An Exploration of Medical Education in Central and Southern China: Measuring the Professional Competence of Clinical Undergraduates
Abstract
:1. Introduction
2. Methods and Materials
2.1. Participants and Settings
2.2. Medical Competence Instrument
3. Results
3.1. Factor Analysis for the Medical Professional Competence Scale
3.2. Correlation Analysis and Internal Consistency Reliability of the Scale
3.3. Medical Professional Competence of Clinical Undergraduates and Its Determinants
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
Item | Contents | Sources |
---|---|---|
16 | Know the country’s policy and development trends in this field. | Yan Zhao, Yunfeng Wang, etc. A comparative study of eight-year students’ professional qualities. China Higher Medical Education, 2017(5): 1–3. |
23 | Know the principle of the rational clinical use of blood. | Objectives relating to clinical skill in College A. |
25 | The ability to help trainees/interns with clinical teaching. | Objectives relating to clinical skill in College A. |
38 | Be able to make reasonable arrangements for practice, activities, and resources. | Ying Li. Study on Developmental Evaluation System of Humanistic Quality of Medical Students. Third Military Medical University, 2011. |
40 | Keep a strong physique and abundant spirit. | Jahan F, Siddiqui M A, Al Zadjali N M, et al. Recognition of Core Elements of Medical Professionalism among Medical Students and Faculty Members. Oman Med. J. 2016, 31(3): 196–204. |
50 | Be able to be friendly and kind to patients and colleagues. | Bernard, A.W.; Matthew, M.; Kman, N.E.; et al. Medical Student Professionalism Narratives: A Thematic Analysis and Interdisciplinary Comparative Investigation [J]. BMC Emergency Medicine, 2011, 11(1): 1–8. |
51 | Keep clean, neat, and polite. | Jahan, F.; Siddiqui, M.A.; Al Zadjali, N.M.; et al. Recognition of Core Elements of Medical Professionalism among Medical Students and Faculty Members. Oman Med. J. 2016, 31(3): 196–204. |
52 | Willing to make efforts in medicine development. | Objectives relating to clinical skill in A university. |
Items | Not at All | A little | Most | Fully |
---|---|---|---|---|
A1. Knowledge of natural science | ||||
A2. Knowledge of essential biomedical theories (human anatomy; organization and embryology; biochemistry and molecular biology; physiology, etc.) | ||||
A3. Essential knowledge of clinical medicine (internal medicine, surgery, gynecology, pediatrics, etc.) | ||||
A4. Knowledge of essential pharmacological theories and clinical rational drug elements | ||||
B5. Knowledge the essential theories of infectious diseases and epidemics | ||||
B6. Knowledge of the emergency treatments of public health practices and preventive medicine knowledge | ||||
B7. Other public health theories (environmental hygiene; child hygiene; maternal and child health care; health education, etc.) | ||||
B8. Know health-related laws, regulations and standards, etc. | ||||
B9. Know essential principles of medical psychology | ||||
B10. Knowledge of medical ethics | ||||
B11. Know the principles and methods of evidence-based medicine | ||||
B12. Comprehend essential health statistics methods | ||||
B13. Comprehend essential theories of health economics | ||||
