BACKGROUND Studying the professional commitment of a student in an 8-year medical training program of China, especially its association with academic performance, can enhance the understanding of professional loyalty in future doctors. This study aimed to investigate the self-efficacy, academic performance, professional commitment, and learning engagement of 8-year program medical students, and explore the mediating roles of professional commitment and learning engagement on the associations between self-efficacy and academic performance. METHODS We conducted a cross-sectional study in a Chinese medical university and collected the General Self-Efficacy Scale, Professional Commitment of Undergraduates Scales, and the Utrecht Work Engagement Scale-Student from self-reported students. Academic performance was ascertained using course examination scores in the most recent year. We conducted a structural equation model (SEM) analysis to examine the mediating roles of professional commitment and learning engagement on the relationship between self-efficacy and academic performance. RESULTS A total number of 402 medical students were included in this study. Students in the clinical practice stage had significantly lower professional commitment and learning engagement than students in the pre-medical and medical course stages. The professional commitment of students from low-income families was significantly lower than that of students from high-income families. Professional commitment and learning engagement were mediators in the relationship between self-efficacy and academic performance. CONCLUSIONS This study is the first to investigate professional commitment among students in the China 8-year medical program. Professional commitment plays an intermediary role between self-efficacy and academic performance.

构建良好的师生互动是高校书院制改革提升育人成效之关键.本研究基于国内外文献研究自编调查问卷,针对548名书院学生展开实证调查并辅以半结构化访谈,探索跨校区办学模式下学生对书院学业导师认同感不高的影响因素.利用IBM SPSS25.0软件和偏差校正百分位Bootstrap法分析书院制认知在师生互通互融和学业导师认同感之间的中介效应.结果显示年级、团学联骨干、书院制认知、师生互通互融及高校推进书院建设重要性评价等因素会影响学生对书院学业导师认同感,且书院制认知在师生互通互融与学业导师认同感间具有正向中介作用.建议书院采取科学措施提升学生对书院学业导师认同感,完善跨校区办学模式下的书院学业导师队伍建设机制,以激活导师与学生的积极性,促进教学和育人的有机衔接.

Blended learning (BL) reform is one of the vital methods to improve the teaching quality of institutions in the intelligent education era. However, institutions are always faced with many obstacles (instructors’ reluctance/inability to change, etc.) in conducting the reform. What is worse, very few studies have reported the design and effect of such a transformation. This study designed an intervention of institutional BL reform by making a unified deployment based on Graham et al.’s BL adoption framework: identifying strategy, structure, and support issues at three developmental stages. More than 900 courses (involving more than 14,000 students and more than 2000 instructors) within S university were taken as a sample. A quasi-experiment was designed to investigate the effect of the intervention on S university’s BL course transformation, students’ learning, instructors’ professional development, etc. Course logs, responses to students’ course evaluation forms, and instructors’ questionnaires were collected and analyzed. Results indicated that S university systematically conducted the BL transformation and gradually reached the mature implementation stage within 7 years. This study contributes to the literature by reporting a best practice of BL institutional adoption. Three implications, relating to strategy, structure, and support, were drawn to shed light for other institutions in moving forward on BL adoption.

加强高校和附属医院协同育人是推进医教协同最直接的途径.高校与附属医院应在医院章程制定过程中,加强对人才培养的目标指向、运行模式、师资队伍、考核评价、投入保障等内容的制度表达,促进医教协同育人落实落地.

大学课程是高等教育重要组成形态,科学评价课程对提升高等教育质量、促进高等教育内涵式发展起着重要作用,"金课"的理论内涵和建设标准为创新课程教学效果评价与分析提供了新思路.通过分析"金课"的价值取向及其对课程评价的启示,构建"金课"价值导向下课程评价指标体系,并在南方医科大学进行应用与实践,从立德树人、教学资源、教学方法、综合能力4个方面对课程进行评价与分析,最后提出"金课"价值导向下课程评价优化及保障策略,为探索高校课程的效果和质量提供参考.

当前,我国医学人才培养存在着院校办学的层次结构失衡、卫生技术人员的学历(职称)结构失衡、人才队伍的学科结构失衡、资源分布的区域结构失衡、人才培养的质量结构失衡等主要问题.提出适应经济社会发展需求调整人才培养规模结构、顺应卫生事业发展方向调整人才培养体系、遵循医学教育规律变革人才培养方式、结合地方经济发展状况调整政策资源投入、基于医学人才需求特点建设质量保障体系等五项策略,推进我国医学教育供给侧结构性改革.

