Objective To study the current situation of doctor-patient communication education for medical undergraduates, and meanwhile to analyze the students’ satisfactory degree to communication education and its influencing factors, so as to provide sound suggestions to promote the students’ clinical communication abilities. Methods Using simple sampling, 50% of the students who majored in clinical medicine in grade 2006-2009 in West China Medical School of Sichuan University were selected as respondents. The investigation was conducted by face to face talk with a self-designed questionnaire. The data were input using EpiData 3.0 software and the results were analyzed by SPSS 13.0 software. Results A total of 450 questionnaires were distributed, and 404 were validly retrieved (89.78%). Among the respondents, 74.3% of them were satisfied with the current situation of doctor-patient communication education; 75.7% of them begun to know doctor-patient communication education since the stage of learning basic knowledge; 49.8% of them were trained by means of problem-based-learning (PBL); and 65.5% of them were trained with auxiliary standardized patient (SP). “Grade”, “Gender”, “SP used” and “PBL used” were the main factors affecting the satisfactory degree to current doctor-patient communication education (P=0.029, 0.023, 0.012, and 0.029, respectively). Conclusion The medical undergraduates’ satisfactory degree to current doctor-patient communication education is generally high, but it is also affected by various factors. Although doctor-patient communication education has started early, the training system is still problematic and the teaching resources coverage is limited. So in order to make a further systematic, standardized, overall designed education for students’ cognition and communication skills, the medical colleges should open integrated doctor-patient communication curriculum that combines with both PBL and SP auxiliary teaching methods, and covers all the undergraduate learning stage.
The health status, health needs and demands as well as the concept of health itself have changes dramatically in the last one hundred years, the organizational and institutional evolutions of health system took place accordingly. To adapt the changes of health system, medical education has experienced three generations of major reform in the last century: the science-based curricula, problem-based instruction, system-based and competence-oriented education. At the same time the organization of medical education evolved from academic medicine to academic health center to academic health system. This article briefly describes the process of this evolution and presents author’s personal views on academic health system.
Objective To investigate the effects of evidence-based medicine (EBM) course on clinical medical students and to propose teaching advice. Methods Using a predesigned questionnaire, we conducted an investigation on the literature retrieval, knowledge of EBM terms, and subject attitude of clinical 5-year and 7-year medical students before and after EBM course, and then an interview was performed to collect the opinions of the students. Data was statistically analyzed. Results After the course, average reading time and frequency of literature retrieval increased significantly compared to the situation before EBM course (Plt;0.05). Knowledge levels of main EBM terms related to practice increased significantly (Plt;0.05). 5-year medical students’ ability of literature appraisal also increased (Plt;0.05). In this interview, these students suggested that course time of literature retrieval and screening should increase and medical statistics should be reviewed. Conclusion Through the study of EBM course, both knowledge and attitude of students changed a lot, and combining case teaching with EBM course has a better teaching effect. Learning the concepts and techniques of EBM for clinical medical students can help them apply medical research evidence correctly in clinical practice, and train their self-learning ability.
Objective To explore teaching effects of case-based learning (CBL) in abdominal physical examination in diagnostics. Methods Among 83 undergraduates in grade 2007 and in major of 8-year clinical medicine were randomly divided into two groups. Under the same conditions, 41 in the CBL group were taught with CBL method, while the other 42 in the control group were taught with traditional teaching method. Their scores in standard patient (SP) practice assessment of abdominal physical examination, examination of abnormal abdominal signs, ability to analyze and write medical records, and right answers to abdominal examination in final exam were compared. Meanwhile, questionnaire surveys were distributed to them after class. Results There was no significant difference between the two groups in the scores of SP practice assessment or medical record writing and analyzing, but the CBL group was obviously superior to the control group in the tests of abnormal abdominal signs and the right answers to abdominal examination in final exam (Plt;0.05). The questionnaire surveys revealed that the CBL group obviously scored higher in the following 3 items: increase the learning interest and commitment, strengthen the ability to analyze and solve problems, and improve the ability to combine theory and practice (Plt;0.05). Conclusion CBL method has an obvious advantage to improve the teaching quality in abdominal physical examination in diagnostics.
