Why clinical training in China should improve: a cross-sectional study of MD graduates

Abstract Background: China is experiencing medical education reform to construct national quality standards, modernise and standardise health professionals, and advance health delivery system requirements. Graduate medical education (GME) is being piloted as a merger of Doctor of Medicine (MD) and PhD programs to improve academic research and clinical training. However, the academic degree-centred system has led to a preoccupation with academic research rather than clinical training. Quality information regarding the clinical training of MD graduates from Chinese medical schools is lacking. This general investigation aims to provide an overview from the perspective of recent MD graduates in China. Methods: Self-reports on MD clinical training were obtained from 432 MD graduates in 2017 via an online survey. The reports included information on overall satisfaction, educational supervision, supervised learning events, curriculum coverage, local teaching, teamwork, educational governance, workload, supportiveness of the environment, feedback, clinical experience, patient safety, handovers, and reporting systems. Descriptive analysis was used to summarise the outcome. Results: Of the 432 MD graduates surveyed, only 37.4% reported satisfaction with the overall clinical training quality; 54.6% rated the informal and bedside quality as “good”; 64.4% reported that they knew who provided clinical supervision; only 35.5% highly rated the quality of clinical supervision; 51.8% reported that they judged senior physicians as “not competent”; 48.1% believed that their concerns about education and training would be addressed; 41.9% agreed that the staff treated each other respectfully; 97.4% admitted that they worked beyond the mandatory hours and claimed they were regularly short of sleep; 84.2% raised concerns about patient safety; 45.3% reported that they received regular informal feedback. Conclusions: This study suggests that the quality of clinical training for MD graduates needs to be improved; however, even though most participants seemed satisfied with their clinical training. The overall satisfaction with the teaching quality was acceptable, whereas the quality of many clinical training aspects was scored poorly. Each aspect may encourage a deeper investigation into the understanding of causes and possible remediation. Some suggestions include improving safe and effective care, providing positive clinical supervision, offering appropriate practice opportunities, providing health care services, and maintaining optimal patient safety.

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Clinical training in China needs to be improved: A cross-sectional study of MD graduates

10.21203/rs.3.rs-1124/v1 ◽

2020 ◽

Author(s):

XIAONING ZHANG ◽

Chong Li ◽

Cailing Yue ◽

Xue Jiang ◽

Junli Cao

Keyword(s):

Medical Education ◽

Patient Safety ◽

Clinical Supervision ◽

Clinical Training ◽

Academic Research ◽

Teaching Quality ◽

Academic Degree ◽

National Quality ◽

Training Quality

Abstract Background: China is experiencing medical education reform to construct national quality standards, modernise and standardise health professionals, and advance health delivery system requirements. Graduate medical education (GME) is being piloted as a merger of Doctor of Medicine (MD) and PhD programs to improve academic research and clinical training. However, the academic degree-centred system has led to a preoccupation with academic research rather than clinical training. Quality information regarding the clinical training of MD graduates from Chinese medical schools is lacking. This general investigation aims to provide an overview from the perspective of recent MD graduates in China. Methods: Self-reports on MD clinical training were obtained from 432 MD graduates in 2017 via an online survey. The reports included information on overall satisfaction, educational supervision, supervised learning events, curriculum coverage, local teaching, teamwork, educational governance, workload, supportiveness of the environment, feedback, clinical experience, patient safety, handovers, and reporting systems. Descriptive analysis was used to summarise the outcome. Results: Of the 432 MD graduates surveyed, only 37.4% reported satisfaction with the overall clinical training quality; 54.6% rated the informal and bedside quality as “good”; 64.4% reported that they knew who provided clinical supervision; only 35.5% highly rated the quality of clinical supervision; 51.8% reported that they judged senior physicians as “not competent”; 48.1% believed that their concerns about education and training would be addressed; 41.9% agreed that the staff treated each other respectfully; 97.4% admitted that they worked beyond the mandatory hours and claimed they were regularly short of sleep; 84.2% raised concerns about patient safety; 45.3% reported that they received regular informal feedback. Conclusions: This study suggests that the quality of clinical training for MD graduates needs to be improved; however, even though most participants seemed satisfied with their clinical training. The overall satisfaction with the teaching quality was acceptable, whereas the quality of many clinical training aspects was scored poorly. Each aspect may encourage a deeper investigation into the understanding of causes and possible remediation. Some suggestions include improving safe and effective care, providing positive clinical supervision, offering appropriate practice opportunities, providing health care services, and maintaining optimal patient safety.

