Construction and application of multidisciplinary scientific research outpatient in clinical research / 中华医院管理杂志

In recent years, some large public hospitals in China had successively opened scientific research outpatients to provide consulting services for clinical research, but there were generally problems such as insufficient audience and single role of expert teams. In July 2021, Shanghai Clinical Research Center established a multidisciplinary scientific research outpatient for the entire clinical research cycle, providing medical staffs with such services as clinical research design and project application, paper revision and achievement transformation. It also provided clerkship for medical students on campus to cultivate their standardized clinical research thinking. As of July 2022, the outpatient had provided research consulting services 16 times, teaching 8 class hours to medical students, and collaborated to solve multi-dimensional clinical research practical problems throughout the entire cycle, such as clinical trial design, project application, and paper publication. Good results had been achieved by this outpatient to provide reference for promoting the development of scientific research outpatients in China and improving the clinical research level of hospitals.

Study on coping styles of clinical ophthalmic interns under psychological stress / 中华医学教育探索杂志

Objective:To study the characteristics and influencing factors of coping styles of clinical ophthalmic interns under psychological stress, so as to provide scientific basis for promoting the mental health development of medical students.Methods:In 2019, 103 students of Sun Yat-sen University who participated in clinical practice of ophthalmology were investigated by cluster sampling with general situation questionnaire and simple coping style questionnaire. The database was established by Epidata, and the data was statistically analyzed by SPSS 25.0 software.Results:The scores of positive coping and negative coping were (1.70±0.10) and (1.30±0.05) respectively, which were all lower than the norm ( P < 0.001). The scores of non first time practice students were 0.087 points higher than those of first time practice students; the scores of eight-year students were 0.124 points higher than those of five-year students; the scores of positive coping increased by 0.015 points for each level of family income increase. Men scored 0.027 points higher than women in negative coping scores; eight-year students scored 0.053 points lower than five-year students in negative coping scores; family income increased by one grade, negative coping scores decreased by 0.017 points; rural registered residence students scored 0.035 points higher than urban registered residence students in negative coping scores; non first practice students scored 0.074 points higher than the first practice students in negative coping scores. Conclusion:Educators should pay close attention to the coping styles of clinical ophthalmic interns, carry out mental health education and guidance of coping methods according to the characteristics of different groups, take effective measures to improve students' stress coping ability and promote the smooth development of clinical practice in ophthalmology.

Investigation on mental health status of medical students in clerkship of a university during the pandemic of Coronavirus disease 2019 / 中华医学教育探索杂志

Objective:To investigate the psychological status of medical students in clerkship during the outbreak of Coronavirus Disease 2019 (COVID-19), analyze the psychological status characteristics and influencing factors of them, and provide an effective basis for carrying out corresponding mental health education and countermeasures.Methods:The survey was conducted on clerkship medical students in the form of questionnaires, including self-made general status questionnaires, symptom checklist 90 (SCL-90) and social support rate scale (SSRS). Statistical analysis was made on above data, chi-square test was used for rates comparison, t test was for comparison between groups, and Spearman correlation analysis was conducted. Results:The survey obtained 359 valid questionnaires, 18.38% of medical students had different aspects of psychological problems. There was no statistical difference between male and female. For those who knew that there was free psychological counseling for the COVID-19, the levels of three factors, such as compulsive symptoms, anxiety, and hostility, were lower than those of the others who didn't know that [(1.30 ± 0.44) vs. (1.41±0.55), (1.19±0.30) vs. (1.26±0.42), (1.17±0.35) vs. (1.26±0.44), P < 0.05]. SSRS results showed that male students had lower social support availability than female students [(7.46±2.03) vs. (8.10±2.06), P=0.004], and except for somatization, other SCL-90 factors scores of the students were negatively correlated with SSRS scores. Conclusion:During the pandemic, medical students in clerkship have a certain degree of psychological problems, which are negatively related to social support, suggesting that these medical students' mental health can be improved by improving social support.

