Mental Distress and Professional Commitment among Chinese Medical Postgraduate Students: A Moderated Mediation of Psychological Capital and the Supervisor-Postgraduate Relationship.

This study determined the relationship between mental distress and professional commitment among medical postgraduate students, and the roles of psychological capital as a mediator and the supervisor-postgraduate relationship as a moderator. This cross-sectional study recruited 836 medical postgraduate students from eight medical universities and the medical college of comprehensive universities in Guangdong Province, China. Participants were assessed through questionnaires, which covered demographic items, the supervisor-postgraduate relationship scale, the psychological capital questionnaire, the symptom checklist - 90 (SCL -90), and the professional commitment scale. We used descriptive statistics to describe demographics and mental distress and professional commitment scores. Pearson's analysis was used to identify correlations between the variables and the SPSS PROCESS macro was performed to confirm mediating and moderating effects of psychological capital and the supervisor-postgraduate relationship. Mental distress was negatively related with professional commitment (r = -0.262, p < 0.01) and psychological capital (r = -0.442, p < 0.01). Psychological capital was positively associated with professional commitment (r = 0.486, p < 0.01). The confidence interval (CI) suggested that psychological capital mediated the relationship between mental distress and professional commitment (95% CI, -0.198 to - 0.143), and the supervisor-postgraduate relationship had a moderate role between psychological capital and professional commitment (95% CI, 0.069 to -0.212). Hence, educators may refer to these findings to improve professional commitment level among medical postgraduate students.

[Acquiring general practitioner roles during the outpatient postgraduate training section and profession-forming postgraduate training conditions in family physician practices - A survey among family medicine residents in Rhineland-Palatinate during their postgraduate training in general medicine]. / Aneignung hausärztlicher Rollen während des ambulanten Weiterbildungsabschnitts und professionsbildende Bedingungen in den Weiterbildungspraxen ­ Eine Befragung rheinland-pfälzischer Ärztinnen und Ärzte in der Weiterbildung Allgemeinmedizin.

BACKGROUND: Postgraduate training in general medicine should be oriented on competencies and profession-forming, as is suggested by the German Regulations on Specialist Training of federal and state governments and the Competence-based Curriculum General Medicine. The learnability of general practitioner (GP) roles and the profession-forming orientation of the postgraduate training conditions during the outpatient postgraduate training period were investigated. METHODS: A cross-sectional study in questionnaire design was conducted from October until December 2019 among 220 physicians in postgraduate training who were registered at the Association of Statutory Health Insurance-Accredited Physicians in Rhineland-Palatinate for the specialty of general medicine. The GP roles surveyed were based on the "CanMEDS General Medicine" roles. Using indicators created from the didactic model "Cognitive Apprenticeship", profession-forming alignment of postgraduate training conditions in the GP practices were studied. The data obtained were analysed descriptively. RESULTS: The response of 70 evaluable questionnaires included a gender distribution of 51 female and 18 male family medicine residents. The family medicine residents were almost equally divided between single-handed practices, cooperating practice associations and group practices. Slightly more than half of the female physicians worked part-time, whereas the male physicians were all full-time employees. The roles of "member of an interprofessional team", "health advocate" and "medical expert" were perceived as learnable by 70 to 90% of the family medicine residents. In addition to approval, varying degrees of indecision and rejection were expressed regarding the learnability of the roles of "teacher/scholar", "member of a network" and "employer". A slight majority considered the appropriation of the role of "practice manager" to be critical. Within the survey of profession-forming postgraduate training conditions, the indicators "accessible contact person", "collegial appreciation" and "assumption of responsibility" were approved by more than 90% in some cases. The indicators "access to GP acting" (approx. 86%) and "resilience" (approx. 71%) also received high approval ratings. However, the indicator "continuous feedback" only received a slight majority of approval. DISCUSSION: GP postgraduate training practices in Rhineland-Palatinate apparently offer suitable educational locations to family medicine residents to acquire a solid basis for professional practising and the skills for patient-oriented communicating of preventive health-promoting contents. Male physicians seem to follow more traditional professional hierarchies. In contrast, female physicians are more receptive to teamwork but tend to be sceptical about adopting a leadership position. The learnability of particular GP roles may benefit from close collaboration with the practice owner, especially in single-handed practices. In addition, the working time model chosen seems to have an effect. CONCLUSIONS: It can be assumed that profession-forming postgraduate training conditions predominate in Rhineland-Palatinate GP postgraduate training practices, where the role of "medical expert" also appeared to be learnable in most cases. In some cases the learnability of GP roles was significantly influenced by the factors "gender", "working time model" and "form of practice". Consequently, it could have a quality-enhancing impact if these factors were taken into account in the development of measures to realize competence orientation in GP postgraduate training.

