Objective:To analyze the influencing factors for choice of secondary disciplines in eight-year medical students majoring in clinical medicine based on the self-determination theory.Methods:Fourteen eight-year students majoring in clinical medicine in 2018 and 2019 from an affiliated medical school of Peking University Health Science Center were selected to conduct semi-structured interviews using purposive sampling and descriptive phenomenological study methods. The thematic framework method was used to analyze the interview data and refine the theme.Results:Through the analysis of interview data, a total of 3 dimensions were obtained, including 6 first-level topics and 19 second-level topics: ①autonomy dimension (interest factor and value factor); ②dimension of competence (personal trait factor and subject requirement factor); and ③belonging dimension (department factor and mentor factor).Conclusions:The sense of autonomy based on interests and values, the sense of competence matched with personal ability and the characteristics of the discipline, and the sense of belonging brought by the atmosphere of the department and the mentor are important factors influencing the choice of secondary disciplines in eight-year medical students. Teachers and teaching managers should pay attention to the cultivation of students' interests and value guidance, early contact with secondary disciplines, provision of competency training, and promotion of good interaction between students and department tutors, so as to enhance students' sense of belonging and optimize the training model of eight-year excellent doctors.

While the importance of implementing competency-based medical education (CBME) has gained widespread recognition, how to implement and evaluate CBME needs more exploration. Drawing upon the five core framework elements of CBME proposed by Van Melle et al. in 2019 as well as prior CBME implementation practices and current domestic circumstances and challenges, we propose that the successful implementation of CBME needs collaborative efforts from government agencies, educational institutions, teaching hospitals, teachers, and learners. To advance the implementation of CBME, it is necessary to highlight support from governmental and administrative bodies, fortify teacher faculty development and incentive mechanisms, enhance training and support for learners, and accelerate the development of digital teaching platforms.

Objective:To investigate teachers' evaluation and willingness and the influencing factors regarding the adoption of the flipped classroom teaching mode in undergraduate pediatrics education.Methods:From December 2022 to December 2024, a questionnaire survey was conducted among the teachers who were responsible for teaching Child Health and Disease（Pediatrics) to the eight-year clinical medicine students at Peking University Health Science Center. Their views, evaluation, and willingness of implementing the flipped classroom teaching mode were investigated. Logistic regression analysis was performed using SPSS 26.0 software to explore the factors influencing teachers' willingness to adopt the flipped classroom teaching mode.Results:A total of 102 questionnaires were collected. Among the teachers, 20.59%（ n=21) believed that the teaching effect of the flipped classroom was better than that of the traditional class, 58.82%（ n=60) considered its effectiveness comparable, and 20.59%（ n=21) found it less effective. The most influential factors affecting the effectiveness of flipped classroom were students' self-learning with online videos [(4.39±0.73) points], student participation in the flipped classrooms [(4.26±0.72) points], the adequacy of teachers' pre-class preparation [(4.18±0.65) points], and the suitability of the teaching content for the flipped classroom [(4.11±0.76) points]. Teachers believed that the flipped classroom significantly enhanced students' autonomous learning ability [(4.11±0.63) points], clinical thinking [(4.04±0.58) points], and expression skills [(3.80±0.61) points]. Additionally, 78.43%（ n=80) of the teachers expressed willingness to continue participating in flipped classroom teaching. Factors influencing teachers' willingness to adopt the flipped classroom included gender, satisfaction with students' classroom participation, and personal experience with the effectiveness of the flipped classroom（ P<0.05). Conclusions:The flipped classroom teaching mode is well-accepted by teachers. Students' classroom participation affects teachers' willingness to continue using the flipped classroom teaching mode. In the future, the content of flipped classroom should be arranged individually according to specific teaching objectives to increase students' classroom participation and promote the cultivation of students' ability.