Reform and exploration of teaching methods for eight-year program medical students' early exposure to clinical practice / 中华医学教育探索杂志

Objective:To explore the effect of early clinical clerkship training in the early exposure to clinical practice of eight-year program medical students.Methods:Experimental control method was used in this study. A total of 120 eight-year program medical students in the third year of Batch 2014 to 2016 from the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were selected as the research objects. The students of each grade were randomly selected by computer and divided into experimental group and control group, with 20 students in each group. Before early clinical exposure, the experimental group received 16 class hours of early clinical clerkship training, while the control group did not receive early clinical clerkship training. After the early clinical exposure, the clinical diagnosis and treatment ability of the two groups of students was compared. SPSS 24.0 software was used for t test. Results:The scores of medical history inquiry of experimental group and control group were [(17.45±1.96) points and (15.95±1.93) points; (18.30±1.03) points and (16.75±1.86) points; (17.95±1.36) points and (16.40±1.60) points, respectively]. The physical examination scores were [(17.75±1.65) points and (16.05±1.64) points; (17.85±1.18) points and (16.80±1.47) points; (18.25±1.16) points and (16.85±1.63) points, respectively]. The clinical judgment scores were [(18.15±1.42) points and (16.35±2.41) points; (18.20±1.24) points and (16.65±1.53) points; (18.35±1.35) points and (16.25±1.83) points, respectively]. Diagnosis and treatment scheme scores were [(17.15±1.57) points and (14.55±2.56) points; (17.30±1.42) points and (15.90±1.48) points; (17.80±1.06) points and (16.35±1.87) points, respectively]. The scores of communication skills were [(17.95±1.15) points and (17.00±1.19) points; (18.55±0.83) points and (17.45±1.50) points; (18.45±1.00) points and (17.45±1.23) points, respectively], with statistically significant differences (all P<0.05). Conclusion:The application of early clinical clerkship training in the early exposure to clinical practice of eight-year program medical students can improve the quality of students' clerkship.

Research progress on moral distress of nursing interns / 中国实用护理杂志

Moral distress generally exists in the nursing interns and has a far-reaching impact. This paper analyzed and summarized the current situation, influencing factors and coping strategies of the nursing interns at home and abroad, in order to provide reference for promoting the professional development of nursing students, strengthening their professional beliefs and stabilizing the nursing team.

5. The 2022 Revision of the Model Core Curriculum for Medical Education in Japan and the Common Achievement Test Being Made an Official Requirement / Participatory Clinical Clerkship / 医学教育

Following the revision of the structure and content of the Model Core Curriculum for Medical Education to be more outcome-based and the legal status of the medical practice performed by medical students in the clinical clerkship, we have revised the Guideline for Participatory Clinical Clerkship. The following items were revised or newly described : significance of enhancing the participatory clinical clerkship, scope of medical practice, confidentiality, patient consent, patient consultation and support service, objectives of the clinical clerkship, simulation education, departments where the clinical clerkship is conducted, assessment in the clinical practice setting, CC-EPOC, and entrustable professional activities. A foundation has been established to promote seamless undergraduate and postgraduate medical education. However, future work is needed to examine the specific level of performance expected at the end of the clinical clerkship and department-specific clinical practice goals and educational strategies.

Obstetric simulation for undergraduate medical education: how to improve students' self-confidence and expectation according to gender

SUMMARY OBJECTIVE: The aim of this study was to evaluate the effects of obstetric simulation training on undergraduate medical students to improve their self-confidence. METHODS: Fifth-year undergraduate medical students were invited to a 2-week course of simulation in obstetrics during their clerkship. The sessions included were as follows: (1) care for the second and third periods of childbirth, (2) partograph analysis and pelvimetry, (3) premature rupture of membranes at term, and (4) diagnosis and management of third-trimester bleeding. Before the first session and at the end of the training period, a questionnaire about self-confidence in obstetric procedures and skills was applied. RESULTS: A total of 115 medical students were included, of whom 60 (52.2%) were male and 55 (47.8%) were female. Comparing initial and final scores, the median results of the subscales "comprehension and preparation" (18 vs. 22, p<0.001), "knowledge of procedures" (14 vs. 20, p<0.001), and "expectation" (22 vs. 23, p<0.01) were significantly higher at the end of the training period in all items of the questionnaire than in the beginning. Differences were found based on the students' gender, i.e., female students had a significantly higher sum of scores than the male students in the initial subscale for "expectation" (median, 24 vs. 22, p<0.001) and "interest" (median, 23 vs. 21, p=0.032), and a higher sum of scores in the subscale for "expectation" (median, 23 vs. 21, p=0.010) in the final questionnaire. CONCLUSION: Obstetric simulation enhances the improvement of students' self-confidence in understanding both the physiology of childbirth and the obstetric care procedures. Further studies are needed to understand the influence of gender on obstetric care.