Examiner perceptions of the MRCGP recorded consultation assessment for general practice licensing during COVID-19: cross-sectional study.

BACKGROUND: The Recorded Consultation Assessment (RCA) was developed rapidly during the COVID-19 pandemic to replace the Clinical Skills Assessment (CSA) for UK general practice licensing. Our aim was to evaluate examiner perceptions of the RCA. METHODS: We employed a cross-sectional design using a questionnaire survey of RCA examiners with attitudinal (relating to examiners thoughts and perceptions of the RCA) and free text response options. We conducted statistical descriptive and factor analysis of quantitative data with qualitative thematic analysis of free text responses. RESULTS: Overall, 182 of 260 (70%) examiners completed the questionnaire. Responders felt that consultations submitted were representative of the work of a typical GP during the pandemic and provided a good sample across the curriculum. They were also generally positive about the logistic, advisory and other support provided as well as the digital platform. Despite responders generally agreeing there was sufficient information available in video or audio consultations to judge candidates' data gathering, clinical management, and interpersonal skills, they were less confident about their ability to make judgments of candidates' performance compared with the CSA. The qualitative analysis of free text responses detailed the problems of case selection and content, explained examiners' difficulties when making judgments, and detailed the generally positive views about support, training and information technology. Responders also provided helpful recommendations for improving the assessment. CONCLUSION: The RCA was considered by examiners to be feasible and broadly acceptable, although they experienced challenges from candidate case selection, case content and judgments leading to suggested areas for improvement.

Analysis of research integrity education and cognitions of academic misconduct among master post-graduate students in a university-affiliated hospital / 中华医学科研管理杂志

Objective:The present study was designed to strengthen the education of research integrity, and to improve the awareness of academic misconduct and academic literacy of medical post-graduate students.Methods:A questionnaire survey was conducted with master post-graduate students of a university affiliated hospital, and statistical analysis on the education of research integrity and the perception of academic misconduct among the survey respondents was performed.Results:Academic master post-graduate students′ cognitions of the misconduct in scientific research process and overall academic misconduct were better than that of professional master post-graduate students, and there were significant differences ( P<0.05). The more times of participation in research integrity training, the better cognition of misconduct of scientific research process, research results publication process, and overall academic misconduct, with significant differences ( P<0.05). Conclusions:The education on scientific research integrity of medical post-graduates should be carried out systematically, while the content should be improved and the form should be enriched for scientific research integrity education, so that the medical post-graduates can have a deeper understanding of the code of academic practices, and an education model of scientific research integrity for medical post-graduate which is suitable for China′s national conditions can be gradually developed.

Development of professional grief scale for medical postgraduate students and its reliability and validity / 中华行为医学与脑科学杂志

Objective:To develop a professional grief scale for medical postgraduate students(PGS-MPS) and test its reliability and validity.Methods:Based on the integrated model of professional grief, the initial item pool was formed after literature analysis, semi-structured interviews, group discussion, and 5 experts were invited to assess the relevance of the items and provided revision suggestion.A total of 506 valid questionnaires were collected.SPSS 25.0 and AMOS 26.0 were used to test its reliability and validity.Results:The PGS-MPS included 41 items, including the professional grief reaction subscale and disenfranchised grief subscale.The professional grief reaction subscale included emotional reaction (14 items), physiological and cognitive reaction (20 items), and the cumulative variance contribution rate of the two factors model was 52.908%.Disenfranchised grief subscale included 7 items, with a single dimension and a variance contribution rate of 51.730%.Confirmatory factor analysis indicated the model fitting well.The Cronbach’s α coefficients for the professional grief reaction subscale and disenfranchised grief subscale were 0.947 and 0.850, respectively.Conclusion:The PGS-MPS has good reliability and validity and can be used to evaluate professional grief of medical postgraduate students.

