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Tong W, Zhang X, Zeng H, Pan J, Gong C, Zhang H. Reforming China's Secondary Vocational Medical Education: Adapting to the Challenges and Opportunities of the AI Era. JMIR MEDICAL EDUCATION 2024; 10:e48594. [PMID: 39149865 PMCID: PMC11337726 DOI: 10.2196/48594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/03/2024] [Accepted: 06/11/2024] [Indexed: 08/17/2024]
Abstract
Unlabelled China's secondary vocational medical education is essential for training primary health care personnel and enhancing public health responses. This education system currently faces challenges, primarily due to its emphasis on knowledge acquisition that overshadows the development and application of skills, especially in the context of emerging artificial intelligence (AI) technologies. This article delves into the impact of AI on medical practices and uses this analysis to suggest reforms for the vocational medical education system in China. AI is found to significantly enhance diagnostic capabilities, therapeutic decision-making, and patient management. However, it also brings about concerns such as potential job losses and necessitates the adaptation of medical professionals to new technologies. Proposed reforms include a greater focus on critical thinking, hands-on experiences, skill development, medical ethics, and integrating humanities and AI into the curriculum. These reforms require ongoing evaluation and sustained research to effectively prepare medical students for future challenges in the field.
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Affiliation(s)
- Wenting Tong
- Department of Pharmacy, Gannan Healthcare Vocational College, Ganzhou, China
| | - Xiaowen Zhang
- Department of Rehabilitation and Elderly Care, Gannan Healthcare Vocational College, Ganzhou, China
| | - Haiping Zeng
- Department of Gastrointestinal Surgery, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianping Pan
- Scientific Research Division, Gannan Healthcare Vocational College, Ganzhou, China
| | - Chao Gong
- Student Work Division, Gannan Healthcare Vocational College, Ganzhou, China
| | - Hui Zhang
- Department of Rehabilitation and Elderly Care, Gannan Healthcare Vocational College, Ganzhou, China
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Urology, Dongguan Hospital Affiliated to Guangzhou University of Chinese Medicine, 22 Songshanhu Avenue, Guangdong Province, Dongguan, 523080, China, 86 0769 2638 5365
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Culhane A, Martin J, Huston Z, Hock SM. Simulating empathy: A qualitative experiential study of embedded resident learners in an empathy curriculum. AEM EDUCATION AND TRAINING 2024; 8:e10957. [PMID: 38516254 PMCID: PMC10951622 DOI: 10.1002/aet2.10957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 03/23/2024]
Abstract
Objectives Physician empathy and communication skills are crucial parts of a successful emergency department (ED) interaction. This study aimed to evaluate whether these skills can be improved through a novel curriculum where interns act as patients for their senior residents during simulated ED cases. Methods Twenty-five residents participated in the curriculum. Prior to the cases, participants filled out the Toronto Empathy Questionnaire (TEQ). They then completed three simulated cases, with the 11 interns portraying the patients and the 14 seniors (postgraduate year [PGY]-2 and PGY-3 residents) in the physician role. Following the cases, the residents participated in a recorded, structured focus group. At the conclusion of the session participants again filled out the TEQ and answered a Likert questionnaire on their thoughts about the curriculum. Qualitative analysis was used to determine themes from the debriefs. Results Twenty-two residents completed all components of the study. The mean (±SD) TEQ scores pre- and postcurriculum for all residents were 46.2 (±4.64) pre and 47.9 (±6.03) post (ns). On qualitative analysis, we derived four major themes: empathy, communication, feedback, and physician experience. The most common subthemes discussed were empathy for the patient situation and the importance of communicating visit expectations. On a 5-point Likert survey related to the simulated cases, respondents rated comfort providing feedback to their peers (mean ± SD 4.41 ± 0.95) and gaining insight into the patient experience (mean ± SD 4.27 ± 0.83). Conclusions The embedded intern exercise was rated well by resident participants, with no observed change in empathy scores. Qualitative analysis identified empathy and communication as major themes. Residents enjoyed this style of simulation and found it realistic.
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Affiliation(s)
- Anna Culhane
- Department of Emergency MedicineMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jerome Martin
- Department of Emergency MedicineRush University Medical CenterChicagoIllinoisUSA
| | | | - Sara M. Hock
- Department of Emergency MedicineRush University Medical CenterChicagoIllinoisUSA
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Liu P, Chen SY, Chang YC, Ng CJ, Chaou CH. Multimodal In-training Examination in an Emergency Medicine Residency Training Program: A Longitudinal Observational Study. Front Med (Lausanne) 2022; 9:840721. [PMID: 35355591 PMCID: PMC8959571 DOI: 10.3389/fmed.2022.840721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background In-training examination (ITE) has been widely adopted as an assessment tool to measure residents' competency. We incorporated different formats of assessments into the emergency medicine (EM) residency training program to form a multimodal, multistation ITE. This study was conducted to examine the cost and effectiveness of its different testing formats. Methods We conducted a longitudinal study in a tertiary teaching hospital in Taiwan. Nine EM residents were enrolled and followed for 4 years, and the biannual ITE scores were recorded and analyzed. Each ITE consisted of 8–10 stations and was categorized into four formats: multiple-choice question (MCQ), question and answer (QA), oral examination (OE), and high-fidelity simulation (HFS) formats. The learner satisfaction, validity, reliability, and costs were analyzed. Results 486 station scores were recorded during the 4 years. The numbers of MCQ, OE, QA, and HFS stations were 45 (9.26%), 90 (18.5%), 198 (40.7%), and 135 (27.8%), respectively. The overall Cronbach's alpha reached 0.968, indicating good overall internal consistency. The correlation with EM board examination was highest for HFS (ρ = 0.657). The average costs of an MCQ station, an OE station, and an HFS station were ~3, 14, and 21 times that of a QA station. Conclusions Multi-dimensional assessment contributes to good reliability. HFS correlates best with the final training exam score but is also the most expensive format among ITEs. Increased testing domains with various formats improve ITE's overall reliability. Program directors must understand each test format's strengths and limitations to bring forth the best combination of exams under the local context.