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Clinical training in China needs to be improved: A cross-sectional study of MD graduates

10.21203/rs.3.rs-1124/v3 ◽

2020 ◽

Author(s):

XIAONING ZHANG ◽

Chong Li ◽

Cailing Yue ◽

Xue Jiang ◽

Junli Cao

Keyword(s):

Medical Education ◽

Patient Safety ◽

Clinical Supervision ◽

Clinical Training ◽

Academic Research ◽

Teaching Quality ◽

Academic Degree ◽

National Quality ◽

Training Quality

Abstract Background: China is experiencing medical education reform to construct national quality standards, modernise and standardise health professionals, and advance health delivery system requirements. Graduate medical education (GME) is being piloted as a merger of Doctor of Medicine (MD) and PhD programs to improve academic research and clinical training. However, the academic degree-centred system has led to a preoccupation with academic research rather than clinical training. Quality information regarding the clinical training of MD graduates from Chinese medical schools is lacking. This general investigation aims to provide an overview from the perspective of recent MD graduates in China. Methods: Self-reports on MD clinical training were obtained from 432 MD graduates in 2017 via an online survey. The reports included information on overall satisfaction, educational supervision, supervised learning events, curriculum coverage, local teaching, teamwork, educational governance, workload, supportiveness of the environment, feedback, clinical experience, patient safety, handovers, and reporting systems. Descriptive analysis was used to summarise the outcome. Results: Of the 432 MD graduates surveyed, only 37.4% reported satisfaction with the overall clinical training quality; 54.6% rated the informal and bedside quality as “good”; 64.4% reported that they knew who provided clinical supervision; only 35.5% highly rated the quality of clinical supervision; 51.8% reported that they judged senior physicians as “not competent”; 48.1% believed that their concerns about education and training would be addressed; 41.9% agreed that the staff treated each other respectfully; 97.4% admitted that they worked beyond the mandatory hours and claimed they were regularly short of sleep; 84.2% raised concerns about patient safety; 45.3% reported that they received regular informal feedback. Conclusions: This study suggests that the quality of clinical training for MD graduates needs to be improved; however, even though most participants seemed satisfied with their clinical training. The overall satisfaction with the teaching quality was acceptable, whereas the quality of many clinical training aspects was scored poorly. Each aspect may encourage a deeper investigation into the understanding of causes and possible remediation. Some suggestions include improving safe and effective care, providing positive clinical supervision, offering appropriate practice opportunities, providing health care services, and maintaining optimal patient safety.

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How do Departmental Lead Educators Review the Quality of Postgraduate Medical Education and Training Provided within Their departments?

MedEdPublish ◽

10.15694/mep.2014.003.0018 ◽

2014 ◽

Author(s):

Fatima El Bakri ◽

Mark Rickenbach

Keyword(s):

Medical Education ◽

Postgraduate Medical Education ◽

Education And Training ◽

Medical Education And Training ◽

And Training

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Web-based Medical Education During COVID-19 Lockdown: A Step Back or a Leap to the Future?

The International Journal of Lower Extremity Wounds ◽

10.1177/15347346211011848 ◽

2021 ◽

pp. 153473462110118

Author(s):

Anna Eleftheriou ◽

Aikaterini Rokou ◽

Christos Argyriou ◽

Nikolaos Papanas ◽

George S. Georgiadis

Keyword(s):

Medical Education ◽

Clinical Training ◽

Medical Training ◽

Medical Schools ◽

Web Based ◽

Clinical Exposure ◽

Virtual Teaching ◽

Based Medicine ◽

The Impact

The impact of coronavirus infectious disease (COVID-19) on medical education has been substantial. Medical students require considerable clinical exposure. However, due to the risk of COVID-19, the majority of medical schools globally have discontinued their normal activities. The strengths of virtual teaching now include a variety of web-based resources. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Conversely, students have received decreased clinical training in certain medical and surgical specialities, which may, in turn, reduce their performance, confidence, and abilities as future physicians. We sought to analyze the effect of telemedicine on the quality of medical education in this new emerging era and highlight the benefits and drawbacks of web-based medical training in building up future physicians. The COVID-19 pandemic has posed an unparalleled challenge to medical schools, which are aiming to deliver quality education to students virtually, balancing between evidence-based and experience-based medicine.

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Adesão à identificação correta do paciente pelo uso da pulseira

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v12i10a234774p2621-2627-2018 ◽

2018 ◽

Vol 12 (10) ◽

pp. 2621

Author(s):

Tamyris Garcia De Assis ◽

Luana Ferreira De Almeida ◽

Luciana Guimarães Assad ◽

Ronilson Gonçalves Rocha ◽

Cíntia Silva Fassarella ◽

...