Objective:To construct an indicator system for entrustable professional activities (EPAs) in the general practice enhancement stage of pediatric specialist physician training.Methods:A draft indicator system for EPAs in the general practice enhancement stage of pediatric physician training was developed through core EPAs working group discussion, literature review, nominal group discussion, and expert consultation. Subsequently, the indicator system was preliminarily implemented and revised.Results:The core EPAs working group consisted of nine specialist physician trainers. In the initial brainstorming stage, a "potential list" of 30 activities was established. After literature review and collation, the draft indicator system included eight EPAs. Through nominal group discussion, the connotation of the draft was enriched, and the importance of the EPAs was ranked and modified. Finally, through expert consultation, the EPAs for the general practice enhancement stage of pediatric specialist physician training were determined. These included basic operations for the treatment of critically ill children, identification and management of critical illnesses, referral of critically ill children, perioperative management, in-hospital consultation, medical and teaching management and system improvement, doctor-patient communication and dispute handling, and response to public health events. During the preliminary implementation stage, a total of nine specialist physicians who participated in the training were evaluated. Based on the problems found in the pre-evaluation, the indicators of EPAs were revised, and a corresponding curriculum training system was developed.Conclusions:Through multiple rounds of nominal group discussion and expert consultation, the indicator system for EPAs in the general practice enhancement stage of pediatric specialist physician training was formulated. The system was preliminarily implemented and revised, and a curriculum system was constructed.

Objective:To analyze the influencing factors for choice of secondary disciplines in eight-year medical students majoring in clinical medicine based on the self-determination theory.Methods:Fourteen eight-year students majoring in clinical medicine in 2018 and 2019 from an affiliated medical school of Peking University Health Science Center were selected to conduct semi-structured interviews using purposive sampling and descriptive phenomenological study methods. The thematic framework method was used to analyze the interview data and refine the theme.Results:Through the analysis of interview data, a total of 3 dimensions were obtained, including 6 first-level topics and 19 second-level topics: ①autonomy dimension (interest factor and value factor); ②dimension of competence (personal trait factor and subject requirement factor); and ③belonging dimension (department factor and mentor factor).Conclusions:The sense of autonomy based on interests and values, the sense of competence matched with personal ability and the characteristics of the discipline, and the sense of belonging brought by the atmosphere of the department and the mentor are important factors influencing the choice of secondary disciplines in eight-year medical students. Teachers and teaching managers should pay attention to the cultivation of students' interests and value guidance, early contact with secondary disciplines, provision of competency training, and promotion of good interaction between students and department tutors, so as to enhance students' sense of belonging and optimize the training model of eight-year excellent doctors.

While the importance of implementing competency-based medical education (CBME) has gained widespread recognition, how to implement and evaluate CBME needs more exploration. Drawing upon the five core framework elements of CBME proposed by Van Melle et al. in 2019 as well as prior CBME implementation practices and current domestic circumstances and challenges, we propose that the successful implementation of CBME needs collaborative efforts from government agencies, educational institutions, teaching hospitals, teachers, and learners. To advance the implementation of CBME, it is necessary to highlight support from governmental and administrative bodies, fortify teacher faculty development and incentive mechanisms, enhance training and support for learners, and accelerate the development of digital teaching platforms.

Objective:To investigate teachers' evaluation and willingness and the influencing factors regarding the adoption of the flipped classroom teaching mode in undergraduate pediatrics education.Methods:From December 2022 to December 2024, a questionnaire survey was conducted among the teachers who were responsible for teaching Child Health and Disease（Pediatrics) to the eight-year clinical medicine students at Peking University Health Science Center. Their views, evaluation, and willingness of implementing the flipped classroom teaching mode were investigated. Logistic regression analysis was performed using SPSS 26.0 software to explore the factors influencing teachers' willingness to adopt the flipped classroom teaching mode.Results:A total of 102 questionnaires were collected. Among the teachers, 20.59%（ n=21) believed that the teaching effect of the flipped classroom was better than that of the traditional class, 58.82%（ n=60) considered its effectiveness comparable, and 20.59%（ n=21) found it less effective. The most influential factors affecting the effectiveness of flipped classroom were students' self-learning with online videos [(4.39±0.73) points], student participation in the flipped classrooms [(4.26±0.72) points], the adequacy of teachers' pre-class preparation [(4.18±0.65) points], and the suitability of the teaching content for the flipped classroom [(4.11±0.76) points]. Teachers believed that the flipped classroom significantly enhanced students' autonomous learning ability [(4.11±0.63) points], clinical thinking [(4.04±0.58) points], and expression skills [(3.80±0.61) points]. Additionally, 78.43%（ n=80) of the teachers expressed willingness to continue participating in flipped classroom teaching. Factors influencing teachers' willingness to adopt the flipped classroom included gender, satisfaction with students' classroom participation, and personal experience with the effectiveness of the flipped classroom（ P<0.05). Conclusions:The flipped classroom teaching mode is well-accepted by teachers. Students' classroom participation affects teachers' willingness to continue using the flipped classroom teaching mode. In the future, the content of flipped classroom should be arranged individually according to specific teaching objectives to increase students' classroom participation and promote the cultivation of students' ability.

