Clinical skills training center of Dongyang People's hospital introduced lean man-agement conception into the resident clinical skills training. The recruited residents were grouped by degree, the training contents were detailed, and teaching plans were normalized, and small class teach-ing and real-time feedback were implemented, which improved the normalization and standardization of resident training. The implementation of lean management leads to great progress in resident train-ing, but still needs further efforts. Only in the long-term management of standardization, can lean man-agement conception be embedded in daily work, making clinical skills training center play its role in cultivating medical talents effectively.

Due to the insufficient education of medical ethics and tending to medical moral educa-tion, the residents lack the ability to make ethical decisions. Therefore, we applied Four Topics method in the clinical ethics training of residents. The clinical ethics training was divided into three stages, and each stage had different training content and objectives. Dongyang People's Hospital adopted the form of lectures and panel discussions. During the group discussion, the group leader was in charge of case preparation, which came from clinical practice, and then all members applied the Four Topics method to analyze and discuss the ethical conflicts, and make the ethical decision. Through this process, residents' ability to solve ethical problems in clinical practice was enhanced.

In order to improve the professional level and service ability of general practitioners, this study is guided by the needs of community medical institutions in the county medical communities. Two small-class training of 15 modules were carried out for a week, taking "2+5" training mode, including 2 days of theoretical teaching and case discussion, and 5 days of bedside teaching. After the training, the theoretical examination, case report and objective clinical structured examination were carried out. Those who passed the examination were issued a certificate of qualification and given corresponding rewards. The results showed that the post-test scores of trainees after training were significantly improved compared with the pre-test scores, and the qualification rate increased from 18.4% to 85.9%. This training mode can be promoted in a wider range, but it should be adjusted appropriately according to the actual situation in various places, and the relevant departments and hospitals should give full support.

In order to strengthen the cultivation of core competence of undergraduate clinical medi-cine interns and improve the quality and efficiency of practice, Dongyang People's Hospital has constructed an integrated training system of practice teaching with objectives, contents, methods and assessment. The system is guided by "actual nursing capacity" and "medical professional knowledge and skills". By setting goals, improving teaching content, improving teaching methods, and strengthening assessment and evalua-tion, the quality of interns' practice has been improved, and the excellent rate of interns' medical history collection and assessment and skill operation assessment has also been improved. According to assessment tests of theory and technical operation, and the passing rate of examination of doctor qualification of the new employees in the past 2 years, the results shows that the scores of new employees who used to practice in the hospital are significantly higher than those in other hospitals.