1.Research on the development of entrustable professional activity indicators for residents in China: a systematic review
Jingyu ZHONG ; Yue XING ; Liangjing LÜ ; Qinghua MIN ; Zhengguang XIAO ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Yi JIANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(6):728-735
Objective:To systematically evaluate the current status of research on the development of indicators for entrustable professional activities (EPAs) of residents in China.Methods:We searched the China National Knowledge Infrastructure, Wanfang Data, Airiti Library, PubMed, Embase, and Web of Science databases for literature on the development of EPA indicators for residents in China published between January 1, 2005 and February 28, 2025. Two researchers independently screened the literature and extracted data, followed by descriptive analysis. The quality of the studies was assessed using the Joanna Briggs Institute critical appraisal tool for expert opinion. Quantitative data were presented as medians (ranges) and qualitative data were presented as frequencies (percentages).Results:A total of eight articles were included, in which two general EPA indicator systems and six specialty-specific EPA indicator systems were developed for residents. The overall quality of the research was high, with the main shortcomings related to the methods used in the process of constructing the consensus indicators. The number of experts recruited ranged from 22 to 45, with 100.00% response rate, high authority coefficients (0.820-0.914), and high coordination coefficients (0.157-0.741). Most of the studies used literature reviews as one source for the indicator pool (8 studies, 100.00%), employed the Delphi method to reach consensus (6 studies, 75.00%), and provided inclusion criteria for the indicators (7 studies, 87.50%). However, only one study (12.50%) explored the practical application of the developed indicators, and none of the studies set indicator weights or conducted quality assessments. The number of EPA indicators developed ranged from 10 to 38 per study. The reporting of EPA indicators was included in most studies regarding titles (8 studies, 100.00%) and the expected levels of entrustment at various stages of training (6 studies, 75.00%), but the reporting on other aspects was lacking. Among the specialty-specific EPA indicators, 38.39% overlapped with the general EPAs indicators.Conclusions:The research on the development of EPA indicators for residents in China is still in its early stages, and there is room for improvement in methodological quality and reporting coverage. There is partial overlap between specialty-specific and general EPA indicators, failing to fully reflect the unique characteristics of different specialties.
2.Accuracy and quality of answer reasoning of Chinese large language model in Chinese middle level professional qualification examination of radiology
Jingyu ZHONG ; Yue XING ; Yangfan HU ; Qinghua MIN ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(2):145-149
Objective:To compare the accuracy of a Chinese large language model (LLM) and radiologists in Chinese middle level professional qualification examination of radiology, and evaluate the quality of answer reasoning provided by the Chinese LLM.Methods:In this study, 100 high-quality questions were selected using stratified random sampling to form a test set. We asked the ERNIE Bot by dialogues on the website to provide the correct answers and answer reasoning for these questions. These questions were also answered by 15 radiologists with different levels of experience. The accuracy of Chinese LLM and that of radiologists were compared. Two radiologists evaluated the quality of answer reasoning using a 5-point semi-quantitative scale.Results:The accuracy of ERNIE Bot was 60.00%, which was lower than the median (interquartile) accuracy of 67.00% (64.00%, 73.00%) for radiologists, and the difference was statistically significant ( W=2.47, P=0.013). The word count of the reasoning provided by Ernie Bot was (196.44±99.25) words, with no significant difference in word count between correct and incorrect answer reasoning, which were (211.03±107.53) words and (174.55±81.84) words, respectively ( t=1.82, P=0.072). Among the correct answers, the quality of reasoning was scored as follows: 1 point for 3 questions, 2 points for 9 questions, 3 points for 12 questions, and 4 points for 36 questions. No reasoning received a score of 5. Conclusions:Chinese LLM demonstrates a certain level of medical knowledge and clinical reasoning ability, which can assist clinical teachers in educational activities. However, it is not yet able to independently tutor residents and lacks the ability of invitational and heuristic teaching.