目的:探索广东省某医科大学基于教学学术的教师发展项目的实施效果及影响因素,为我国医学院校开展基于教学学术的教师发展项目提供参考.方法:选取广东省某医科大学美国国际医学教育与研究促进基金会区域中心2016级和2017级项目成员共38人为研究对象,采用问卷调查法和访谈法评价该项目的实施效果.结果:问卷调查显示学习者增长了医学教育和领导力的理论知识(P＜0.001),提高了教学能力、教育研究能力和项目管理能力(P＜0.01),从而促进了其职业发展(P＜0.001).访谈结果表明基于教学学术的教师发展项目通过改变教师的知识、技能和态度来促成其行为的变化.结论:良好的教学学术环境是教师提高教学质量的必要条件之一,同时医学院校加强基于教学学术的教师发展项目的开发有助于促进教与学.

医学既是科学和技术,又是人学和仁术.医学院校如何系统地将思政教育与课程教学融合起来,推动课程教学向课程思政转化、专业教育向专业育人转化,实现价值塑造、知识传授和能力培养的有机统一,成为新时代医学教育面临的新问题.该文从顶层设计、协同实施、要素切入、改革评价和特色彰显等角度系统介绍医学院校推进课程思政改革的路径与实践探索,为高等医学院校完善立德树人落实机制、深化课程思政教学改革提供借鉴参考.

Facing the challenge of COVID-19 pandemic, online education rapidly occupied the daily teaching in China, which promoted the development of “Online+Offline” (blended) teaching. Medical Parasitology majorly aims to cultivate students' basic knowledge of Parasitology and the ability of "diagnosis and control of parasitic diseases". The Massive Online Open Course (MOOC), intelligent teaching software and Parasitology multimedia laboratory are used for blended teaching. Theoretical teaching includes intensive lectures, self-learning and flipped classrooms. Practices are taught in blended manner. The most representative means is the flipped classroom integrating learning with application through “case discussion - laboratory examination - uploading diagnosis basis on line - group report for peer learning". An evaluation combining formative and summative evaluation, online and offline assessment is jointly applied. We selected Clinic Medicine major as the experimental group, the Basic Medicine, Medical Experimental Technology and Biotechnology majors as the control group. The experimental group was taught in the blended teaching mode of “combining virtuality with reality, learning with application”; and the control group was taught in the traditional mode of lectures in big group and practices in small groups. The scores of the final computer test and the final offline experimental test were used in comparison. The experiment and theory scores of the experimental group are both significantly higher than that of the control group. The blended teaching is highly recognized by our students, and the teaching mode has been widely demonstrated and recommended to other courses in and out of the university. This mode comprehensively cultivated students' basic knowledge of Parasitology, and the ability of diagnosis and control of parasitic diseases. This blended teaching mode of “combining virtuality with reality, learning with application” effectively improved students' academic performance and application abilities, and well cultivated students' thinking of diagnosis and control of parasitic diseases.

学院是高等院校教学工作的主体,是高等教育人才培养活动的实施者,其教学状态直接反映高等院校的教学质量和办学水平,决定着学校内涵建设的质量.建立一套全面、客观、实用的本科教学绩效评价及激励机制,是提高学校整体教学水平的核心抓手.本文在科学分析高校建立教学绩效评价长效机制必要性的基础之上,总结与借鉴现有研究成果和实践经验,结合南方医科大学的实践,探讨了高等院校二级学院教学绩效评价指标体系构建的具体问题.

医学史叙事对于医生和医学生的职业身份形成具有重要意义.现代医学之父威廉·奥斯勒(William Osler)认为,用医学史上的伟人和人文主义医生的故事感染凡人,是教育赋予人类最伟大的礼物之一.本文从叙事医学理念出发,讲述1905年诺贝尔生理学或医学奖获得者罗伯特·科赫(Robert Koch)及罗伯特·科赫研究所(Robert Koch Institute)培养出来的埃米尔·贝林(Emil Behring)、保罗·埃尔利希(Paul Ehrlich)、约翰尼斯·菲比格(Johannes Fibiger)、理查德·菲佛(Richard Pfeiffer)、北里柴三郎、亚历山大·耶尔森(Alexandre Yersin)、伍连德(Wu Lien-teh)等微生物学家、防疫学家和医学科学家的故事.可以说,这个杰出的团队创造了病原细菌学的巅峰时代.自此,微生物学作为一门独立学科发展了起来,以罗伯特·科赫研究所培养的科学家为代表的各分支学科,如细菌学、免疫学、土壤微生物学、病毒学、植物病理学、真菌学、酿造学以及化学治疗法等也相继建立起来.