Keyword(s):

Patient Safety ◽

Descriptive Statistics ◽

University Hospital ◽

Patient Identification ◽

Hospital Data ◽

Health Team ◽

Systems Quality ◽

Quantitative Descriptive ◽

And Training

RESUMO Objetivo: analisar a adesão à identificação do paciente por pulseira pela equipe de saúde e pelos pacientes. Método: trata-se de estudo quantitativo, descritivo e documental. Constituiu-se a amostra por 137 pacientes internados em uma unidade cardiointensiva de um hospital universitário. Coletaram-se os dados, mediante o preenchimento de um formulário estruturado, em seguida, organizados e analisados utilizando-se a estatística descritiva simples. Resultados: observou-se a presença da pulseira de identificação em 100% dos pacientes. Destes, 26% apresentavam não conformidades. Ansalisou-se, a partir dos relatos dos pacientes, que 61% dos profissionais não utilizaram a pulseira para identificá-los no momento dos procedimentos e 90% dos pacientes não foram orientados quanto ao motivo e importância da utilização da pulseira. Conclusão: observou-se de forma unânime a identificação dos pacientes, no entanto, necessita-se, na prática, de maior sensibilização e treinamento da equipe multiprofissional para a adequação conforme se preconiza na Meta 1 de Segurança do Paciente. Descritores: Segurança do Paciente; Sistemas de Identificação de Pacientes; Qualidade da Assistência à Saúde; Gestão de Risco; Hospitalização; Hospitais Universitários.ABSTRACT Objective: to analyze the adherence to the identification of the patient by hospital wristband by the health team and by the patients. Method: this is a quantitative, descriptive and documentary study. The sample consisted of 137 patients hospitalized in a cardio-intensive unit of a university hospital. Data was collected by completing a structured form, then organized and analyzed using simple descriptive statistics. Results: the presence of the identification wristband was observed in 100% of the patients. Of these, 26% had nonconformities. From the patients' reports, 61% of the professionals did not use the wristband to identify them at the time of the procedures and 90% of the patients were not guided as to the reason and importance of the use of the wristband. Conclusion: the identification of patients was unanimously observed, however, it is necessary, in practice, to increase awareness and training of the multi-professional team for the adequacy as recommended in Goal 1 of Patient Safety. Descriptors: Patient Safety; Patient Identification Systems; Quality of Health Care; Risk Management; Hospitalization; Hospitals, University.RESUMENObjetivo: analizar la adhesión a la identificación del paciente por pulsera por el equipo de salud y por los pacientes. Método: se trata de un estudio cuantitativo, descriptivo y documental. Se constituyó la muestra por 137 pacientes internados en una unidad cardiointensiva de un hospital universitario. Se recogen los datos, mediante el llenado de un formulario estructurado, a continuación, organizado y analizado utilizando la estadística descriptiva simple. Resultados: se observó la presencia de la pulsera de identificación en el 100% de los pacientes. De ellos, el 26% presentaba no conformidades. Se analizó, a partir de los relatos de los pacientes, que el 61% de los profesionales no utilizaron la pulsera para identificarlos en el momento de los procedimientos y el 90% de los pacientes no fueron orientados en cuanto al motivo e importancia del uso de la pulsera. Conclusión: se observó de forma unánime la identificación de los pacientes, sin embargo, se necesita, en la práctica, de mayor sensibilización y entrenamiento del equipo multiprofesional para la adecuación conforme se preconiza en la Meta 1 de Seguridad del Paciente. Descriptores: Seguridad del Paciente; Sistemas de Identificación de Pacientes; Calidad de la Atención de Salud; Gestión de Riesgos; Hospitalización; Hospitales Universitarios.

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Reforming medical education admission and training in low- and middle-income countries: who gets admitted and why it matters

Human Resources for Health ◽

10.1186/s12960-019-0426-9 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Katherine Tumlinson ◽

Dilshad Jaff ◽

Barbara Stilwell ◽

Dickens Otieno Onyango ◽

Kenneth L. Leonard

Keyword(s):

Medical Education ◽

Intrinsic Motivation ◽

Healthcare Providers ◽

Extrinsic Factors ◽

Middle Income ◽

Negative Behaviors ◽

Middle Income Countries ◽

And Training ◽

Low And Middle Income

AbstractRecent studies reveal public-sector healthcare providers in low- and middle-income countries (LMICs) are frequently absent from work, solicit informal payments for service delivery, and engage in disrespectful or abusive treatment of patients. While extrinsic factors may foster and facilitate these negative practices, it is not often feasible to alter the external environment in low-resource settings. In contrast, healthcare professionals with strong intrinsic motivation and a desire to serve the needs of their community are less likely to engage in these negative behaviors and may draw upon internal incentives to deliver a high quality of care. Reforming medical education admission and training practices in LMICs is one promising strategy for increasing the prevalence of medical professionals with strong intrinsic motivation.

