Exploration of Modern Integrated Chinese and Western Medicine Model：from Target to State / 中医杂志

It is the current confusion encountered by integrated Chinese and Western medicine that how to find the breakthrough direction of integrating Chinese and Western medicine， from crossover to integration to innovation， and open up a new horizon of integrated Chinese and Western medicine. The progress of Chinese medicine lay in expanding the scope of diagnosis and treatment with the help of modern diagnostic and therapeutic equipments and developing “micro” identification， while the progress of Western medicine lay in looking at “macro” and developing systemic medicine and integrated medicine， both of which are in the direction of each other. The “state-target identification and treatment” may become an important way to build a modern diagnosis and treatment system of integrated Chinese and Western medicine， and the thinking mode of “from target to state” is a further refinement and development on the basis of the theoretical system of “state-target identification and treatment”， which provided a clearer solution for the current stage of the integrated Chinese and Western medicine model， and pointed out the important development direction for the future integrated Chinese and Western medicine. From the perspective of strategic level and diagnosis and treatment practice， it integrated the “target-state” thinking mode into the modern diagnosis and treatment model of the integrated Chinese and Western medicine， i.e.， “Western medicine as the basis and treating with Chinese medicine； Chinese medicine as the basis and treating with Western medicine”. On the one hand， Western medicine should strengthen the reference to the traditional theories and holism of Chinese medicine， and advocate a higher level of education on the integrated Chinese and Western medicine under the guidance of the traditional theories of Chinese medicine. On the other hand， the “from target to state” mode of thinking should be applied to guide the establishment of diagnostic and treatment strategies and clinical selection of medicines in clinical practice， so as to locate the target and adjust the body state in a gradual and orderly manner， and to provide practical methods for the modern clinical work of the integrated Chinese and Western medicines. Chinese and Western medicine systems can learn from each other， combine organically， give full play to their respective strengths， and form an internal law， so as to make breakthroughs and innovations in the integrated Chinese and Western medicine model.

Application of organ system based learning model in undergraduate clinical practice teaching of anesthesiology / 中华医学教育探索杂志

Objective:To evaluate the teaching effect of organ system based learning model on undergraduate clinical practice teaching of anesthesiology.Methods:Thirty-five undergraduates of Batch 2013 who practiced in the Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University (round 2) were enrolled as the control group; another 27 undergraduates of Batch 2014 were enrolled as the experimental group. The examination before entering the department evaluated the basic knowledge levels of the two groups. The control group was given the traditional practice teaching mode, while the experimental group was given the practice teaching mode based on organ system. The teaching effect of the organ system based learning model on the practice of department of anesthesiology was evaluated by the examination after the practice and questionnaire survey on students. SPSS 19.0 was used for data statistics and t test was conducted for analysis. Results:There was no significant difference in gender, age and admission education performance between the two groups ( P=0.168, 0.592, 0.750). In the quality and analysis scores of the medical records, the review defense scores, and the theoretical scores, the average scores of the experiment group were all higher than those in the control group ( P=0.021, <0.001, <0.001) at the end of the practice; there was no significant difference in operational exam between the two groups ( P=0.106). The results of questionnaire survey showed that the average scores of the experiment group in the satisfaction of learning mode, teaching efficiency, education and teaching level and teaching information were all higher than those in the control group ( P<0.001, <0.001, <0.001, <0.001); there was no significant difference between the two groups in students' learning efficiency and inspiration ( P=0.778, 0.104). Conclusion:The organ system based learning model in undergraduate clinical practice teaching of anesthesiology has significantly improved the education quality, the theoretical achievement and comprehensive ability of interns.

Effect analysis of organ system based integrated curriculum in the teaching of clinical medicine undergraduates / 中华医学教育探索杂志

Objective:To explore the teaching effect of organ system based integrated curriculum in the undergraduates of clinical medicine.Methods:A retrospective cohort study was conducted among 284 undergraduates majoring in clinical medicine from Batch 2011 to Batch 2016 in Shanghai Jiao Tong University School of Medicine. The observation group were 147 undergraduates from Batch 2014 to Batch 2016, taking organ system based integrated curriculum. The control group included 137 undergraduates from Batch 2011 to Batch 2013, taking the traditional mode of subject-centered curriculum. SPSS 21.0 was performed for independent sample t test, and questionnaires were issued to investigate students' evaluation of the teaching of organ system based integrated curriculum. Results:The examination scores of internal medicine problem based learning test, surgical theory test and surgical operation test were better in observation group than in control group [(86.34±2.74) vs. (85.51±3.36); (79.69±8.41) vs. (77.18±6.92); (81.43±10.72) vs. (76.78±11.29), P<0.05]. Obstetrics and pediatric theory test scores were lower in observation group than in control group ( P<0.05). There was no significant difference in test scores of internal medicine between the two groups ( P=0.935). The satisfaction rate of organ system based integrated curriculum in the observation group was 83.75%. Conclusion:The teaching of organ system based integrated curriculum can improve students' comprehensive abilities, and has certain requirements for students' learning autonomy.

Comparison of Subjective/Objective Evaluation of Medical Students at Social Medicine Training between Different Grades in the Same Academic Year: Focus on Student Readiness / 医学教育

Background: The aims of the present study were to reveal the impact of the introduction of social medicine training one year earlier in a new university curriculum on subjective/objective evaluation of medical students, and to discuss the readiness of said students. Methods: In this natural experiment study, subjects comprised 73 third- (n = 31) and fourth-grade (n = 42) medical students who participated in social medicine training, namely “Family Health Practice Tutorial,” in 2017. The data consisted of student’s self-assessment and assessment from clients. The associations between these assessments and student grade were analyzed using the Mann-Whitney U test and ordinal logistic regression. Results: The score for “Language” in the assessment from the clients was significantly lower in the third-grade students than in the fourth-grade students after adjustment for gender (odds ratio = 0.147; 95% confidence interval = [0.027, 0.797]). Discussion: Insufficient readiness for language to residents in the community was found in third-grade medical students. Advanced communication training prior to practice for third-grade students may contribute to sustainable social medicine training in the community.

Community-based distributive medical education: advantaging society.

This paper presents a narrative summary of an increasingly important trend in medical education by addressing the merits of community-based distributive medical education (CBDME). This is a relatively new and compelling model for teaching and training physicians in a manner that may better meet societal needs and expectations. Issues and trends regarding the growing shortage and imbalanced distribution of physicians in the USA are addressed, including the role of international medical graduates. A historical overview of costs and funding sources for medical education is presented, as well as initiatives to increase the training and placement of physicians cost-effectively through new and expanded medical schools, two- and four-year regional or branch campuses and CBDME. Our research confirms that although medical schools have responded to Association of American Medical Colleges calls for higher student enrollment and societal concerns about the distribution and placement of physicians, significant opportunities for improvement remain. Finally, the authors recommend further research be conducted to guide policy on incentives for physicians to locate in underserved communities, and determine the cost-effectiveness of the CBDME model in both the near and long terms.