3.An investigation of the current status of Chinese-foreign cooperative education programs for medical majors
Jingyu ZHONG ; Yue XING ; Qinghua MIN ; Zhengguang XIAO ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Yi JIANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(5):577-582
Objective:To investigate the current status of Chinese-foreign cooperative education programs for medical majors, and to discuss the potential problems and development trends of this field.Methods:Related data were collected from the information platform of Chinese-Foreign Cooperation in Running Schools by Ministry of Education of the People's Republic of China, and the characteristics of Chinese-foreign cooperative education programs for medical majors were extracted for analysis. Categorical data were expressed as frequency (percentage), and continuous data were expressed as mean±standard deviation.Results:A total of 83 Chinese-foreign cooperative education programs for medical majors were included in the study, accounting for only 3.45% (83/2 406) of all programs. Chinese partners in these cooperative programs were mainly from East China (41 programs, 49.40%), while foreign partners were mainly from Europe (39 programs, 46.99%). The mean duration of these programs was (3.61±0.88) years, with an enrollment of (87.08±35.52) students. Most of the students were included in National General Higher Education Enrollment Plan (79 programs, 95.18%), and the main majors included nursing (39 programs, 46.99%), medical technology (19 programs, 22.89%), and clinical medicine (11 programs, 13.25%), with the main enrollment level of junior college (45 programs, 54.22%). Chinese partners in the cooperative programs mainly issued academic certificate (45 programs, 54.22%) or academic certificate plus degree certificate (36 programs, 43.37%), while most foreign partners did not issue such certificates (44 programs, 53.01%).Conclusions:There are several problems in Chinese-foreign cooperative education programs for medical majors, such as a limited number of programs, a significant regional difference, an imbalanced distribution of specialties, a low level of education, and inconsistency in issuance of certificates, which still requires further improvement and standardization. However, there are also high-level and high-quality programs for reference.
4.Research on the development of entrustable professional activity indicators for residents in China: a systematic review
Jingyu ZHONG ; Yue XING ; Liangjing LÜ ; Qinghua MIN ; Zhengguang XIAO ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Yi JIANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(6):728-735
Objective:To systematically evaluate the current status of research on the development of indicators for entrustable professional activities (EPAs) of residents in China.Methods:We searched the China National Knowledge Infrastructure, Wanfang Data, Airiti Library, PubMed, Embase, and Web of Science databases for literature on the development of EPA indicators for residents in China published between January 1, 2005 and February 28, 2025. Two researchers independently screened the literature and extracted data, followed by descriptive analysis. The quality of the studies was assessed using the Joanna Briggs Institute critical appraisal tool for expert opinion. Quantitative data were presented as medians (ranges) and qualitative data were presented as frequencies (percentages).Results:A total of eight articles were included, in which two general EPA indicator systems and six specialty-specific EPA indicator systems were developed for residents. The overall quality of the research was high, with the main shortcomings related to the methods used in the process of constructing the consensus indicators. The number of experts recruited ranged from 22 to 45, with 100.00% response rate, high authority coefficients (0.820-0.914), and high coordination coefficients (0.157-0.741). Most of the studies used literature reviews as one source for the indicator pool (8 studies, 100.00%), employed the Delphi method to reach consensus (6 studies, 75.00%), and provided inclusion criteria for the indicators (7 studies, 87.50%). However, only one study (12.50%) explored the practical application of the developed indicators, and none of the studies set indicator weights or conducted quality assessments. The number of EPA indicators developed ranged from 10 to 38 per study. The reporting of EPA indicators was included in most studies regarding titles (8 studies, 100.00%) and the expected levels of entrustment at various stages of training (6 studies, 75.00%), but the reporting on other aspects was lacking. Among the specialty-specific EPA indicators, 38.39% overlapped with the general EPAs indicators.Conclusions:The research on the development of EPA indicators for residents in China is still in its early stages, and there is room for improvement in methodological quality and reporting coverage. There is partial overlap between specialty-specific and general EPA indicators, failing to fully reflect the unique characteristics of different specialties.