课堂教学是人才培养的主渠道、主阵地,是高校落实立德树人根本任务的关键环节.开展教学评价是学校教学质量监控的重要手段,杜绝"水课",打造"金课",需要通过提升课堂教学水平来实现.本文总结现有研究成果,结合南方医科大学原有课堂教学质量评价指标的不足,在"金课"价值导向下,通过建立全员、全课程、全环节的课堂教学评价体系,达到加强评价指标的针对性和评价参与度、规范教学过程、提高课堂教学质量的应用效果.

Abstract Background Aimed to corroborate students' and faculty's experiences with e-learning during the current pandemic. Methods A cross-sectional study was conducted from February to June 2020. Seven surveys were distributed electronically to all undergraduate students and the faculty (4 to students and 3 to teachers) at the Southern Medical University (China). Descriptive statistics and t-tests were used to analyze the data. Statistical significance was set at p < .05. Results Most students had some exposure to e-learning prior to the all e-learning regiment, contrasted with close to 90% of teachers having no or very limited experience. Students' perceptions of the most helpful e-learning activities did not change significantly overall (Week 3 vs. Week 9). Approaching 60% of students (Week 9) did find online discussion/Q&A/forum helpful, an increase from less than 30% (Week 3). Among teachers, gaps emerged (Week 9) between e-teaching activities used and their perceived effectiveness. Despite pre-recorded lectures being the most frequently used method, the least gap was associated with live-stream lectures—the least used. Over time, teacher's perceived effectiveness of e-teaching vs. in-person teaching did not differ significantly overall. When the results among students (Week 7) and teachers (Week 9) were corroborated, a slightly higher percentage of teachers viewed online teaching to be less effective than in-person teaching and a slightly higher percentage of teachers viewed online teaching as far less effective. For preferred learning modes after the resumption of in-person learning, students' preferences did not differ significantly overall (Week 3 vs. week 9). Surveys conducted in Week 9 found that a slightly higher percentage of students (~ 70%) than teachers (~ 60%) preferred some forms of hybrid learning and a lower percentage of students preferred face-to-face learning only. Approximately three quarters of teachers responded that at least 50% of course materials could be mastered by students on their own. Conclusions Overall, the perceived effectiveness of e-learning among students and teachers has not changed significantly over time. Nor have students' preferences shifted significantly for various learning modes after the in-person learning resumed. However, informative directional trends have emerged. Our research illustrates empirically the need to corroborate students' and instructors' experiences over time to inform more holistic improvements of e-learning.

PURPOSE:To primarily investigate: (1) whether a 10-minute instant meditation practice using a mobile app could enhance arthroscopy performance and (2) whether a 10-day app-based meditation could reduce short-term arthroscopic skills deterioration. METHODS:Orthopaedic residents with no previous experience in arthroscopy and meditation were randomly assigned to groups A, B, and C. After initial standard competency-based arthroscopy training on the simulator on day 1, a pretest was performed via the simulator by all participants to assess their initial level of performance, then groups A and B were required to practice app-based mindfulness meditation 10 min/day for 10 consecutive days while group C did nothing. On day 11, all participants returned to perform a posttest. Before the posttest, the participants in group A practiced app-based meditation (10 minutes), whereas groups B and C had no intervention. RESULTS:In total, 43 participants were included and reached similar level of performance after initial training phase in day 1. On day 11, participants in group A had statistically a better instant arthroscopy performance than group B, with greater total score (mean difference [MD] 3.57; P < .001), less completion time (MD -42.89 seconds; P = .001), shorter camera (MD -23.38 cm; P < .001) and grasper (MD -15.23 cm; P = .002) path length, and less cartilage injury (MD -1.07%; P = .012). Participants in group B had less skills deterioration than group C, with better total score (MD -5.42; P < .001), less completion time (MD 51.96s; P = .002), camera path length (MD 28.41 cm; P = .007), and cartilage injury (MD 1.19%; P = .038). CONCLUSIONS:Meditation training using a mobile app enhanced instant simulation-based arthroscopy performance and reduced short-term skills deterioration of orthopaedic residents with no arthroscopy hands-on experience. CLINICAL RELEVANCE:A meditation using mobile app for clinicians and educators should be incorporated into simulation-based arthroscopy curriculums and perhaps clinical settings to improve arthroscopy performance and mental health of orthopaedic residents without any previous arthroscopy experience.