Segurança do paciente na prática clínica dos estudantes de enfermagem: conhecimentos e atitudes / Seguridad del paciente en la práctica clínica de los estudiantes de enfermería: conocimientos y actitudes / Patient safety in clinical practice of nursing students: knowledge and attitudes

Objetivos: mensurar os conhecimentos e atitudes de estudantes de enfermagem sobre segurança do paciente em campos de prática desenvolvido em unidades hospitalares. Método: pesquisa transversal e quantitativa, realizada em um centro universitário privado da capital paranaense. Foi aplicado o Latino Students Patient Safety Questionnaire a 26 estudantes entre os meses de junho e agosto de 2022. Os dados foram analisados por estatística descritiva. Itens/questões com escore ?4 pontos indicam resultado satisfatório Resultados: das 21 afirmativas, 57,1% foram consideradas insatisfatórias. A consciência do erro individual, das normas de segurança adotadas pela instituição e da impossibilidade de evitar a maioria dos erros clínicos obtiveram as menores médias (2,7 cada). Os itens da dimensão atitude proativa para evitar risco à segurança apresentaram-se satisfatórios (≥4 pontos). Conclusão: os estudantes apresentam atitude proativa para evitar risco à segurança, embora haja lacunas de conhecimento acerca da segurança do paciente em campos práticos.

Objetivos: medir los conocimientos y actitudes de estudiantes de enfermería sobre seguridad del paciente en campos de práctica desarrollado en unidades hospitalarias. Método: investigación transversal y cuantitativa, realizada en un centro universitario privado de la capital paranaense. Se aplicó el Latino Students Patient Safety Questionnaire a 26 estudiantes entre los meses de junio y agosto de 2022. Los datos fueron analizados por estadística descriptiva. Ítems/cuestiones con puntaje ?4 puntos indican resultado satisfactorio Resultados: de las 21 afirmativas, 57,1% fueron consideradas insatisfactorias. La conciencia del error individual, de las normas de seguridad adoptadas por la institución y de la imposibilidad de evitar la mayoría de los errores clínicos obtuvieron las menores medias (2,7 cada una). Los ítems de la dimensión actitud proactiva para evitar riesgo a la seguridad se presentaron satisfactorios (≥4 puntos). Conclusión: los estudiantes presentan actitud proactiva para evitar riesgo a la seguridad, aunque hay lagunas de conocimiento acerca de la seguridad del paciente en campos prácticos.

Objective: to measure the knowledge and attitudes of nursing students about patient safety in fields of practice developed in hospital units. Method: cross-sectional and quantitative research, conducted in a private university center in the capital of Paraná. The Latino Students Patient Safety Questionnaire was applied to 26 students between June and August 2022. Data were analyzed by descriptive statistics. Items/questions with ?4 points score indicate satisfactory result. Results: of the 21 statements, 57.1% were considered unsatisfactory. Awareness of individual error, safety standards adopted by the institution and the impossibility of avoiding most clinical errors obtained the lowest averages (2.7 each). The items of the proactive attitude dimension to avoid safety risk were satisfactory (≥4 points). Conclusion: students present a proactive attitude to avoid safety risk, although there are gaps in knowledge about patient safety in practical fields.