B14. Comprehend the basic principles of health management | ||||
B15. Know the history of medical development | ||||
B16. Know the country’s policy and development trends in the field | ||||
C17. The ability to collect medical history flexibly and accurately | ||||
C18. The ability to write cases correctly | ||||
C19. The ability to perform physical examinations accurately | ||||
C20. The ability to perform mental examinations accurately | ||||
C21. The ability to distinguish the severity of the disease in time, and master general first-aid skills | ||||
C22. The ability to choose the most suitable and economical diagnostic program | ||||
C23. Know the principles of the rational clinical use of blood | ||||
C24. The ability to use essential drugs | ||||
C25. The ability to help trainees/interns with clinical teaching | ||||
C26. Be able to communicate with patients and relatives clearly, thoughtfully, and carefully | ||||
C27. Be able to be harmonious into the team | ||||
C28. The ability to communicate with community residents, other departments and the public media effectively | ||||
C29. The ability to provide advice and accurate information to patients and their families rigorously | ||||
C30. The ability to perform clinical research | ||||
C31. Possess essential medical information retrieval capabilities | ||||
C32. Proficient in medical English | ||||
C33. The ability to obtain a proper diagnosis | ||||
D34. The ability to apply new technology and methods to the medical field | ||||
D35. Possess innovative thinking | ||||
D36. Be good at observing things as well as putting forward your own point of view | ||||
D37. Able to consciously think and make a rational judgment after analyzing a problem independently | ||||
D38. The ability to make reasonable arrangements for practice, activities, and resources | ||||
D39. Desire for lifelong learning | ||||
D40. Maintain a strong physique and abundant spirit | ||||
E41. Have a passion for your profession | ||||
E42. Adhere to a concept of patient-centered service | ||||
E43. Know about professional ethics | ||||
E44. Honesty and justice | ||||
E45. Have no discrimination with regard to a patient’s gender, race, age and other differences | ||||
E46. Willing to protect the legitimate rights of patients (personal safety, right to know, consent, privacy, etc.) and economic interests | ||||
E47. Able to realize your deficiency. When the medical activities you have to deal with beyond your ability, take the initiative to seek the help of other doctors | ||||
E48. Desire to relieve the patient’s pain sincerely | ||||
E49. Remain sincere and honest to patients, family members, colleagues, and so on | ||||
E50. Friendly and kind to patients and colleagues | ||||
E51. Always keep clean, neat, and polite | ||||
E52. Willing to make efforts to medicine development |
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Global Minimum Essential Requirements in Medical Education (GMER) | International Standards for Undergraduate Education in the World Federation of Medical Education (WFME Standards) | WHO Standards | Chinese Standards | |
---|---|---|---|---|