Quality issues in reviews written by medical postgraduate students: investigation and countermeasures / 中华医学教育探索杂志

Objective:To investigate the quality issues in medical reviews written by medical postgraduate students, and to provide a reference for improving the quality of medical reviews written by such students.Methods:A total of 141 medical reviews written by the medical postgraduate students from various affiliated hospitals of Shanghai Jiao Tong University School of Medicine from 2018 to 2022 were collected, and the quality of these medical reviews was evaluated in terms of topic selection and writing expression skills. As for topic selection, a self-designed innovative questionnaire (hereinafter referred to as topic questionnaire) was used to collect the evaluation of external experts, and as for writing expression, the reviews were assessed based on the criteria in relevant literature from the aspects of the outline of the review, the timeliness of references, analysis and evaluation, and the quality of the text. EPIDATA 3.2 was used to input data, and SPSS 20.0 was used for the chi-square test.Results:A total of 135 (96%, 135/141) valid questionnaires were collected in this study, and the results showed that 70% (94/135) of the review topics lacked novelty. The assessment of writing skills showed that 95% (128/135) of the reviews had outdated references, and 68% (92/135) lacked focus, hierarchy or logic in outline, which accounted for a higher proportion than the reviews with analysis and evaluation issues (59%, 80/135) and text quality issues (61%, 83/135) ( P<0.05). Conclusion:There are many quality issues in the medical reviews written by medical postgraduate students, such as a lack of novelty in topic selection and low overall quality of outlines. In order to improve the abilities of scientific research among medical postgraduate students, universities and supervisors should strengthen the guidance of innovative thinking in topic selection and enhance the training of writing expression skills, such as scientific analysis and logic.

Postgraduate training system of biomedical science in the USA and its implications to China: taking the City of Hope National Medical Center as an example / 中华医学教育探索杂志

This paper, taking the City of Hope National Medical Center as an example, introduces the application and admission of biomedical science doctors in the USA, analyzes the curriculum system and teaching patterns, elaborates the requirement of degree awarding, and compares the differences in postgraduate training system between China and the USA, thereby providing valuable experience and reference for training biomedical science postgraduate students with Chinese characteristics in the domestic universities.

A comparative study about attitudes towards the efficiency, effectiveness, and atmosphere of offline and online learning among medical students.

Background: In recent decades, the mode of education has changed, and online learning via the Internet has gradually entered the medical education system. During the Coronavirus disease 2019 pandemic, online learning rapidly became one of the main learning methods for medical students, this has impacted medical undergraduates and postgraduates to varying degrees; however, currently, little is known about its effectiveness as a learning mode. Methods: This study included undergraduates and postgraduates in medical schools at some universities in China. The student participants were asked to complete a questionnaire survey in which they self-evaluated the learning effectiveness, learning efficiency, learning atmosphere, and other issues associated with online and offline learning. SPSSAU was used to analyze the acquired data. Results: Most medical students expressed the view that offline learning was superior to online learning in terms of effectiveness, efficiency, and atmosphere. However, online learning was better in terms of the acquisition of learning resources and flexibility. The attitudes of medical undergraduates and postgraduates participating in this research were largely similar (P>0.05); however, undergraduates placed a higher value on offline learning than postgraduates (P<0.05). Conclusions: Both online and offline learning have advantages and disadvantages. The differences between undergraduates and postgraduates may be related to subtle differences in the training objectives at these 2 levels of medical education. Combining the advantages of online and offline learning may improve the learning of medical students.

