Clinical Thinking Ability Research Articles

Experimental Design and Application of Comprehensive Experimental Courses in Medical Morphology Based on Improving Students' Clinical Thinking Ability

Experimental Design and Application of Comprehensive Experimental Courses in Medical Morphology Based on Improving Students' Clinical Thinking Ability

Effects of seminar teaching method versus lecture-based learning in medical education: A meta-analysis of randomized controlled trials

Purpose The aim of this review is to explore the effects of the seminar teaching method versus lecture-based learning (LBL) in the education of medical students by meta-analysis. Method Data and information available on PubMed, Cochrane Library, EMBASE, MEDLINE, China National Knowledge Infrastructure, WanFang Data, China Science Periodical Database, and Chinese BioMedical were searched and examined from the inception up to January 2020. Randomized controlled trials (RCTs) that investigated the effects of the seminar teaching method versus LBL in medical education were included. Results A total of 16 RCTs were included, with a total sample size of 1122 medical students. The seminar teaching method significantly improved knowledge scores (SMD = 1.38, 95%CI 0.92–1.84; p < 0.001) and skill scores (SMD = 1.46, 95%CI 1.00–1.91; p < 0.001) and the seminar teaching method significantly improved teaching effects, including active learning ability, learning interest, scientific innovation, and independent thinking ability, expression and communication ability, clinical thinking ability, teamwork, teacher-student interaction, and classroom atmosphere. Conclusions This meta-analysis showed that the seminar teaching method is an effective method for improving knowledge scores, skill scores, active learning ability, student collaboration, classroom atmosphere, and interaction between teachers and students.

Application of mixed assessment of competence of general practitioners in Shanghai suburban communities

A pilot mixed assessment method was used to evaluate the clinical and teaching ability of general practitioners (GPs) in a suburban district of Shanghai. In December 2018, 29 GPs from 20 community health centers in a suburban district of Shanghai were assessed by a mixed method consisting of 3 domains and 8 stations for one day. The average age of GPs was (37.8±4.7) years and 22 were females (75.9%). In 3 domains, the average score (66.8±9.7) and qualified rate (75.9%) of clinical thinking abilities were the lowest. In 8 stations, the average score [(53.8+13.4) points] and qualified rate (34.5%) of adult SOAP medical record writing station were the lowest. The average score of pediatric outpatients consult station of GPs with 15 years of work experience [(68.6+10.2) vs. (58.5+9.4), t=2.787, P<0.05]. There was no significant difference in the scores among GPs with different teaching years and titles. The average scores of clinical thinking ability domain (t=2.115) and adult outpatient consult station (t=3.410); in the clinical operation ability domain the ophthalmoscopy and readings (t=3.816) and otoscopy and reporting station (t=2.286); clinical teaching abilities (t=2.618) and simulated educational situation station (t=2.452) and mini lectures station (t=2.802) of GPs in the community teaching base were higher than those in non-community teaching base (all P<0.05). Mixed assessment method can be used as one of the important means for GPs′ ability assessment. The community teaching bases have effectively improved the clinical and teaching abilities of GPs in suburban areas, however, the clinical thinking abilities of them are still weak. Key words: General practitioner; Clinical and teaching ability; Mixed assessment

Clinical discipline-oriented teaching reform on laboratory diagnostics and its effect evaluation

Objective To explore a clinical discipline-oriented teaching model for laboratory diagnostics and evaluate its effect in medical education. Methods changed the arrangement of traditional teaching content, re-edited the content of the teaching materials under the guidance of clinical subjects, compiled innovative textbooks and introduced new teaching methods such as CBL and PBL. The procedure could be briefly described below. 78 students from two natural classes in batch 2015 were selected as the observation group, and 77 students from other two natural classes were selected as the control group. The new teaching model and traditional teaching model were applied respectively in the students to compare the teaching effect in the way of formative evaluation. Results The total score of theoretical exams in the observation group was significantly higher than that of control group (P<0.01). It was found that the scores of the observation group were significantly higher than of the control group in terms of practical techniques, clinical application type and the selection and evaluation of test items (P<0.01). However, there was no significant difference in terms of the scores of basic knowledge and theory between the observation group and the control group (P=0.470). Conclusion The clinical discipline-oriented teaching method of laboratory diagnostics can promote the students in the assessment of applied and improved knowledge as well as the selection and evaluation of clinical disease examination items, which is helpful to cultivate students' clinical thinking ability, and the ability to reasonably select the test items and analyze the test results scientifically. Key words: Laboratory diagnostics; Clinical discipline-oriented; Clinical thinking