目的 分析来自我国24所医学院校教师的教学学术研究课题,探索我国医学院校教师教学学术研究趋势.方法 对南方医科大学-FAIMER区域中心项目成员的60份教学学术研究课题进行内容分析,运用NVivo 12软件统计研究主题和关键词.结果 我国医学院校教师教学学术研究主要围绕六大类主题展开,即教学方法、课程建设、学习评价、临床教学、教师发展和组织发展.结论 教学方法和课程改革是我国医学院校教师教学学术研究的主流;学习评价方法研究是我国医学院校教师教学学术研究的重点;教师发展是我国医学院校教师教学学术水平提升的必要条件.

目的 探讨情景病例模拟教学在急诊医师心肺复苏(cardio-pulmonary resuscitation,CPR)技能培训中的应用效果.方法 选取2018年9月—2019年9月在郑州人民医院急诊科轮转的50名医师为研究对象,采用随机数字表法分为实验组(n=24)和对照组(n=26).实验组采取情景病例模拟教学进行CPR技能培训,对照组采用传统讲授方法培训.培训4周后,对2组学员进行理论考核和技能考核,以及发放问卷进行培训满意度调查.结果 实验组学员理论考核成绩为(82.52±4.01)分,对照组为(81.45±3.01)分,差异无统计学意义(P>0.05);实验组心肺复苏、气管插管及临床综合素质成绩分别为(31.21±2.51)分、(17.30±1.01)分及(16.25±2.31)分,对照组分别为(28.59±2.25)分、(15.68±0.72)分及(15.08±2.84)分,实验组评分高于对照组,差异有统计学意义(P<0.05).实验组电除颤培训成绩分别为(16.49±0.59)分,对照组为(16.65±1.21)分,差异无统计学意义(P>0.05).实验组除提高临床思维水平、提高临床抢救效率外,其余各方面满意度均优于对照组,差异有统计学意义(P<0.05).结论 采用情景病例模拟教学进行CPR技能培训取得了较好的效果.

痛苦是生命的常态,人人都应了解痛苦哲学,学会承受并跨越生命的苦难.隐喻和叙事的欲望是生命主体遭受痛苦时的"基本冲动".在阐释常见的痛苦隐喻策略类型的基础上,通过展现苦痛者自我救赎的隐喻智慧和引发医护人员职业反思的苦难者隐喻,阐明痛苦隐喻的生成和表达对由苦难造成的生命叙事断裂所产生的弥合作用,倡导通过隐喻性叙事帮助构建主体间叙事互动关系,帮助受苦者走出伤痛叙事闲锁,重新融入和谐动态的生命叙事进程中.

BACKGROUND:Flipped classroom has received much attention during the last few years in China, but inconsistent conclusions are made about the effectiveness this approach in health professions education. This review examined the findings of controlled studies published in Chinese in order to summarize the effects of the flipped classroom methodology. These studies focused specifically on undergraduate level of health professions students.METHODS:A literature search was conducted using China National Knowledge Infrastructure (CNKI) and Wanfang Data Knowledge Service Platform in June 2019. No date restrictions were used. Peer-reviewed papers were reviewed and experimental studies were included if the study compared student outcomes using flipped classroom method versus traditional lectures. The revised version of the Kirkpatrick's model was applied to evaluate the effectiveness of the flipped classroom approach.RESULTS:In total, 934 articles were obtained. Among them, 235 articles were full text reviewed and 59 met the inclusion criteria. Most of the student agreed that flipped classroom strategy was very helpful improving their self-learning ability, problem solving ability, teamwork, and communication skills, but reported increased workload and less-efficiency compared with traditional lectures. However, the majority of studies (n = 52) showed positive findings of the flipped classroom on changes in knowledge and skills, and 3 in negative. Among these 59 studies, there was little evidence of changes in behavior, organizational practice and patient outcome.CONCLUSIONS:Better design with reduced content should be considered for instructors to promote learning effectiveness. Long-term effects of flipped classroom should be considered in future studies.

在叙事医学语境下,以医生为第一人称叙事者的非虚构疾病自传叙事作品出版呈现快速增长趋势.当医生成为病人,医生关于疾病的生命医学视角不得不与疾痛的个人视角合并,产生某种张力,激发他们寻求疾病书写这一媒介来反思医生职业和医患关系.“生过病的医生”可以类比为荣格的“受伤的治愈者”.“受过伤的故事讲述者”更能“病吾病以及人之病”,他们比没有生过病的医生更容易与病人达到共情状态,更能将自己的患病经历化为协助病人战胜疾病的精神力量.因而,生过病的医生所撰写的疾病自传叙事可视为一种“元病理叙事”.

医学教育认证对促进医学教育改革、提高医学教育质量具有重要意义.分析临床医学专业认证的步骤、意义,对照认证标准从专业建设、专业认证实践等方面探讨临床医学专业认证重点关注的问题,可为同类院校提供借鉴和参考.