História do Centro Docente Assistencial de Fonoaudiologia da Universidade Federal da Bahia / History of the Speech-Language Pathology Teaching Assistance Center at the Federal University of Bahia / Historia del Centro de Asistencia Docente de Logopedia de la Universidad Federal de Bahía

Introdução: As clínicas-escolas de fonoaudiologia exercem papel fundamental na formação dos futuros profissionais. O Centro Docente Assistencial de Fonoaudiologia (CEDAF) foi criado com o intuito de ser uma clínica-escola do Curso de Graduação em Fonoaudiologia da Universidade Federal da Bahia. Objetivo: Descrever a história do CEDAF, a fim de contextualizar as mudanças pelas quais passou, destacando os principais acontecimentos a partir do olhar de atores que fazem parte desse percurso. Método: Trata-se de um estudo qualitativo, caracterizado como exploratório e descritivo, realizado na clínica CEDAF. Foram utilizadas fontes de dados orais, coletadas por meio de entrevistas e grupo focal, gravadas em áudio, transcritas e analisadas conforme categoria temática, buscando identificar os núcleos de sentido. Resultados: Foi possível perceber a intensa transformação pela qual o CEDAF passou ao longo dos seus vinte anos de história. Entre as mudanças mais significativas estão a ampliação do espaço físico, aumento do número de alunos do curso e a contratação de novos docentes, a admissão de fonoaudiólogas na clínica e o convênio firmado com a rede municipal de saúde. Conclusão: Deixar registrada uma primeira versão da história do CEDAF pode contribuir para fazer deste local um campo de pesquisa em contínuo aperfeiçoamento na formação dos futuros profissionais de fonoaudiologia e na prestação de serviço.

Introduction: Speech therapy clinic-schools play a fundamental role in the training of future professionals. The Speech-Language Pathology Teaching Assistance Center (CEDAF) was created with the intention of being a clinic-school of the Graduation Course in Speech Therapy at the Federal University of Bahia. Purpose: Describe the history of CEDAF, to contextualize the changes it has gone through, highlighting the main events from the perspective of actors who are part of this path. Method: This is a qualitative study, characterized as exploratory and descriptive, carried out at the CEDAF clinic. Oral data sources were used, collected through interviews and focus groups, recorded in audio, transcribed, and analyzed according to thematic category, seeking to identify the core meanings. Results: It was possible to perceive the intense transformation that CEDAF has undergone throughout its twenty years of history. Among the most significant changes are the expansion of the physical space, the increase in the number of students in the course and the hiring of new professors, the admission of speech therapists in the clinic and the agreement signed with the municipal health network. Conclusion: Registering a first version of the history of CEDAF can contribute to making this place a field of research in continuous improvement in the training of future professionals in speech therapy and service provision.

Introducción: Las clínicas-escuelas de logopedia juegan un papel fundamental en la formación de los futuros profesionales. El Centro de Asistencia Docente de Logopedia (CEDAF) se creó con la intención de ser clínica-escuela del Curso de Graduación en Logopedia de la Universidad Federal de Bahía.Objetivo: Describir la historia del CEDAF, con el fin de contextualizar los cambios que ha atravesado, destacando los principales hechos desde la perspectiva de los actores que forman parte de este camino. Método: Se trata de un estudio cualitativo, caracterizado como exploratorio y descriptivo, realizado en la clínica CEDAF. Se utilizaron fuentes de datos orales, recolectadas a través de entrevistas y grupos focales, grabadas en audio, transcritas y analizadas según categoría temática, buscando identificar los significados centrales. Resultados: Se pudo percibir la intensa transformación que ha experimentado CEDAF a lo largo de sus veinte años de historia. Entre los cambios más significativos se encuentran la ampliación del espacio físico, el aumento del número de alumnos en el curso y la contratación de nuevos profesores, la admisión de logopedas en la clínica y el convenio suscrito con la red municipal de salud. Conclusión: Registrar una primera versión de la historia del CEDAF puede contribuir a hacer de este lugar un campo de investigación en mejora continua en la formación de los futuros profesionales en logopedia y prestación de servicios.

