/2 721) of the total. A significant 39.1% (1 065/2 721) of the dissertations remained uncited. An analysis of the research topics of doctoral dissertations in the field of stomatology from 2003 to 2023 reveals a trend of diversification and interdisciplinary integration centered on bone metabolism, disease mechanisms, and repair techniques. The research in stomatology has evolved from basic tissue engineering to molecular mechanisms and clinical translation. Since 2015, the frequency of keywords related to inflammation and immunity, such as macrophages and autophagy, has increased significantly. Additionally, the study of “exosomes”has attracted more attention from scholars. Conclusions The institutions and supervisors of doctoral dissertations in the field of stomatology in China are relatively concentrated. The citation frequency of these dissertations is relatively low, and the quality of the papers needs to be further improved. Future research can focus on exosome delivery systems, regulation of the inflammatory microenvironment, immunotherapy, and integration of multidisciplinary technologies to open up new avenues for the prevention and treatment of oral diseases.

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Reform of the admission methods of medical programs in German public universities and its implications

Hu Liang, Xiang Ke, Xu Yun, Li Yan

2025, 45 (5): 390-395. DOI: 10.3760/cma.j.cn115259-20240106-00024

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The selection of medical students constitutes a fundamental component of medical education, and attracting high-caliber candidates is a significant task in the reform of medical education. This article provides an overview of the historical development of admission methods for medical programs in German public universities, analyzing the strategies and resultant outcomes across various phases. It introduces the current multidimensional admission methods, including admission based on academic performance evaluation through standardized secondary education assessments (Abitur in German), institution-specific admission criteria, comprehensive ability assessment, specialized programs as well as program aims at training rural physicians. Furthermore, it encompasses an examination of diverse assessment metrics, including the test for medical studies, medical-related vocational trainings, and professional experience. The current range of admission methods and selection criteria for medical programs in German public universities is characterized by its diversity, optimizing the deployment of medical educational resources and preserving the high standards of medical education, all while upholding the legal precept of educational equity. It is anticipated that these findings will provide valuable insights for the reform of medical admissions methods and the enhancement of the quality of medical students in China.

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Analysis of the curriculum system for the doctor of medicine training in Johns Hopkins University School of Medicine

Xie Zhen, Hou Jianlin, Xie Ana

2025, 45 (5): 396-400. DOI: 10.3760/cma.j.cn115259-20240507-00458

Abstract ( 14 )

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The curriculum system is an important part of medical education, and it is the prerequisite for cultivating high-quality talents in line with the requirements of the new era. This paper describes and analyzes the doctor of medicine (MD) curriculum system of the Johns Hopkins University School of Medicine. The genes to society curriculum model of Johns Hopkins University School of Medicine requires students to not only pay attention to biology and disease itself, but also emphasize the role of social, environmental and psychological factors in health and disease, and emphasizes interdisciplinary teaching, practical ability training, social responsibility, innovative educational ideas and international perspective. These ideas provide important enlightenment for the reform of medical education in China, and through the study and reference of the genes to society curriculum model of Johns Hopkins University School of Medicine, it is helpful to improve the concept of medical education in China and help us to train high-quality medical talents who can adapt to the challenges of modern medicine.

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