Objective:To construct an indicator system for entrustable professional activities (EPAs) in the general practice enhancement stage of pediatric specialist physician training.Methods:A draft indicator system for EPAs in the general practice enhancement stage of pediatric physician training was developed through core EPAs working group discussion, literature review, nominal group discussion, and expert consultation. Subsequently, the indicator system was preliminarily implemented and revised.Results:The core EPAs working group consisted of nine specialist physician trainers. In the initial brainstorming stage, a "potential list" of 30 activities was established. After literature review and collation, the draft indicator system included eight EPAs. Through nominal group discussion, the connotation of the draft was enriched, and the importance of the EPAs was ranked and modified. Finally, through expert consultation, the EPAs for the general practice enhancement stage of pediatric specialist physician training were determined. These included basic operations for the treatment of critically ill children, identification and management of critical illnesses, referral of critically ill children, perioperative management, in-hospital consultation, medical and teaching management and system improvement, doctor-patient communication and dispute handling, and response to public health events. During the preliminary implementation stage, a total of nine specialist physicians who participated in the training were evaluated. Based on the problems found in the pre-evaluation, the indicators of EPAs were revised, and a corresponding curriculum training system was developed.Conclusions:Through multiple rounds of nominal group discussion and expert consultation, the indicator system for EPAs in the general practice enhancement stage of pediatric specialist physician training was formulated. The system was preliminarily implemented and revised, and a curriculum system was constructed.

Objective:To understand the research hotspots and development trends of medical simulation education in China and other countries and to provide a reference for the development of medical simulation education in China.Methods:CNKI and Web of Science were used as databases to retrieve Chinese and international research articles related to medical simulation education since the 21st century. These included 4 338 articles from CNKI and 5 986 articles from Web of Science. CiteSpace data analysis software was used to compare and visualize the research hotspots and development trends of medical simulation education in China and other countries.Results:The annual publication volume of research on medical simulation education in China and other countries generally increased with periodic fluctuations. The United States, Canada, and the United Kingdom showed centralities greater than 0.1 in the international cooperation network. Institutions and authors in other countries demonstrated a higher degree of collaboration than those in China. The journals of BMC Medical Education and China Higher Medical Education published the highest number of articles. The research hotspots in other countries included virtual reality and patient safety, while the research in China focused on standardized patients and nursing education. Cutting-edge topics in other countries included medical education and training, postgraduate medical education, 3D printing, augmented reality, and feedback. In China, the cutting-edge research focused on education, resident physicians, satisfaction, and comprehensive capabilities.Conclusions:Medical simulation education remains a hot topic in future research. Compared with China, other countries have demonstrated advantages in construction of medical simulation education discipline, the efficiency of simulation center usage, faculty training systems, curriculum design, and talent development systems, with more systematic and diversified research frontiers and hotspots.

Objective:To understand the research hotspots and development trends of medical simulation education in China and other countries and to provide a reference for the development of medical simulation education in China.Methods:CNKI and Web of Science were used as databases to retrieve Chinese and international research articles related to medical simulation education since the 21st century. These included 4 338 articles from CNKI and 5 986 articles from Web of Science. CiteSpace data analysis software was used to compare and visualize the research hotspots and development trends of medical simulation education in China and other countries.Results:The annual publication volume of research on medical simulation education in China and other countries generally increased with periodic fluctuations. The United States, Canada, and the United Kingdom showed centralities greater than 0.1 in the international cooperation network. Institutions and authors in other countries demonstrated a higher degree of collaboration than those in China. The journals of BMC Medical Education and China Higher Medical Education published the highest number of articles. The research hotspots in other countries included virtual reality and patient safety, while the research in China focused on standardized patients and nursing education. Cutting-edge topics in other countries included medical education and training, postgraduate medical education, 3D printing, augmented reality, and feedback. In China, the cutting-edge research focused on education, resident physicians, satisfaction, and comprehensive capabilities.Conclusions:Medical simulation education remains a hot topic in future research. Compared with China, other countries have demonstrated advantages in construction of medical simulation education discipline, the efficiency of simulation center usage, faculty training systems, curriculum design, and talent development systems, with more systematic and diversified research frontiers and hotspots.