5.Accuracy and quality of answer reasoning of Chinese large language model in Chinese middle level professional qualification examination of radiology
Jingyu ZHONG ; Yue XING ; Yangfan HU ; Qinghua MIN ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(2):145-149
Objective:To compare the accuracy of a Chinese large language model (LLM) and radiologists in Chinese middle level professional qualification examination of radiology, and evaluate the quality of answer reasoning provided by the Chinese LLM.Methods:In this study, 100 high-quality questions were selected using stratified random sampling to form a test set. We asked the ERNIE Bot by dialogues on the website to provide the correct answers and answer reasoning for these questions. These questions were also answered by 15 radiologists with different levels of experience. The accuracy of Chinese LLM and that of radiologists were compared. Two radiologists evaluated the quality of answer reasoning using a 5-point semi-quantitative scale.Results:The accuracy of ERNIE Bot was 60.00%, which was lower than the median (interquartile) accuracy of 67.00% (64.00%, 73.00%) for radiologists, and the difference was statistically significant ( W=2.47, P=0.013). The word count of the reasoning provided by Ernie Bot was (196.44±99.25) words, with no significant difference in word count between correct and incorrect answer reasoning, which were (211.03±107.53) words and (174.55±81.84) words, respectively ( t=1.82, P=0.072). Among the correct answers, the quality of reasoning was scored as follows: 1 point for 3 questions, 2 points for 9 questions, 3 points for 12 questions, and 4 points for 36 questions. No reasoning received a score of 5. Conclusions:Chinese LLM demonstrates a certain level of medical knowledge and clinical reasoning ability, which can assist clinical teachers in educational activities. However, it is not yet able to independently tutor residents and lacks the ability of invitational and heuristic teaching.
6.An investigation of the current status of Chinese-foreign cooperative education programs for medical majors
Jingyu ZHONG ; Yue XING ; Qinghua MIN ; Zhengguang XIAO ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Yi JIANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(5):577-582
Objective:To investigate the current status of Chinese-foreign cooperative education programs for medical majors, and to discuss the potential problems and development trends of this field.Methods:Related data were collected from the information platform of Chinese-Foreign Cooperation in Running Schools by Ministry of Education of the People's Republic of China, and the characteristics of Chinese-foreign cooperative education programs for medical majors were extracted for analysis. Categorical data were expressed as frequency (percentage), and continuous data were expressed as mean±standard deviation.Results:A total of 83 Chinese-foreign cooperative education programs for medical majors were included in the study, accounting for only 3.45% (83/2 406) of all programs. Chinese partners in these cooperative programs were mainly from East China (41 programs, 49.40%), while foreign partners were mainly from Europe (39 programs, 46.99%). The mean duration of these programs was (3.61±0.88) years, with an enrollment of (87.08±35.52) students. Most of the students were included in National General Higher Education Enrollment Plan (79 programs, 95.18%), and the main majors included nursing (39 programs, 46.99%), medical technology (19 programs, 22.89%), and clinical medicine (11 programs, 13.25%), with the main enrollment level of junior college (45 programs, 54.22%). Chinese partners in the cooperative programs mainly issued academic certificate (45 programs, 54.22%) or academic certificate plus degree certificate (36 programs, 43.37%), while most foreign partners did not issue such certificates (44 programs, 53.01%).Conclusions:There are several problems in Chinese-foreign cooperative education programs for medical majors, such as a limited number of programs, a significant regional difference, an imbalanced distribution of specialties, a low level of education, and inconsistency in issuance of certificates, which still requires further improvement and standardization. However, there are also high-level and high-quality programs for reference.
7.Interpretation of the radiologist training system in Canada and enlightenment
Jingyu ZHONG ; Yue XING ; Yangfan HU ; Defang DING ; Xianwei LIU ; Qinghua MIN ; Zhengguang XIAO ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2024;23(9):1210-1216
This paper aims to discuss the ideas and experience about the radiology residency training system of Canada with a presentation of its base accreditation standards for five aspects, competency goals for seven roles, four stages of training arrangement, and two types of final assessment questions. Although the Canada's radiology residency program differs from China's standardized resident and specialist training programs for radiology, there are still several points that are worth referencing, including emphasizing the training priority of competency goals, providing a specific basis for the stratification of training, offering clear guidance for the implementation of training content, and improving assessment methods to focus on competency goals. These points are of great value for improving the standardized radiology resident and specialist training programs in China, so as to provide a reference for the training of excellent radiologists in China.