Dimension | Professional values, behavior and ethics | Essential biomedical sciences | General objectives | Objectives relating to ideological and moral and professional quality |
Scientific foundation of medicine | Behavior, social sciences and medical ethics | Objectives relating to knowledge | Objectives relating to knowledge | |
Communication skills | Clinical sciences and skills | Objectives relating to skills | Objectives relating to skills | |
Clinical skills | Objectives relating to professionalism | |||
Population health and health systems; | ||||
Management of information; | ||||
Critical thinking and research |
Dimensions of the Scale in This Study | Total Number in Each Dimension | GMER | WHO Standards | WFME Standards | Chinese Standards | Others |
---|---|---|---|---|---|---|
Essential medical knowledge | 4 | 4 | 4 | 4 | 4 | 0 |
Public health and social science knowledge | 12 | 3 | 2 | 3 | 11 | 1 |
Clinical professional skills | 17 | 11 | 11 | 5 | 9 | 2 |
Critical thinking/adaptation | 7 | 3 | 1 | 1 | 3 | 2 |
professionalism | 12 | 0 | 3 | 0 | 6 | 3 |
Items | Factors | |||||||
---|---|---|---|---|---|---|---|---|
F1 | F2 | F3 | F4 | F5 | F6 | F7 | F8 | |
A1 | 0.365 | 0.163 | 0.241 | 0.199 | −0.005 | 0.121 | 0.435 | −0.010 |
A2 | 0.280 | 0.208 | 0.190 | −0.006 | 0.321 | 0.135 | 0.666 | 0.049 |
A3 | 0.217 | 0.160 | 0.204 | 0.008 | 0.377 | 0.095 | 0.690 | −0.014 |
A4 | 0.398 | 0.125 | 0.109 | 0.107 | 0.093 | 0.192 | 0.600 | 0.115 |
B5 | 0.554 | 0.146 | 0.107 | 0.365 | 0.002 | 0.204 | 0.395 | −0.059 |
B6 | 0.612 | 0.063 | 0.189 | 0.327 | 0.084 | 0.223 | 0.301 | −0.012 |
B7 | 0.699 | −0.018 | 0.163 | 0.192 | 0.016 | 0.160 | 0.274 | 0.136 |
B8 | 0.700 | −0.062 | 0.090 | 0.053 | 0.113 | 0.097 | 0.118 | 0.173 |
B9 | 0.738 | 0.069 | 0.106 | 0.089 | 0.169 | 0.094 | 0.062 | 0.080 |
B10 | 0.642 | 0.247 | 0.110 | 0.186 | 0.199 | 0.014 | 0.101 | 0.061 |
B11 | 0.764 | 0.009 | 0.117 | 0.155 | 0.113 | 0.094 | 0.039 | 0.110 |
B12 | 0.738 | 0.074 | 0.111 | 0.096 | 0.083 | 0.103 | 0.147 | 0.102 |
B13 | 0.802 | 0.041 | 0.140 | 0.122 | −0.011 | 0.113 | 0.084 | 0.075 |
B14 | 0.805 | −0.004 | 0.168 | 0.099 | 0.073 | 0.143 | −0.012 | 0.117 |
B15 | 0.717 | 0.119 | 0.289 | −0.049 | 0.057 | 0.136 | 0.085 | 0.050 |
B16 | 0.667 | 0.073 | 0.274 | −0.016 | 0.185 | 0.100 | 0.177 | 0.112 |
C17 | 0.196 | 0.205 | 0.275 | 0.310 | 0.664 | 0.086 | 0.185 | −0.012 |
C18 | 0.182 | 0.278 | 0.154 | 0.165 | 0.769 | 0.075 | 0.092 | −0.012 |
C19 | 0.191 | 0.121 | 0.130 | 0.150 | 0.752 | 0.183 | 0.201 | 0.079 |
C20 | 0.312 | 0.096 | 0.173 | 0.183 | 0.222 | 0.554 | 0.268 | 0.140 |
C22 | 0.298 | 0.083 | 0.192 | 0.273 | 0.354 | 0.401 | 0.219 | 0.234 |
C23 | 0.355 | 0.034 | 0.229 | 0.383 | 0.122 | 0.541 | 0.125 | 0.104 |
C24 | 0.324 | 0.086 | 0.121 | 0.215 | 0.244 | 0.552 | 0.186 | 0.143 |
C25 | 0.286 | 0.105 | 0.259 | 0.305 | 0.162 | 0.551 | 0.207 | −0.019 |
C30 | 0.304 | −0.009 | 0.264 | 0.151 | −0.043 | 0.536 | −0.026 | 0.292 |
C26 | 0.200 | 0.153 | 0.223 | 0.579 | 0.302 | 0.343 | 0.060 | 0.007 |
C27 | 0.216 | 0.264 | 0.220 | 0.585 | 0.331 | 0.092 | 0.014 | −0.030 |
C28 | 0.257 | 0.100 | 0.210 | 0.687 | 0.090 | 0.196 | 0.113 | 0.170 |
C29 | 0.193 | 0.155 | 0.205 | 0.659 | 0.182 | 0.235 | 0.041 | 0.142 |
C31 | 0.478 | 0.017 | 0.238 | 0.077 | −0.083 | 0.412 | 0.042 | 0.510 |