Reform and Practice of Medical Fundamental Curriculum System Based on “Three-Early Education”: A Case Study on Youjiang Medical University for Nationalities Located in the Minority Areas of Southwest China

Objective: “Three-early Education” for undergraduate majored in medicine aims to providing them with the opportunities to participate in clinical practice, research, and social practice at the first and second year of their college life. It is the key demand of Accreditation Standards for Basic Medical Education in China—Clinical Medicine, and is of vital importance to medical students from medical college in minority areas to enhance their clinical thinking ability, scientific literacy, communication ability, self-motivated and lifelong learning ability, professional literacy, and to get qualified for serving the strategy of Great Healthy China. The majority of the clinical medicine students at Youjiang Medical University for Nationalities (YMUN), a school from the minority areas of southwest China, are from rural countryside, with minority students accounting for 70%. At enrollment, their basic knowledge was not solid enough, and their abilities in communication, autonomous learning, critical thinking and practical skills were also weak. Method: School of Fundamental Medical Sciences of YMUN constructs “three-early education” system through a series of training on updating teaching philosophy and improving teaching skills, revised undergraduate program including integrated courses and reformed teaching mode, and reinforced administration. Specifically, our final goal is to promote the student to be qualified for being a clinical doctor, through an establishment of comprehensive education system integrated with advanced teaching mode as well as efficient evaluation and motivation system, upholding the philosophy which inherit the communist tradition, focus on morality education, and build a solid foundation of basic medical theory, knowledge and skills. Result: In this way, the minority students who are at a disadvantage can catch up with their peers and be eligible for the clinical doctors. In this study, implications for course reform and practice in other medical colleges with similar background were provided, based on the case study on the improved medical basic curriculum system built upon “three-early education” at YMUN.

Exploration for clinical teaching mode of evidence-based laboratory medicine in clinical laboratory students

In order to improve the core competitiveness and the comprehensive ability of laboratory medicine students, we implemented the clinical teaching mode of evidence-based laboratory medicine in the department of Clinical Laboratory Center of Beijing Children's Hospital, Capital Medical University. This study relied on the platform of National Center for Children's Health, which had abundant case resources and excellent expert team. This study started with the clinical problem, summarized the scientific problem, and carried out teaching activities around the scientific problem. By guidance of the teachers, students used evidence-based medicine methods (clinical case information collection, literature reading, interviews with clinical experts and experimental data collection) to solve the clinical problem. Through research cases,evidence-based medicine methods, clinical thinking and scientific thinking were imparted to students, which can help them integrate theoretical knowledge with clinical practice, and improve learning efficiency, training in clinical thinking and scientific research innovation ability, so as to enhance core competitiveness. Key words: Laboratory medicine; Evidence-based medicine; Teaching mode

Application of micro-lecture combined with Simbaby teaching model in neonatal practical teaching

