With the advancement of competency-based medical education, scenario-based simulation has been increasingly valued in China for its effectiveness in cultivating and assessing the competencies of healthcare practitioners in specific clinical scenarios. This expert interview focuses on five questions: the necessity of scenario-based simulation, the sources and applicability of teaching cases, curriculum development, the role of teaching teams, and suggestions for simulation practitioners and educational managers. The discussion aims to help a growing number of practitioners in simulation-assisted medical education better understand the connotation and significance of scenario-based simulation, clarify its practical path, and further promote the effective implementation of scenario-based simulation in China.

Medical simulation-based assessments have emerged as a vital method for evaluating the clinical competence of healthcare professionals. These assessments provide examinees with opportunities to practice clinical skills in a controlled environment that mirrors real-life medical scenarios. However, assessment organizers must implement specific measures to ensure that these assessments yield valid and reliable results. The reliability of simulation-based assessments is a crucial component of quality assurance. This article delineates twelve practical recommendations to enhance the reliability of medical simulation-based assessments across the three key dimensions of raters, simulation environment, and assessment tools. These recommendations include ① selecting raters with relevant professional backgrounds and extensive experience in simulation-based teaching and assessment; ②providing raters with standardized training for the assessment; ③conducting mock ratings and piloting to reach consensus among raters; ④preventing excessive work hours or cognitively overload while rating; ⑤providing standardized personnel with adequate training and re-training; ⑥implementing immediate and long-term quality assurance measures for standardized patient role performance; ⑦maintaining consistent operation of simulation equipment; ⑧guaranteeing the simulation provides adequate functional fidelity for the examinees; ⑨clearly defining each element and item in assessment tools while controlling their quantity; ⑩ensuring consistency when multiple assessment tools are used; 11using assessment tools with evidence of construct validity when possible; and 12establishing systems to ensure consistency in data (scoring) collection while safeguarding data security. These strategies aim to assist medical educators in developing structured and reliable simulation-based assessment schemes.

Medical simulation-based assessments have emerged as a vital method for evaluating the clinical competence of healthcare professionals. These assessments provide examinees with opportunities to practice clinical skills in a controlled environment that mirrors real-life medical scenarios. However, assessment organizers must implement specific measures to ensure that these assessments yield valid and reliable results. The reliability of simulation-based assessments is a crucial component of quality assurance. This article delineates twelve practical recommendations to enhance the reliability of medical simulation-based assessments across the three key dimensions of raters, simulation environment, and assessment tools. These recommendations include ① selecting raters with relevant professional backgrounds and extensive experience in simulation-based teaching and assessment; ②providing raters with standardized training for the assessment; ③conducting mock ratings and piloting to reach consensus among raters; ④preventing excessive work hours or cognitively overload while rating; ⑤providing standardized personnel with adequate training and re-training; ⑥implementing immediate and long-term quality assurance measures for standardized patient role performance; ⑦maintaining consistent operation of simulation equipment; ⑧guaranteeing the simulation provides adequate functional fidelity for the examinees; ⑨clearly defining each element and item in assessment tools while controlling their quantity; ⑩ensuring consistency when multiple assessment tools are used; 11using assessment tools with evidence of construct validity when possible; and 12establishing systems to ensure consistency in data (scoring) collection while safeguarding data security. These strategies aim to assist medical educators in developing structured and reliable simulation-based assessment schemes.

With the advancement of competency-based medical education, scenario-based simulation has been increasingly valued in China for its effectiveness in cultivating and assessing the competencies of healthcare practitioners in specific clinical scenarios. This expert interview focuses on five questions: the necessity of scenario-based simulation, the sources and applicability of teaching cases, curriculum development, the role of teaching teams, and suggestions for simulation practitioners and educational managers. The discussion aims to help a growing number of practitioners in simulation-assisted medical education better understand the connotation and significance of scenario-based simulation, clarify its practical path, and further promote the effective implementation of scenario-based simulation in China.

Objective:To explore and optimize the teaching content of clinical case discussion course based on clinical pathophysiology and therapy (CPPT), and to improve the teaching quality of this course.Methods:Self-compiled evaluation form was sent to all the students who participated in this course in 2016-2017 school year, and the teaching satisfaction and teaching characteristics were evaluated. The differences of evaluation results from students with different educational programs or teachers with different seniority were compared, and the correlation between evaluation results and teachers' seniority was analyzed.Results:The students had a high evaluation on the course, but students from different programs had significant different comments on thinking inspiring, speech encouraging, questions guiding, process holding and effective feedback, as well as the self-evaluation of mastery degree. For teachers with different seniority, there were significant differences in scores in all aspects except speech encouraging, but no differences in mastery degree. Spearman analysis showed that there was a certain correlation between scores and teachers' seniority.Conclusion:The overall situation of the CPPT case discussion course in our school is worthy of recognition, but it needs to be improved in many aspects.

Objective:To make bibliometric analysis of Debriefing related research papers, and to lay a foundation for further research.Methods:A bibliometric analysis was conducted on the distribution of years, nations, institutions, the situation of citations, and main research contents of Debriefing related researches.Results:Analysis of the distribution of the publication years of Debriefing related literature indicated that since the relevant literature of Debriefing had been reported in 1979, its publication volume has been increasing year by year, mainly published by the United States, the United Kingdom, Canada and other countries. In addition, most journals that publish more literature on Debriefing are related to medical education, and most of the highly cited studies focus on relevant research theories based on Debriefing. Debriefing may be mainly applied in clinical teaching, nursing students' simulation teaching and training and its clinical application, among which nursing, psychiatry, emergency, internal medicine, pediatrics, surgery, anesthesiology, and other departments are common.Conclusion:Through the bibliometric analysis of Debriefing related research papers, this paper has a preliminary understanding of the status quo and hotspots of this field, which lays a good foundation for the subsequent research.