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Impact of the COVID-19 Pandemic on Student and Resident Teaching and Training in Surgical Oncology

Journal of Clinical Medicine ◽

10.3390/jcm9113431 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3431

Author(s):

Hans-Michael Hau ◽

Jürgen Weitz ◽

Ulrich Bork

Keyword(s):

Medical Education ◽

Surgical Training ◽

Surgical Education ◽

Surgical Oncology ◽

Healthcare Systems ◽

Skills Development ◽

High Quality ◽

The Face ◽

And Training

The COVID-19 pandemic has tremendously changed private and professional interactions and behaviors worldwide. The effects of this pandemic and the actions taken have changed our healthcare systems, which consequently has affected medical education and surgical training. In the face of constant disruptions of surgical education and training during this pandemic outbreak, structured and innovative concepts and adapted educational curricula are important to ensure a high quality of medical treatment. While efforts were undertaken to prevent viral spreading, it is important to analyze and assess the effects of this crisis on medical education, surgical training and teaching at large and certainly in the field of surgical oncology. Against this background, in this paper we introduce practical and creative recommendations for the continuity of students’ and residents’ medical and surgical training and teaching. This includes virtual educational curricula, skills development classes, video-based feedback and simulation in the specialty field of surgical oncology. In conclusion, the effects of COVID 19 on Surgical Training and Teaching, certainly in the field of Surgical Oncology, are challenging.

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Developing a Framework Strategy for Supporting Radiographers in the Clinical Supervision of Radiography Students in Zambia: A Mixed Methods Study

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v30i6.15 ◽

2020 ◽

Vol 30 (6) ◽

Author(s):

Osward Bwanga

Keyword(s):

Clinical Supervision ◽

Clinical Education ◽

Clinical Training ◽

Online Questionnaire ◽

Clinical Supervisors ◽

Third Phase ◽

Professional Body ◽

Study Population ◽

Training Resources

BACKGROUND፡ Clinical supervisors of radiography students play a key role in the facilitation of practice-based learning. However, there is a scarcity of evidence-based strategies to support clinical supervisors. This study aimed at exploring the level of support required by radiographers in order to develop a framework strategy for supporting clinical supervisors ofradiography students in Zambia.METHODS: This study used an exploratory sequential mixedmethods approach. The qualitative phase was conducted first, and the findings were used to develop the questionnaire for the quantitative phase. The study population was radiographers working in the Lusaka and Copperbelt provinces of Zambia. For the first phase, data were collected from a purposive sample of 10 clinical supervisors of radiography students. For the survey, data were collected from 120 radiographers using a questionnaire. In the third phase, a group of experts validated the proposed framework using an online questionnaire. Qualitative data were analysed thematically and quantitative data using statistics.RESULTS: Four support areas were identified: training and education in clinical supervision, clinical training resources, human resources and relationships, and quality assurance programmes related to clinical supervision. These findings informed the development of a support framework strategy for clinical supervisors.CONCLUSION: This study has revealed that clinical supervision of radiography students requires coordinated support from stakeholders: schools of radiography, professional body, and radiology and hospital management. It is anticipated that the developed framework, when implemented, will enhance the experiences of clinical supervisors and improve the quality of clinical education.

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TP8.2.26 A new simulation-based course to improve trauma management by junior doctors

British Journal of Surgery ◽

10.1093/bjs/znab362.096 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Hannah Schneiders

Keyword(s):

Medical Education ◽

Patient Safety ◽

Small Group ◽

Unmet Need ◽

Junior Doctors ◽

Trauma Management ◽

Likert Scales ◽

Sample Group ◽

Simulation Based

Abstract Aims Trauma calls at small hospitals are often attended by small and/or junior teams, especially overnight. The quality of primary surveys was subjectively observed to be extremely variable, sufficient to cause concern about patient safety. In addition, the introduction of the ‘ward trauma call’ for falls was generating anxiety amongst juniors. I recognised an unmet need and gained permission from the Director of Medical Education to create a half-day ‘Introduction to Trauma’ simulation-based course. Method A sample group of Foundation doctors attended a pilot course. Confidence in aspects of trauma management was assessed using Likert scales. Results Pre-course results indicated doctors were reasonably confident with their A-E assessments (63% moderately or very confident) but lacked confidence in trauma skills such as using a scoop. After the course 100% reported increased confidence about what will happen in a trauma call, and 63% reported increased confidence in their A-E assessments. Increased confidence was also widely reported in trauma skills (e.g. log roll 88%), how to manage a ward trauma call (100%), and where to find further guidance (100%). Conclusions This pilot demonstrated that a small group simulation-based teaching intervention can significantly increase the confidence of foundation doctors in all aspects of their role in trauma management. The most notable increases were in trauma equipment use and in managing ward trauma, suggesting these are areas where foundation doctors lack guidance or experience. The course is now part of trust induction for new foundation doctors.

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