Objective To investigate the effect of Micro-lecture combined with Simbaby teaching model in the practical teaching of neonatology for undergraduates. Methods A total of 160 five-year medical undergraduates from grade 2013 to grade 2015 were divided into group A (the control group) and group B (the experimental group), with 40 male students and 40 female students in each group. Students in group B received Micro-lecture combined with Simbaby teaching model, while students in group A received traditional teaching method. In group A, teachers adopted traditional teaching method with the use of common teaching models, then students practiced on these models following the demonstrations from teachers. In group B, students previewed the contents before class in micro-lecture, then teachers made Simbaby to be used as case models and explained to the students as how to use the model in actual class. Students made diagnosis and gave treatment to the Simbaby after physical examination. At last, teaching effects were evaluated by questionnaire survey and theoretical test. The SPSS 24.0 was used to conduct t-test and chi square test. Results The average scores of theoretical test (88.40±9.40) and skill test in group B (79.53±8.84) were significantly higher than those in group A (84.86±9.50) and (72.35±9.70), with statistically significant differences (P 0.05). Conclusion Micro-lecture combined with Simbaby teaching model can help students comprehend the basic theories of neonatal disease and improve their clinical operation skills, self-learning ability and clinical thinking ability, which is worth to be promoted in neonatal clinical teaching. Key words: Micro-lecture; Simbaby; Newborn; Clinical teaching

Effectiveness of flipped classroom combined with team-, case-, lecture- and evidence-based learning on ophthalmology teaching for eight-year program students

BackgroundThis study aimed to investigate the benefits and challenges of the flipped classroom combined with team-, case-, lecture- and evidence-based learning (FC-TCLEBL) for ophthalmology teaching for eight-year program students.MethodsFC-TCLEBL and the traditional lecture-based classroom (LBC) were compared based on student and teacher feedback questionnaires, student learning burden, and scores on standardized tests as well as their effects on the abilities of clinical thinking, scientific research, active-learning, practical application, humanistic care and communication with patients.ResultsBoth the students and teachers were more satisfied with the FC-TCLEBL model. More students in the FC-TCLEBL group agreed that the course helped them to develop skills in creative thinking, problem solving, and teamwork. Students in the FC-TCLEBL group spent significantly more time preparing for class than those in the LBC group, but the time spent on review was significantly lower in the FC-TCLEBL group. The students from the FC-TCLEBL group performed better in a post-test on diabetic retinopathy (DR) as compared to the LBC group.ConclusionsFC-TCLEBL teaching model is effective and suitable for ophthalmology teaching.

Effect of goal orientation combined with plan-do-check-act cycle improvement on the professional teaching of critical care medicine

Objective To investigate the promotional effect of the new teaching method of goal orientation combined with plan-do-check-act (PDCA) cyclic improvement on specialized medical knowledge and operation skills among physicians in critical care medicine. Methods A total of 84 physicians who received critical care medicine training in Department of Critical Care Medicine in Foshan Hospital of Traditional Chinese Medicine from January 2013 to December 2015 were selected, and according to the time of admission, they were divided into control group with 41 physicians and experimental group with 43 physicians. The physicians in the experimental group received the new teaching method of goal orientation combined with PDCA cyclic improvement, i.e., the physicians started systematic learning according to the learning goals sent out by the teaching secretary, summarized problems during learning and looked for optimal solutions every week, and then continued learning in the next week through PDCA cyclic improvement. The physicians in the control group received traditional teaching combined with bedside teaching, but no learning goals were set for them. The two groups were compared in terms of theoretical examination scores, clinical operation skills, and results of the questionnaire survey. The t-test and Wilcoxon ranksum test were used for comparison of scores between the two groups by SPSS 18.0. Results Compared with the control group, the experimental group had significant increases in the scores of theoretical examination (91.50±4.18 vs. 87.80±3.63) and operation skills (88.80±3.34 vs. 85.40±2.88). The questionnaire survey showed that compared with the control group, the experimental group had a significantly higher degree of satisfaction, significantly greater learning interests, and significantly greater improvements in operation skills, clinical thinking ability, and self-confidence. Conclusion The new teaching method of goal orientation combined with PDCA cyclic improvement can stimulate learning interests, clarify learning goals, help physicians to master important and difficult issues, and thus improve their learning outcomes and scores in Department of Critical Care Medicine. Key words: Goal orientation; Plan-do-check-act; Critical care medicine; Teaching method