8.Development of neurological medical education in China: historical opportunities and challenges
Chinese Journal of Medical Education Research 2024;23(10):1308-1313
Despite the significant progress and advancement in contemporary medical education in China, it still fails to fully address the needs of developing medical disciplines and nurturing medical talents in the country. There are several shortcomings in the medical education in the representative discipline of neurology. Medical education research in China often covers disparate topics, lacks systematic foundation and theoretical innovation, predominantly emphasizes single-center clinical teaching, and rarely results in the publication of high-impact, internationally recognized research manuscripts. In addition, there remains a significant gap in the level of basic neurology research between China and abroad. As the "Healthy China" plan drives the need for enhanced medical education, coupled with global technological advancements and evolving health needs and medical practice, new theoretical shifts in medical education are emerging. Strategic planning in neurology, interdisciplinary advancements in neuroscience, and the integration of information technology have created substantial opportunities for the development of neurology medical education. However, this pivotal moment has posed new challenges to research in neurology medical education, including transitioning from practical research to innovative theoretical exploration and fostering versatile talents. This article systematically discusses the opportunities and challenges arising from the aforementioned issues and proposes effective strategies to address these concerns.
9.Quality issues in reviews written by medical postgraduate students: investigation and countermeasures
Chinese Journal of Medical Education Research 2023;22(6):864-868
Objective:To investigate the quality issues in medical reviews written by medical postgraduate students, and to provide a reference for improving the quality of medical reviews written by such students.Methods:A total of 141 medical reviews written by the medical postgraduate students from various affiliated hospitals of Shanghai Jiao Tong University School of Medicine from 2018 to 2022 were collected, and the quality of these medical reviews was evaluated in terms of topic selection and writing expression skills. As for topic selection, a self-designed innovative questionnaire (hereinafter referred to as topic questionnaire) was used to collect the evaluation of external experts, and as for writing expression, the reviews were assessed based on the criteria in relevant literature from the aspects of the outline of the review, the timeliness of references, analysis and evaluation, and the quality of the text. EPIDATA 3.2 was used to input data, and SPSS 20.0 was used for the chi-square test.Results:A total of 135 (96%, 135/141) valid questionnaires were collected in this study, and the results showed that 70% (94/135) of the review topics lacked novelty. The assessment of writing skills showed that 95% (128/135) of the reviews had outdated references, and 68% (92/135) lacked focus, hierarchy or logic in outline, which accounted for a higher proportion than the reviews with analysis and evaluation issues (59%, 80/135) and text quality issues (61%, 83/135) ( P<0.05). Conclusion:There are many quality issues in the medical reviews written by medical postgraduate students, such as a lack of novelty in topic selection and low overall quality of outlines. In order to improve the abilities of scientific research among medical postgraduate students, universities and supervisors should strengthen the guidance of innovative thinking in topic selection and enhance the training of writing expression skills, such as scientific analysis and logic.
10.Application of blended teaching in clinical skill practice course for undergraduate medical students
Jie CHEN ; Baohua DUAN ; Jun YU ; Haibo SHEN ; Jingshen CHU
Chinese Journal of Medical Education Research 2023;22(12):1806-1810
Objective:To investigate the application and effect of blended teaching model in clinical skill training.Methods:According to the practical teaching syllabus for undergraduate medical students in Shanghai Jiao Tong University School of Medicine and the national practical operation examination for medical practitioners, 20 basic skills of internal medicine, surgery, gynecology, pediatrics, and emergency were selected. A total of 120 junior medical students in the experimental group received the practice course of basic clinical skill operations using the online and offline blended teaching model in the academic years of 2020-2021, and 120 medical students in the control group received this course using the offline teaching model alone during the same period of time. The two groups were compared in terms of process completeness, skill proficiency, aseptic concept, communication and care, and clinical thinking, and a questionnaire survey was conducted for the students in the experimental group to investigate course design, adaptability, interest, satisfaction, and learning effect. SPSS 21.0 was used to perform the Wilcoxon rank-sum test and the chi-square test.Results:There were no significant differences between the two groups in general information such as sex and major. The experimental group had significantly better scores of the above practical abilities than the control group [88 (86,89) vs. 75 (72,77), 57 (56,58) vs. 52 (50,54), 7 (6,8) vs. 5 (4,6), 8 (7,8) vs. 5 (4,6), 9 (8,9) vs. 6(6,7), 8 (7,9) vs. 7 (6,7), P<0.001], and the questionnaire survey showed that the students in the experimental group gave a relatively high overall evaluation of the course (4.0-4.8 points). Conclusions:The blended teaching model is beneficial to the cultivation of clinical skills and practical ability in undergraduate medical students and can help to enhance their self-learning and operational abilities and improve classroom efficiency and teaching effectiveness.

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