Applicability assessment and application of the general self-efficacy scale among medical postgraduates / 中华医学教育探索杂志

Objective:To assess the reliability, constructive validity and item characteristics of the general self-efficacy scale (GSES) among Chinese medical postgraduates using classical test theory and item response theory.Methods:A questionnaire survey was conducted among 1 021 medical postgraduates from 6 comprehensive level Ⅲ A hospitals in Beijing. Demographic characteristics and general self-efficacy were investigated. SPSS 24.0 software was used for statistical analysis. Internal consistency of the GSES was evaluated using Cronbach’s α coefficient and intraclass correlation coefficient. Factor analyses were implemented to test the structure of the scale. An item response theory (IRT) framework with a graded response model was performed to estimate the parameters of each item. Results:The overall Cronbach’s α coefficient of the GSES was 0.92. Parallel analysis and confirmatory factor analysis supported the unidimensional structure of the GSES. The discrimination parameter of the 10 items ranged from 1.82 to 3.65, and the difficulty parameter ranged from -3.51 to 1.66, with a monotonically increasing trend. The maximum test information of the scale among medical postgraduates was 19.16. Conclusion:The GSES has good reliability, validity and measurement precision, showing a good applicability in the survey of medical postgraduates. However, the difficulty of specific items is relatively low, and the scale may be further optimized and improved.

Construction of the competency evaluation index system for postgraduate tutors of clinical medicine / 中华医学教育探索杂志

Objective:To construct a scientific and complete competency evaluation index system for postgraduate tutors of clinical medicine.Methods:Based on literature research, group discussion and expert interviews, the research used the competency model theory, and conducted twice expert consultation by Delphi method, then the index weight was determined by mathematical analysis method and precedence diagram method. SPSS 22.0 was used for data statistical analysis.Results:According to the characteristics of the competency model and expert opinions, 4 first-level indicators, 12 second-level indicators, and 40 third-level indicators were finally determined, and the tutor evaluation index system was constructed.Conclusion:The system is highly scientific and reliable, which will provide a reference for the comprehensive evaluation of postgraduate tutors at medical colleges and will be of great significance for strengthening the construction of tutors and ensuring the cultivation quality of postgraduate.

Survey of trainee attitudes to skill development and simulation training in trauma and orthopaedics.

Background: Simulation training in surgery is widespread and allows surgeons to practise novel operative techniques and acquaint themselves with unfamiliar surgical procedures. The use of box or virtual reality simulators in many surgical specialities is established; however, its use within trauma and orthopaedics (T&O) in the UK and the attitudes of trainee towards it are not known. The aim of this study is to explore the experiences and opinions of T&O trainees towards simulation training. Methods: An electronic survey consisting of 11 questions on the experiences of simulation training and attitudes towards it was sent to all T&O speciality trainees in London. Results: Fewer than 10% of the responders had used or had ready access to simulators to prepare for unfamiliar operations, with almost 90% preferring to read about them in a journal or watch them on an online video site. Over half had only seen simulators on courses or been aware of them. Over 75% of the responders believed that simulators should be available for trainees, but most did not feel that they should be used as part of formal assessments. Conclusions: Methods for preparing for new operations have expanded over the past 20 years, yet the use of simulator machines is not widespread. Many trainees believe current machines are not widely available nor realistic enough to be useful, with most preferring online videos and operative technique books for preparing for an unfamiliar operation.

How to enhance and assess reflection in specialist training: a mixed method validation study of a new tool for global assessment of reflection ability.