Problems and solutions in clinical practice of orthopedics for medical students

In view of problems such as students in clinical orthopedic practice lack of basic theoretical knowledge and practical ability, both teachers and students' lack of preparations for clinical practice and their insufficient attention etc., this paper attempts to strengthen the standardized management of department teaching. Some measures were adopted to stimulate the potential of students, such as teaching based on case combination, department discussion, strengthening education of humanities, improving examination methods and so on, so as to improve students' comprehensive ability and achieve teaching goals. The results showed that by changing the above teaching methods, students can improve their mastery of knowledge, proficiency in basic operation, clinical thinking ability, communication and coordination ability, subjective initiative and so on. At the same time, students' problem-solving ability, learning interests, self-confidence and the satisfaction with teaching effect have also been improved, which promoted the performance of students in clinical practice. Key words: Medical students; Orthopedics; Education; Clinical practice

Evaluation of innovative teaching mode on obstetrics and gynecology for clinical interns

Objective To evaluate an innovative teaching mode on obstetrics and gynecology for clinical interns. Methods A total of 195 students from Grade 2015 of Clinical Medicine (Group 2018) were enrolled to receive the innovative teaching mode. This mode was based on organ integration medicine,focused on solving problems and improving teacher-student interaction, and provided creative homework and more clinical practice for students. The teaching results were evaluated objective and structured clinical examinations and questionnaire, and by comparing their scores with those of the former two grades (Grade 2013 and 2014). The statistical analysis was performed with SPSS 21.0. Results Scores of objective and structured clinical test in Group 2018 was higher than those in the two groups former of the same period, and the difference was statistically significant (P<0.05). Satisfaction in Group 2018 was higher than that in the former two groups (P<0.05). Conclusion The their innovative teaching mode can help students to integrate theories with practice and cultivate ability of clinical thinking. Key words: Clinical internship; Teaching reform; Objective and structured clinicaltest

How to develop clinical thinking ability of critical care medicine

重症医师临床思维的培养首先离不开科学、严谨的思维和在复杂环境中敏锐洞察力和判断力。本文探讨如何培养重症医师准确获取重症治疗中数据的能力，基于数据准确诊断的能力，强化目标导向治疗的重症治疗核心理念，明确病因治疗是重症患者治疗中的重要部分和培养重症医师良好的人文素质等五大核心胜任力。.

An exploration of the application of case-based learning combined with teaching rounds in standardized training of residents in department of hematology

Objective To investigate the application value of case-based learning (CBL) combined with teaching rounds in the standardized training of residents in department of hematology. Methods A total of 124 residents who received standardized training in department of hematology from August 2015 to July 2018 were selected and randomly divided into experimental group and control group. The residents in the experimental group received the teaching method of CBL combined with teaching rounds, while those in the control group received traditional teaching rounds. The two groups were compared in terms of department examination scores and teaching quality. Results Compared with the control group, the experimental group had significantly higher scores of the department examinations of hematological theoretical knowledge and case analysis (P<0.05). The residents in the experimental group thought that the new teaching method of CBL combined with teaching rounds could stimulate their interest in learning hematological diseases, improve self-study abilities, help them to combine theoretical knowledge with clinical practice, enhance their knowledge of hematological diseases, and cultivate their clinical thinking ability. Conclusion CBL combined with teaching rounds has achieved good results in standardized training of residents in department of hematology, and thus it holds promise for application in standardized training of other specialties in internal medicine. Key words: Case-based learning; Teaching round; Department of hematology; Standardized training of residents

Practice of the rotation training model for professional clinical postgraduate students in department of gastroenterology