Delivering Electives the Clerkship Way: Consolidating the Student Doctor Method of Training

Student doctor method of clinical training or clinical clerkship provides students with exposure to the entire longitudinal illness of the patient. The students participate in patient care as a part of treating team and can refine their clinical, communication and procedural skills. It provides them with an opportunity to work with the faculty and experience the future workplace. Although the graduate medical education regulations (GMER) provide for student doctor method of training, the time provided is too little and opportunistic. Electives have also been recently added to the new curriculum for the first time. We propose a model to deliver the electives using the clerkship method, so as to consolidate what students learn from the ongoing clerkship. This model is feasible, practical and can be introduced in the current GMER for Indian medical undergraduates without any major disruptions.

Two thumbs up! A review of the “PULMOSERYE: Pulmonary patient miniseries… Dead or Alive: The saga of Mang Jose”- a clerkship learning activity during the pandemic

@#The World Health Organization declared Covid 19 a pandemic in March 2020, disrupting medical education and creating a significant void in the hospital rotation of the clinical clerks. Alternative methods of teaching and learning had to be instituted, and since face-to-face encounters were still not allowed, all these activities had to be online. While the various activities were able to challenge critical analysis and thinking, the Section on Pulmonary Medicine felt that the clerks would benefit most from activities that would most closely simulate an actual patient encounter. And so, the PulmoSerye was born: a miniseries that followed the patient from initial consultation in the emergency room resulting in admission, events that happened in the ward, formulation of the Master Problem List, progress notes, giving discharge orders, writing the discharge summary, and finally a follow up via Telemedicine. This is what the clerks would have experienced if they had been in hospital. Activities such as the Pulmoserye should be highly considered as a viable option should clerkship hospital rotations once again be put on hold.

The virtual cardiology rotation: Situated cognition and the signature pedagogy in medicine

Background@#Corona Virus 2019 (COVID-19) challenged the delivery of medical education and training, especially to the 4th year medical students. Medicine's signature pedagogy, the ward rounds in the hospital, was put on hold in compliance with safety precautions during this pandemic and the Commission on Higher Education’s (CHED) suspension of face-to-face classes in all levels. How the University of Santo Tomas Faculty of Medicine & Surgery (UST FMS) Cardiology Rotation was delivered despite these restrictions is described. Using Google Classroom, Blackboard Collaborate, and Zoom, a 7-day online Cardiology Clerkship rotation was delivered to UST FMS 4th year students (clerks) using the synchronous and asynchronous mode of delivery. It consisted of the following: 1) Cardiovascular (CV) Ward Rotation with 3 cases using Google Classroom's adaptive release to create a vicarious experience of taking care of a patient and doing all the tasks that a clerk is supposed to do; 2) Virtual Ward Rounds by a consultant; 3) Outpatient Department (OPD) / Ambulatory Care Services (ACS) case discussions with a consultant and a 4) Heart Station Rotation for training in electrocardiogram (ECG) interpretation. @*Conclusion@#The advances in technology and software provided just-in-time resources that made possible the creative delivery of Medicine's signature pedagogy.

Application of flipped classroom combined with online interactive teaching in clinical clerkship of cardiology / 中华医学教育探索杂志

Objective:To explore the application effect of flipped classroom combined with online interactive teaching in clinical clerkship of cardiology.Methods:The study collected 56 students from Batch 2017 five-year clinical medicine undergraduate class of Medical College of China Three Gorges University and they were randomly divided into experimental group and control group in average. The control group adopted the traditional teaching method while the experimental group adopted the combined teaching method. The differences of test scores after teaching were compared between the two groups and the feedback of students on the two methods was also analyzed. SPSS 12.0 was used for t test and chi-square test. Results:The final score of clinical thinking in the experimental group (84.38±3.18) was significantly higher than in the control group (75.43±5.85) ( P<0.05), and the satisfaction of the experimental group to the teaching mode was [86% (24/28)], which was significantly higher than that of the control group [50% (14/28)]. More than 80% of the students in the experimental group regarded that the combined teaching method was helpful to promote the interaction between teachers and students, master relevant knowledge, and improve learning interest and learning efficiency. Conclusion:This combined teaching method can enhance students' clinical thinking ability, learning enthusiasm and efficiency, and finally effectively improve the effect of clerkship.