Objective To evaluate the effectiveness of teaching evidence-based medicine (EBM). Methods 1. Introducing EBM teaching material in Chinese. 2. Offering EBM course in medical college of Sichuan University. 3. Problem-based,self-directed teaching methods. 4. A variety of test method. Results 36 Cochrane systematic review titles were registered, 17 Cochrane systematic review protocols were published in Cochrane Library, 6 Cochrane systematic reviews were published in Cochrane Library. 62 EBM research papers were published on Chinese Journal of EBM. Feedback of teaching EBM from postgraduates: 77.6%, 22.4% postgraduates consider this EBM course is very helpful and helpful for them respectively; 14.3%, 80% postgraduates achieve completely the goal and achieve the goal in greater part by this EBM course respectively; the reason of not achieving the goal is a lack of time to read and attend the course. 61.2%-80% and 16.3%-32.7% postgraduates consider the teaching contents is very good and good respectively; 61.2%-75.5% and 12.3%-28.6% postgraduates consider this teaching model is very good and good respectively; 44.9% postgraduates hope to increase hours of EBM course, increase discusses, increase EBM practice in future; 10.2% postgraduates consider the questions of test are hard to solve. Conclusion This EBM course is effective.
Objective To assess the effect of a new educational model for evidence-based medicine (EBM), which is called "2+N" model with the main characteristic of classroom teaching plus volunteer practice. Methods Questionnaire survey was conducted to collect data. Results There were averagely 39 volunteers participated in this activity per year, with an increasing trend. Most of them were sophomore and junior undergraduates from different specialties in medical filed. All participates acquired a better understanding of EBM knowledge; more than 60% of them could handle data searching, collecting and assessing by themselves in the end of the activity. Conclusion Our five years’ experience of EBM education practice for medical students suggested that the new educational model has a promising future.
Objective To learn about the attitudes and understanding of resident doctors with concerning Global Minimum Essential Requirements in Medical Education (GMER).Methods Two hundred and five resident doctors of West China Hospital of Sichuan University were investigated by using questionnaires. Results The majority of the resident doctors regarded 4 domains of GMER important, but they were lack of the recognition of the importance of “population health and health systems”, “communication skills”, and “management of information” domains. Conclusions Medical curriculum should be revised to strengthen the recognition of the importance of all the 7 domains in medical education, including the postgraduate medical education, so as to cultivate doctors’ suitability for their responsibility in healthcare.
Objective To evaluate the quality of undergraduate medical education so as to provide useful and effective feedback information for medical schools and to extend GMER (Global Minimum Essential Requirements in Medical Education) standard. Methods Through questionnaires, 205 resident doctors self-evaluated their abilities or qualities based on GMER standard. The unconditioned logistic regression model was used for data analysis. Results Graduates from undergraduate medical programs mastered the abilities or qualities required in 4 GMER domains i.e. “professional values, attitudes, behaviors and ethics”, “clinical skills”, “communication skills”, and “scientific foundation of medicine”. But the abilities or qualities required in “information management”, “population health and health systems” as well as “critical thinking and research” domains have not been obtained. The main factors that affected the evaluation results were corresponding training to the essentials, learner’s attitude, teaching models and teaching hours. Conclusion Educational sectors should adjust curriculum design so as to help medical students master the abilities required in the 3 domains stated above. Medical schools should conduct some educational research to formulate the most beneficial teaching methods, and import advanced ones to raise the quality of medical education in China.
Objective To study the application of virtual reality bronchoscopy stimulation in novice trainees. Methods Four novice bronchoscopists entered the training programby using a VR bronchoscopy in the clinical skill center. After the program, the dexterity, speed, and accuracy of all the four doctors were tested using the virtual simulation models. Results were compared to four skilled physicians as control group who had performed at least 50 bronchoscopies. Before-training and after-training test scores were compared using paired t tests. For comparisons between after-training novice and skilled physician scores, unpaired twosample t tests were used. Results All of the four trainees finished the training program. The novices significantly improved their dexterity, speed and accuracy. The percentage of observed segments increased from ( 74. 0 ±5. 1) % to ( 89. 3 ±4. 0) % . The number of contacts with the bronchial wall decreased from 87. 5 ±13. 2 to 30. 5 ±9. 3, and total time spent shortened from ( 700. 8 ±56. 6) s to ( 607. 0 ±17. 8) s. There were no statistically significant differences between novice accuracy ( the percentage of observed segments) after training and skilled physician accuracy [ ( 89. 3 ±4. 0) % vs ( 91. 3 ±3. 0) % , P = 0. 456] . Conclusion Practice using a virtual bronchoscopy simulator help novice trainees to attain a level of skill at performing diagnostic bronchoscopy, and it might play an important role in the training of chest physicians.