Objective To investigate the significance of merge model versus model in rotation training for professional clinical postgraduate students in department of gastroenterology. Methods The professional clinical postgraduate students who underwent rotation training in Qingdao Municipal Hospital from July 2012 to July 2016 were enrolled as subjects and were trained with the merge model and the model, respectively. The two groups of subjects were compared in terms of clinical knowledge, skills, and core competencies. Results The postgraduates trained by the merge model had a significantly higher total score of clinical examinations than those trained by the model [(92.60±2.52) vs. (83.80±3.14), t=10.93, P<0.01], while there were no significant differences in professional quality and doctor-patient communication between the two groups. Compared with those trained with the model, the postgraduates trained by the merge model had significantly better understanding of clinical knowledge and clinical thinking ability, diagnosis and treatment skills, and psychological quality (χ2=27.00, 10.23, and 12.21, all P<0.01); however, there was no significant difference in clinical research ability between the two groups (χ2=1.39, P=0.24). Conclusion The model of professional clinical postgraduate training combined with standardized training of residents is superior to the traditional training model, and compared with the model, the merge model is more beneficial to the training of comprehensive clinical practice abilities and thus holds promise for further application. Key words: Gastroenterology; Professional degree; Postgraduate education; Standardized training of residents; Training model

The Application of Intelligent Simulated Human Teaching Equipment in Clinical Practice

The application of modern science and technology to the basic experimental teaching of medical students is an important trend in the reform of experimental teaching in medical colleges and universities. The international advanced intelligent simulated human ECS teaching equipment and integrated functional experimental teaching are organically combined to operate and apply in the virtual clinical cases, and the theoretical knowledge and clinical skills are tested. This has achieved remarkable results in the cultivation of modern medical education talents, and has achieved the goal of cultivating students’ clinical thinking and analytical ability, and improving the comprehensive quality of medical students, thus providing new ideas for the reform of modern functional experiment teaching.

An exploration of the training and evaluation systems of medical undergraduates in the context of tutorial system

Objective To investigate the training process of clinical practice ability in medical undergraduates in the context of tutorial system, as well as new clinical training models and evaluation methods. Methods A total of 40 medical undergraduates who entered the stage of clinical practice were randomly divided into tutorial group and control group, with 20 undergraduates in each group. A diversified evaluation system was used to perform a comprehensive evaluation of clinical practice ability of medical undergraduates at different stages, with a combination of professional theory examination, Mini-Clinical Evaluation Exercise, Direct Observation of Procedural Skills, and clinical case report. All the data were analyzed by SPSS 23.0, t test was used for statistical analysis. Results Compared with the control group after the internship ended, the tutorial group had significantly higher scores of clinical professional theory(86.24±2.93), clinical practice ability (7.53±0.48), clinical operation skills (4.35±0.47), and clinical thinking ability (6.31±0.52) (all P<0.05). Conclusion The application of the tutorial training mode during the internship of medical undergraduates can improve their comprehensive qualities such as professional quality, medical theory, and practical skills. The diversified evaluation system can evaluate the teaching effect and reflect the cultivation of comprehensive quality among students. Key words: Tutorial system; Diversified evaluation system; Clinical practice ability

Reform and reflection on the cultivation of postgraduates in neurosurgery in "5+3" training plan

At present, the standardized training of neurosurgery resident is in the primary stage in our country, and the master's degree postgraduates of Neurosurgery major are the main part of the students of neurosurgery planning training in our department. At present, a systematic and sound training system and teaching mechanism hasn’t been formed in the standardized training of postgraduates in Neurosurgery. It is imperative to explore the training mode of postgraduates majoring in neurosurgery to keep pace with the times and meet the needs of the society. Based on the problems in the current training mode of neurosurgery in the First Affiliated Hospital of Heavy Medicine and combined with the existing problems, this paper focuses on the cultivation of professional basic theoretical knowledge, clinical practice ability, clinical thinking and innovative ability and aims to establish professional assessment team, so as to boost the education development of postgraduates with neurosurgery degree and improve the quality of standardized training. Key words: Neurosurgery; Professional degree graduate student; Standardized training of residents; Reform