Application of CBL teaching based on self-made dynamic cardiovascular three-dimensional model in clinical clerkship of valvular heart disease / 中华医学教育探索杂志

Objective:To explore the effect of self-made dynamic cardiovascular three-dimensional model combined with CBL (case-based learning) teaching method in the clerkship of valvular heart disease for medical students.Methods:Sixty five-year clinical medical undergraduates from Nanjing Medical University (Batch 2016) were randomly divided into experimental group and control group. The experimental group received dynamic cardiovascular 3D model combined with CBL teaching method, while the control group received traditional model combined with CBL teaching method. After the course, the teaching effect was evaluated by examination and questionnaire. SPSS 19.0 was used for independent sample t test and chi-square test. Results:Compared with the control group, the students in experimental group had higher scores of basic theoretical knowledge [(43.10±3.51) vs. (40.87±3.19)] and clinical thinking ability [(42.20±3.15) vs. (40.20±3.81)], with significant differences ( P<0.05). Furthermore, they showed higher evaluation and satisfaction to learning initiative and enthusiasm, mastery of theoretical knowledge, clinical thinking ability, classroom learning interest, classroom activity and clarity of knowledge teaching, with significant differences ( P<0.05). Conclusion:In the teaching of valvular heart disease clerkship, the application of self-made dynamic cardiovascular three-dimensional model combined with CBL teaching method, can cultivate students' clinical diagnostic thinking ability and improve teaching quality.

Application of situation video feedback combined with problem-based learning in clinical clerkship teaching of cardiac surgery for medical students in class of organ-systems-based curriculum / 中华医学教育探索杂志

Objective:To study the application effects of situation video feedback combined with problem-based learning (PBL) on the clinical clerkship teaching of cardiac surgery for medical students in experimental class of organ-systems-based curriculum (OSBC).Methods:Medical students of Batch 2016 and 2018 OSBC reform experimental class of Jianghan University were selected as the research objects. The study group used situation video feedback combined with PBL teaching method to conduct cardiac surgery clerkship teaching, and the control group used conventional teaching method. At the end of the clerkship, the self-made "Clerkship Satisfaction Questionnaire" was distributed for questionnaire survey and the theoretical test was carried out at the same time. After the course, the theoretical examination was conducted, and the results were compared. SPSS 17.0 was used for t-test and Chi-square test. Results:The clerkship satisfaction investigation results showed that the study group was more satisfied than the control group in such 10 aspects as improving the interest of learning, learning efficiency, the ability of teamwork, clinical thinking, interpersonal communication, combining theory with practice, active knowledge acquirement, language expression, understanding knowledge point, and confidence to become a real doctor. Moreover, there were significant differences in improving the interest of learning, the ability of clinical thinking, and combining theory with practice ( P<0.05). The two theoretical test scores of the study group [(77.46±4.73) points and (79.80±7.53) points] were significantly higher than those of the control group [(70.68±5.16) points and (75.94±8.16) points] ( P<0.05). Conclusion:Situation-based video feedback combined with PBL can improve the clinical clerkship teaching effect of cardiac surgery for medical students under the teaching mode of OSBC.

Application of Rain Classroom combined with situational teaching in clinical clerkship of internal medicine / 中华医学教育探索杂志

Objective:To explore the effect of Rain Classroom combined with situational teaching in clinical clerkship of internal medicine.Methods:A total of 72 undergraduate students with clinical majors of Batch 2015 were selected and randomly divided into a control group and an experimental group using computer scrolling pause method, with 36 students in each group. The control group adopted traditional teaching methods, and the research group adopted Rain Classroom combined with situational teaching. The teaching effect evaluation was carried out through a 10-point questionnaire based on the internal medicine theory examination, clinical skill assessment and learning interest, knowledge mastery and application, and clinical thinking and practical ability. SPSS 20.0 was used to conduct t-test. Results:The average scores of the students in the experimental group including the theoretical test (87.94±5.68) and the skill test scores (88.08±5.73) were significantly higher than those in the control group (83.00±5.89) and (83.86±4.80)( P<0.01). The results of the questionnaire showed that students' interest in learning improvement, self-learning ability, new knowledge acquisition, application of knowledge, clinical thinking, clinical practice, problem solving, self-expression, teamwork, doctor-patient communication ability in the study group were better than those in the control group ( P < 0.01). Conclusion:The Rain Classroom combined with situational teaching method is helpful to improve students' knowledge mastery and application, improve clinical thinking and practical ability, improve learning interest and clinical clerkship teaching effect.