BACKGROUND: In Danish GP training we had the ambition to enhance and assess global reflection ability, but since we found no appropriate validated method in the literature, we decided to develop a new assessment tool. This tool is based on individual trainee developed mind maps and structured trainer-trainee discussions related to specific complex competencies. We named the tool Global Assessment of Reflection ability (GAR) and conducted a mixed method validation study. Our goal was to investigate whether it is possible to enhance and assess reflection ability using the tool. METHODS: In order to investigate acceptability, feasibility, face validity, and construct validity of the tool we conducted a mixed method validation study that combined 1) qualitative data obtained from 750 GP trainers participating in train-the-trainer courses, 2) a questionnaire survey sent to 349 GP trainers and 214 GP trainees and 3) a thorough analysis of eight trainer-trainee discussions. RESULTS: Our study showed an immediate high acceptance of the GAR tool. Both trainers and trainees found the tool feasible, useful, and relevant with acceptable face validity. Rating of eight audio recordings showed that the tool can demonstrate reflection during assessment of complex competencies. CONCLUSIONS: We have developed an assessment tool (GAR) to enhance and assess reflection. GAR was found to be acceptable, feasible, relevant and with good face- and construct validity. GAR seems to be able to enhance the trainees' ability to reflect and provide a good basis for assessment in relation to complex competencies.

The construction and practice of medical postgraduate students' core curriculum system for cultivating scientific research and innovation abilities based on the integration of science and teaching / 中华医学科研管理杂志

Objective To promote the research innovative capacity for the academic medical graduate student to adapt to the development of modern medicine,life science,as well as the trend of interdisciplinary integration.Methods The curriculum reform of the medical graduate student was carried out by taking into account of the knowledge context and systematic implementation,which covered the latest development of global life science and scientific research methodologies from the context perspective,also the interdisciplinary integration and the consistency and extension of knowledge from the structure perspective.Results A totally new core curriculum system for medical graduated students,which including four modules:public courses,core courses,professional courses and elective courses,was set up.Furthermore,related administrative mechanism reform was also carried out.Conclusions The new curriculum constructed is based on the integration of research and teaching,highlighted the needs for research innovation which is well adapted with the development trend of life science,break down the traditional barriers of different disciplines,contributes to the integration of interdisciplinary,as well as the promotion of research innovative capacities of graduate students.

[Infectious diseases - a specialty of internal medicine]. / Infektiologie ­ ein Schwerpunkt der Inneren Medizin.

Infectious diseases have recently gained wide public interest. Emerging infections and rising rates of antibiotic resistance are determining this trend. Both challenges will need to be addressed in international and local collaborations between different specialties in medicine and basic science. Infectious diseases as a clinical specialty in this scenario is directly responsible for the care of patients with infectious diseases. Its involvement in the care of patients with complicated infections has proved to be highly effective. Antibiotic stewardship programmes are effective measures in slowing the development of antibiotic resistance and have been widely implemented. But antibiotic stewardship specialists should not be confused with or taken as an alternative to infectious disease experts. Infectious diseases requires appropriate and specific training. It mainly uses the instrumentarium of internal medicine. With the current challenges in modern medicine, infectious diseases in Germany should thus be upgraded from a subspecialty to a clinical specialty, ideally within Internal Medicine.

Reflection on the postgraduate education of medical students under the background of new medical science / 医学研究生学报

With the upcoming of the new scientific, technological and industrial revolution, the combination of medicine and artificial intelligence(AI), big data, and the Internet is becoming closer and closer. Adapting to the trend of knowledge developing from differentiation to integration, new medical science comes up to meet the realistic need of "Healthy China" and the social demand for cross-integration medical talents. The essence of the transformation of talent training model under new medical background is based on the inheritance and innovation of training concept, training path and training Objective s. Medical postgraduate education which cultivates high-quality medical talents ought to follow the trend. Therefore, we should rethink the talent training and implementation path of medical postgraduate students from the aspects of innovating training concept, optimizing training mode, and renewing evaluation standards so as to provide beneficial references for training outstanding innovative talents with international vision, innovative spirit and cross-integration thinking in accordance with the development of medical science in new era.

Modified task-based learning program promotes problem-solving capacity among Chinese medical postgraduates: a mixed quantitative survey.