Current situation and improvement of cardiovascular clinical teaching

There are some problems in clinical teaching of cardiovascular medicine, such as insufficient attention to the three bases skills, not teaching trainees in accordance with their aptitude adequately, monotonous instructional mode, and assessment becoming a mere formality. Aiming at these problems, we have explored the training methods of medical talents adapted to the modern medical model, and improved the clinical basic skills and thinking of the students and the quality of teaching through such measures as paying close attention to basic skills training, standardizing ward rounds, paying attention to teaching students in accordance with their aptitude, and reforming teaching methods and assessment modes. Key words: Clinical basic skills; Clinical thinking ability; Problem-based learning (PBL); Assessment reform

Evaluation of the implementation of the organ-system based integrated curriculum model in medi-cal education

Objective Comparing the organ-system-based integrated curriculum model and tradi-tional teaching model in medical education to evaluate the effect of Integrated curriculum model. Methods The experiment group (Group A) included 45 students who had graduated in 2016 under integrated curricu-lum model, the control group (Group B) included 82 students who had graduated in the same year under traditional teaching model. Comparing the test score between two groups to see if a significant difference emerged, including general education courses, graduation examination, clinical intern examination, uninte-grated curriculum and National Medical Licensing Examination. Using SPSS 19.0 statistics, 2-Independent-sample T test. Results There were no significant difference in the scores of general education courses between the groups. The total score of graduation theory examination in group A was 54.71±8.58, which was significantly higher than group B (49.13±12.21) (P=0.008), especially in internal medicine, surgery, gyne-cology and obstetrics, the contrast of the two groups being P=0.015, P=0.022, P=0.002 respectively. The total score of OSCE in group A was 69.56±5.64, which was significantly higher than group B (65.74±5.37) (P=0.000), especially in diagnose, clinical thinking ability, interpersonal communication skills and total score, the contrast of the two groups being P=0.019, P=0.001, P=0.000 respectively. The scores of clinical Intern examination in group A were superior to group B, especially in internal medicine, surgery, gynecology and obstetrics, the contrast of the two group being P=0.029, P=0.015, P=0.003 respectively. The scores of 3 unintegrated curriculum in group A were the same with group B. The total score of National Medical Licens-ing Examination in group A was (429.690±31.197), which was significantly higher than group B (412.370±46.858) (P=0.048), especially in Clinical medicine, Preventive Medicine, the contrast of the two groups were P=0.011, P=0.022 respectively, in the level of knowledge, comprehension, application, the contrast of the two groups being P=0.022, P=0.041 respectively. Conclusions The integrated curriculum modal has more advantages in developing students' Comprehensive ability. There is no fixed pattern of integrated curriculum, and it needs continuous evaluation and improvement to ensure the effect. Key words: Medical education; Organ-system; Integrated curriculum; Evaluation

Application of WPBL teaching method in the teaching of respiratory system integration curriculum

Objective To evaluate the application of Web problem-based learning (WPBL) mode of respiratory system integration curriculum. Methods Experimentclasses 1 and 2 of the 2014 grades of the Qiqihar Medical University were divided into control group(48 students) and experiment group (48 students). Traditional PBL teaching was conducted in control group: the contents of the case were printed and discussed with the material of each class. WPBL teaching was conducted in experiment group: autonomous learning before class, showing cases by Video, asking questions and discussion in group and reporting results in class. The teaching effect was evaluated by PBL evaluation form, questionnaire and final grade. SSPS 19.0 statistical software was used for data analysis and measurement. T test was conducted among groups. Counting data were tested by Chi-square and the results were expressed as percentage. Results The students in the experiment group were better than those of control groupin the aspects of contents understanding, course interest, clinical thinking ability, classroom atmosphere and the course attitude. The scores of PBL (16.65±2.82), experiment exam (8.21±0.44) and final grade(76.77±12.31) in the experiment group were higher than those in the control group. There are statistical differences in two groups (P<0.05). Conclusions WPBL teaching can improve students'learning interest,clinical thinking ability and improve the teaching quality of respiratory integration curriculum. Key words: Web problem-based learning; Respiratory system; Integration curriculum