Practice of organ system integration education in the clerkship teaching of digestive system / 中华医学教育探索杂志

The integration education is organized around "an organ system" of the body, and integrates multiple medical disciplines orderly, which is the main trend of medical education reformation at home and abroad. Digestive diseases are diverse and complicated, so that it is of great significance to apply integration education mode in the clinical teaching of digestive system. Taking the clinical clerkship teaching of digestive system in The First Affiliated Hospital of Chongqing Medical University as an example, through reasonably integrating the course content, fully applying problem-based learning (PBL) method, taking multiple teaching methods, combing ideological and political education, and paying more attention to improving the teachers' training, the learning enthusiasm of students could be stimulated, their independent thinking ability and holistic medical view could be cultured, and the teaching effect would be effectively improved.

Practice of online clinical clerkship teaching mode based on "3P" model / 中华医学教育探索杂志

In order to construct the online teaching mode of clinical clerkship course and improve the online clerkship teaching system of clinical medicine in China, based on the "3P" model, a complete set of online clinical clerkship mode has been constructed from three links of teaching, pre-class preparation, classroom teaching and after-class evaluation, and applied to clinical teaching practice of Internal Medicine. The practice suggests that students are highly satisfied and the teaching effect is good, which provides a new idea for the reform of online clerkship teaching of clinical medicine.

Perceptions and attitudes of 4th year medical students in clinical clerkship in the era of the Coronavirus disease 2019

BACKGROUND@#In the advent of coronavirus disease 2019 global crisis, hands-on patient care and inhospital training of fourth year medical students were suspended across the globe and shifted to remote online education. The aim of this study is to assess the perception and attitude of the 4th year medical students about clinical clerkship training during the COVID-19 pandemic.@*METHODS@#An online survey was sent to fourth-year medical students in three medical schools in lloilo City, from July 2021 to October 2021. The survey questionnaire is a combined dichotomous, multiplechoice, and Likert response scale questions.@*RESULTS@#Of the hundred sixty-eight students who completed the online survey, sixty-six percent did not experience hospital rotation. On average, students were very interested in COVID-19 (8.83) and willing to join in patient care if requested by a hospital or university to help during COVID-19 pandemic (8.65), but felt they were not ready (70%) due to a lack of the ability for clinical practice (90%). Most (82%) of the students expressed they wanted to maintain hands-on clinical practice education despite the pandemic. Overall, students who have experienced hospital rotation have a higher level of understanding of how much their life, behavior (9.30), and role as a medical student (9 .74) were affected by the pandemic as compared to the rest of the students.@*CONCLUSION@#This present pandemic has affected the medical students as a whole in areas of their role as students, behavior, and life. Their lack of confidence despite willingness to help correlated to their inadequate clinical experience. Specific policy adjustments concerning the curriculum of clinical clerkship during this time of pandemic should be revisited to tailor fit the students" needs for safe education to help them prepare to become a competent medical practitioner.

3. Learner Support for Medical Students Who Can't Communicate Well in Clinical Clerkship / 医学教育

In this paper, as support for “student who is not good at communication”, a fictional case of a pharmaceutical student will be examined from the followingthree perspectives. The first, from a developmental and social psychological perspective, is the possibility of “unlearning or mislearning of communication” and “discrepancy between the actual self, the ideal self, and the ought self.” In support, learning assertion skills can be effective. The second is from a clinical psychological perspective, in terms of “social anxiety disorder” and “narcissism”. In support, pharmacotherapy and cognitive behavioral therapy will be discussed. Third, from the perspective of neurodevelopmental syndrome, the possibility of “autism spectrum disorder” is considered. In this case, involvement that enhances self-understanding and self-affirmation will be important. Educators and supporters are required to make an accurate assessment of the cause of the difficulty.