Objective To understand the effect of teacher training to provide reference for teachers' teaching methods in the standardization of clinical resident training.Method The teachers carried out five days of teacher training.Teacher training adopted the method of theory teaching and group discussion.The main content of the training had a "daily rounds with teaching","the proper use of ORIME evaluation","feedback of sandwich type","a minute tutor teaching method","SOAP method to report cases".Before the training,100 residents were randomly selected to evaluate the teaching in teaching teachers through self-designed questionnaire.After the training,the questionnaire survey was conducted among 100 residents again.All data were statistically analyzed by SPSS 22.0.The measurement data were represented by (mean or + standard deviation),and the date were compared by t test.Results Residents believed that after the teacher training,teachers' teaching level improved (P＜0.05).The three aspects of "general and phased learning goals","training students' clinical thinking ability through questions","requiring students to report cases and give guidance and feedback" were the most obvious.The pre training score was (3.28 ± 0.92) (3.31 ± 1.12) (3.55 ± 0.85),and the corresponding score was after training (3.98 ±0.85) (4.19 ± 0.85) (4.11 ± 0.74).Conclusion From the comparison of the survey results before and after the residents,the teachers' teaching modes,skills and methods have been improved after receiving teachers' training.

Objective To explore the prevalence and clinical significance of metabolic disorder of lipids, glucose and uric acid at different fibrosis stages of patients with chronic hepatitis B (CHB).Methods From January 2006 to December 2014, 1 812 CHB patients in Department of Infectious Diseases, Shunde Hospital of Southern Medical University were retrospectively enrolled and analyzed.All biochemistry indexes were obtained by automatic biochemical instrument.Polymerase chain reaction was used for detecting serum hepatitis B virus (HBV) DNA, and particles immune detection kit was used for detecting hepatitis B e antigen (HBeAg).In statistical analyses, chi-square test, nonparametric test and Logistic analysis were used.Results The metabolic disorder prevalence in 1 812 CHB patients was as follows, 455 cases (25.1%) with decreased high density lipoprotein, 435 cases (24.0%) with increased uric acid, 342 cases (18.9%) with increased total cholesterol, 254 cases (14.0%) with increased triglyceride, 171 cases (9.4%) with decreased apolipoprotein A, 165 cases (9.1%) with increased apolipoprotein B, 162 cases (8.9%) with increased low density lipoprotein and 117 cases (6.5%) increased fasting blood glucose.Patients who had mild liver fibrosis tended to have metabolic disorders of uric acid (26.4%), total cholesterol (22.8%) and high density lipoprotein cholesterol (20.5%).Patients who had moderate liver fibrosis tended to have metabolic disorders of high density lipoprotein (27.2%) and uric acid (20.9%).Patients who had severe liver fibrosis tended to have metabolic disorders of high density lipoprotein (33.6%) and uric acid (22.2%).Multivariate Logistic regression analysis showed that inflammation activty (OR=17.31, 95% CI: 13.410-22.336, P=0.001), age (OR=1.019, 95%CI:1.005-1.035, P=0.010), sex (OR=1.497, 95% CI: 1.061-2.111, P=0.022), apolipoprotein A (OR=0.50, 95% CI: 0.281-0.892, P=0.019) and HBV DNA (OR=0.904, 95% CI: 0.858-0.952, P=0.001) may be independent predictors of moderate and severe liver fibrosis.Conclusions CHB patients with mild liver fibrosis tend to have metabolic disorders of uric acid, total cholesterol and high density lipoprotein cholesterol;patients with moderate liver fibrosis tend to have metabolic disorders of high density lipoprotein and uric acid;and patients with severe liver fibrosis tend to have metabolic disorders of high density lipoprotein and uric acid.

Objective idiopathic hemothorax .Methods 46 patients wifh idiopathic hemothorax To explore the treatment method of were first closed thoracic drainage catheter ,of which 12 patients underwent emergency explor-atory thoracotomy,with video-assisted thoracic surgery in 10 cases,non-surgical treatment of 24 cases.Results 46 patients were cured without complications ,were followed up 3 months to 5 years.without recurrence .Conclusion Idi-opathic hemothorax once diagnosed , treatment principles that should be placed closed thoracic drainage , and timely surgical treatment,especially video-assisted thoracic surgery ,patients can reduce the amount of blood transfusion ,ef-fective,less invasive,faster recovery,less bleeding,the patient easy to accept .

The job burnout level and psychological status of 109 medical staff in Shennongjia forest region were investigated, and the Chinese maslach burnout inventory (CMBI) and symptom check list-90(SCL- 90) were adopted in the survey. The survey revealed that 69.7% (76/109) of the subjects had job burnout, including 53.2% (58/109) had slight burnout, 12. 8% (14/109) moderate burnout and 3. 7%(4/109) severe burnout. The single-factor detection rates of job burnout were 56.9% (62/109) for diminished personal accomplishment, 17.4% (19/109) for depersonalization, and 15.6% (17/109) for emotional exhaustion. Both the interpersonal sensitivity factor score and the positive symptom average score of SCL-90 were significant lower than those of Chinese norm ( P ＜ 0. 01 ), the total average score and the other factor scores of the subjects had no significant differences from those of Chinese norm ( P ＞ 0. 05 ). The results suggest that the majority of medical staff in the study region have experienced the job burnout, the main manifestation is the feeling of diminished personal accomplishment, on the other hand the psychological status of the subjects is similar with those in the general population.