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Affiliation(s)
- Pin Liu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan, Taiwan.,Department of Emergency Medicine, West Garden Hospital, Taipei, Taiwan
| | - Shou-Yen Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, Division of Medical Education, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Che Chang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan, Taiwan.,Chang Gung, Medical Education Research Center, Taoyuan, Taiwan
| | - Chip-Jin Ng
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan, Taiwan
| | - Chung-Hsien Chaou
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan, Taiwan.,Chang Gung, Medical Education Research Center, Taoyuan, Taiwan
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Barton SM, Calhoun AW, Bohnert CA, Multerer SM, Statler VA, Bryant KA, Arnold DM, Felton HM, Purcell PM, Kinney MD, Parrish-Sprowl JM, Marshall GS. Standardized Vaccine-Hesitant Patients in the Assessment of the Effectiveness of Vaccine Communication Training. J Pediatr 2022; 241:203-211.e1. [PMID: 34699909 DOI: 10.1016/j.jpeds.2021.10.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To determine if training residents in a structured communication method elicits specific behaviors in a laboratory model of interaction with vaccine-hesitant parents. STUDY DESIGN Standardized patients portraying vaccine-hesitant parents were used to assess the effectiveness of training in the Announce, Inquire, Mirror, Secure (AIMS) Method for Healthy Conversations. Blinded pediatric residents were pseudorandomized to receive AIMS or control training and underwent pre- and post-training encounters with blinded standardized patients. Encounters were assessed by blinded raters using a novel tool. Participant confidence and standardized patient evaluations of the participants' general communication skills were assessed. RESULTS Ratings were available for 27 AIMS and 26 control participants. Statistically significant increases in post-training scores (maximum = 30) were detected in AIMS, but not in control, participants (median, 21.3 [IQR, 19.8-24.8] vs 18.8 [IQR, 16.9-20.9]; P < .001). Elements (maximum score = 6) with significant increases were Inquire (0.67 [IQR, 0-1.76] vs -0.33 [IQR, -0.67 to 0.33]; P < .001); Mirror (1.33 [IQR, 0 to 2] vs -0.33 [IQR, -0.92 to 0]; P < .001) and Secure (0.33 [IQR, 0 to 1.67] vs -0.17 [IQR, -0.67 to 0.33]; P = .017). Self-confidence increased equally in both groups. Standardized patients did not detect a difference in communication skills after training and between groups. Internal consistency and inter-rater reliability of the assessment tool were modest. CONCLUSIONS Standardized patients proved useful in studying the effectiveness of structured communication training, but may have been limited in their ability to perceive a difference between groups owing to the predetermined encounter outcome of vaccine refusal. AIMS training should be studied in real-world scenarios to determine if it impacts vaccine acceptance.
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Affiliation(s)
- Shanna M Barton
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Aaron W Calhoun
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Carrie A Bohnert
- Department of Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY
| | - Sara M Multerer
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Victoria A Statler
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Kristina A Bryant
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Daniel M Arnold
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Heather M Felton
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Patricia M Purcell
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Matthew D Kinney
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - John M Parrish-Sprowl
- Department of Communication Studies, Global Health Communication Center, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Gary S Marshall
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY.
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Chen SY, Chaou CH, Yu SR, Chang YC, Ng CJ, Liu P. High-fidelity simulation is associated with good discriminability in emergency medicine residents' in-training examinations. Medicine (Baltimore) 2021; 100:e26328. [PMID: 34128876 PMCID: PMC8213238 DOI: 10.1097/md.0000000000026328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/25/2021] [Indexed: 01/04/2023] Open
Abstract
In-training examinations (ITEs), arranged during residency training, evaluate the residents' performances periodically. There is limited literature focusing on the effectiveness of resident ITEs in the format of simulation-based examinations, as compared to traditional oral or written tests. Our primary objective is to investigate the effectiveness and discriminative ability of high-fidelity simulation compared with other measurement formats in emergency medicine (EM) residency training program.This is a retrospective cohort study. During the 5-year study period, 8 ITEs were administered to 68 EM residents, and 253 ITE measurements were collected. Different ITE scores were calculated and presented as mean and standard deviation. The ITEs were categorized into written, oral, or high-fidelity simulation test forms. Discrimination of ITE scores between different training years of residency was examined using a one-way analysis of variance test.The high-fidelity simulation scores correlated to the progression of EM training, and residents in their fourth training year (R4) had the highest scores consistently, followed by R3, R2, and then R1. The oral test scores had similar results but not as consistent as the high-fidelity simulation tests. The written test scores distribution failed to discriminate the residents' seniority. The high-fidelity simulation test had the best discriminative ability and better correlation between different EM residency training years comparing to other forms.High-fidelity simulation tests had the good discriminative ability and were well correlated to the EM training year. We suggest high-fidelity simulation should be a part of ITE in training programs associated with critical or emergency patient cares.
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Affiliation(s)
- Shou-Yen Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan
| | - Chung-Hsien Chaou
- Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan
- Chang-Gung Medical Education Research Center
| | | | - Yu-Che Chang
- Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan
- Chang-Gung Medical Education Research Center
| | - Chip-Jin Ng
- Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan
| | - Pin Liu
- Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan
- Department of Emergency Medicine, West Garden Hospital, Taipei, Taiwan
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