BACKGROUND: Despite great advances, China's postgraduate education faces many problems, for example traditional lecture-based learning (LBL) method provides fewer oppotunities to apply knowledge in a working situation. Task-based learning (TBL) is an efficient strategy for increasing the connections among skills, knowledge and competences. This study aimed to evaluate the effect of a modified TBL model on problem-solving abilities among postgraduate medical students in China. METHODS: We allocated 228 first-year postgraduate students at Third Military Medical University into two groups: the TBL group and LBL group. The TBL group was taught using a TBL program for immunohistochemistry. The curriculum consisted of five phases: task design, self-learning, experimental operations, discussion and summary. The LBL group was taught using traditional LBL. After the course, learning performance was assessed using theoretical and practical tests. The students' preferences and satisfaction of TBL and LBL were also evaluated using questionnaires. RESULTS: There were notable differences in the mean score rates in the practical test (P < 0.05): the number of high scores (>80) in the TBL group was higher than that in the LBL group. We observed no substantial differences in the theoretical test between the two groups (P > 0.05). The questionnaire results indicated that the TBL students were satisfied with teaching content, teaching methods and experiment content. The TBL program was also beneficial for the postgraduates in completing their research projects. Furthermore, the TBL students reported positive effects in terms of innovative thinking, collaboration, and communication. CONCLUSIONS: TBL is a powerful educational strategy for postgraduate education in China. Our modified TBL imparted basic knowledge to the students and also engaged them more effectively in applying knowledge to solve real-world issues. In conclusion, our TBL established a good foundation for the students' future in both medical research and clinical work.

A new relationship between medical postgraduates and their supervisors in scientific research / 医学研究生学报

Most medical postgraduates desire to develop their research mentality and experiment skills and become capable medical students with potentialities and innovation consciousness.Medical postgraduates can be classified into academic, general, and clinical types based on their needs, education background, experiences and personal abilities, while their supervisors fall into high-, medium-, and low-expectation types according to their research abilities and demands.Cross-pairing analysis shows that a high-level cooperation can be achieved when the type of a postgraduate matches that of his supervisor, otherwise a low-level cooperation may result.Therefore, it is essential to optimize the two-way choice system between postgraduates and supervisors, establish a moral code for supervisors and academic standards for postgraduates, and further enhance their interaction.A new relationship should be formed between medical postgraduates and supervisors, which is postgraduate-centered, emphatic on conversation, discussion, equality, and mutual trust and respect, and capable of promoting the harmonious development of academic activities.

The application of the theory of cognition, emotion, will and behavior in research integrity educational practice for the medical postgraduate students:based on experiences from United States / 中华医学科研管理杂志

Objective The study analyzes the inadequacies of the research integrity educational practice for the medical postgraduate students in the present stage of China.Furthermore,the paper puts forward improvement suggestions and clears the direction for further efforts.Methods From the perspective of the educational law about cognition,emotion,will and behavior,the comparative analysis method is used,based on the rich experience in the United States.Results There are inadequacies of the research integrity educational practice for the medical postgraduate students in China,including that students lack knowledge learning motivation,and the pattern of education is simple.There are not enough emotional experience channels and the participation of students.Students lack honesty will training,and the intensity of supervision and punishment is not strong.The honesty recognition mechanism is weak,and cannot be used to guide practice.Conclusions In order to improve the level of the research integrity for the medical postgraduate students in China,we should optimize the system,follow the law of education,strengthen the transmission of knowledge,put the academic honesty education into normal work,enhance the emotional experience,build a participatory mechanism,highlight the positive guide,and increase the intensity of punishment.

Discussion on the ideas of education in the medical postgraduate exempted from admission examination during clinical practice phase / 中华医学教育探索杂志

There nearly have 1 year for the medical postgraduate exempted from admission examination to enjoy the postgraduate life,meanwhile to finish the clinicalpractice task as a medical undergraduate.For students,supervisors and the university,analysis of opportunities and difficulties faced by the medical postgraduate exempted from admission examination in this stage can be made,feasible training plan can be developed,in advance to allow students to avoid the psychological confusion,change the way of learning,lay the foundation for scientific research and improve their clinical skills.These measures will contribute to improve the quality of the medical postgraduate exempted fmm admission examination and the education quality.