C32 | 0.401 | 0.056 | 0.258 | 0.058 | 0.071 | 0.277 | 0.100 | 0.621 |
C33 | 0.336 | 0.056 | 0.216 | 0.121 | 0.071 | 0.107 | 0.035 | 0.730 |
D34 | 0.431 | 0.012 | 0.539 | 0.151 | −0.002 | 0.203 | −0.092 | 0.407 |
D35 | 0.337 | 0.025 | 0.683 | 0.161 | 0.075 | 0.146 | 0.043 | 0.223 |
D36 | 0.291 | 0.060 | 0.755 | 0.200 | 0.066 | 0.139 | 0.105 | 0.145 |
D37 | 0.289 | 0.174 | 0.796 | 0.121 | 0.158 | 0.134 | 0.094 | 0.002 |
D38 | 0.260 | 0.172 | 0.735 | 0.161 | 0.105 | 0.141 | 0.171 | 0.072 |
D39 | 0.153 | 0.286 | 0.579 | 0.183 | 0.311 | 0.052 | 0.119 | 0.098 |
D40 | 0.091 | 0.277 | 0.601 | 0.035 | 0.147 | 0.111 | 0.230 | 0.049 |
E41 | 0.106 | 0.577 | 0.068 | 0.193 | −0.141 | −0.025 | 0.353 | 0.058 |
E42 | 0.130 | 0.759 | −0.031 | 0.263 | −0.021 | −0.043 | 0.188 | 0.253 |
E43 | 0.148 | 0.771 | 0.002 | 0.281 | 0.088 | −0.015 | 0.152 | 0.203 |
E44 | 0.095 | 0.812 | 0.048 | 0.197 | 0.064 | −0.155 | 0.093 | 0.211 |
E45 | 0.046 | 0.815 | 0.111 | 0.169 | 0.032 | −0.135 | 0.131 | 0.147 |
E46 | 0.015 | 0.817 | 0.127 | 0.151 | 0.062 | −0.112 | 0.053 | 0.048 |
E47 | 0.062 | 0.784 | 0.136 | 0.042 | 0.110 | 0.006 | −0.019 | −0.036 |
E48 | −0.026 | 0.821 | 0.098 | −0.098 | 0.067 | 0.114 | 0.035 | −0.222 |
E49 | 0.002 | 0.837 | 0.125 | −0.010 | 0.114 | 0.161 | 0.039 | −0.146 |
E50 | −0.019 | 0.864 | 0.107 | −0.022 | 0.118 | 0.216 | −0.001 | −0.124 |
E51 | −0.009 | 0.857 | 0.057 | −0.103 | 0.146 | 0.158 | −0.017 | −0.089 |
E52 | 0.114 | 0.805 | 0.098 | −0.068 | 0.147 | 0.198 | 0.008 | 0.068 |
Dimensions | F1 | F2 | F3 | F4 | F5 | F6 | F7 | F8 | Total | Cronbach’s α | X ± S |
---|---|---|---|---|---|---|---|---|---|---|---|
F1 | 1 | 0.800 | 1.76 ± 0.54 | ||||||||
F2 | 0.636 * | 1 | 0.939 | 1.38 ± 0.61 | |||||||
F3 | 0.534 * | 0.449 * | 1 | 0.852 | 1.92 ± 0.51 | ||||||
F4 | 0.572 * | 0.684 * | 0.542 * | 1 | 0.852 | 1.54 ± 0.64 | |||||
F5 | 0.498 * | 0.533 * | 0.572 * | 0.665 * | 1 | 0.842 | 1.77 ± 0.59 | ||||
F6 | 0.435 * | 0.643 * | 0.272 * | 0.630 * | 0.466 * | 1 | 0.833 | 1.25 ± 0.70 | |||
F7 | 0.538 * | 0.611 * | 0.501 * | 0.652 * | 0.581 * | 0.595 * | 1 | 0.899 | 1.60 ± 0.65 | ||
F8 | 0.362 * | 0.214 * | 0.373 * | 0.237 * | 0.345 * | 0.161 * | 0.338 * | 1 | 0.952 | 2.34 ± 0.57 | |
Total | 0.741 * | 0.827 * | 0.663 * | 0.809 * | 0.744 * | 0.681 * | 0.809 * | 0.596 * | 1 | 0.962 | 1.70 ± 0.60 |
Dimensions | Determinants | n | Scores (X ± S) | t | p | |
---|---|---|---|---|---|---|
Essential medical knowledge | Academic grade | Below average | 153 | 6.82 ± 1.717 | 2.406 | 0.017 |
Above average | 135 | 7.30 ± 1.658 | ||||
Critical thinking/adaptation | College | College A | 95 | 4.147 ± 1.930 | 2.611 | 0.010 |
College B | 193 | 3.568 ± 1.689 | ||||
Professionalism | Gender | Male | 129 | 27.02 ± 5.782 | 3.147 | 0.002 |
Female | 159 | 29.05 ± 5.140 | ||||
College | College A | 95 | 29.38 ± 5.728 | 2.696 | 0.007 | |
College B | 193 | 27.53 ± 5.325 |
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Cheng, X.; Chen, J. An Exploration of Medical Education in Central and Southern China: Measuring the Professional Competence of Clinical Undergraduates. Int. J. Environ. Res. Public Health 2019, 16, 4119. https://doi.org/10.3390/ijerph16214119
Cheng X, Chen J. An Exploration of Medical Education in Central and Southern China: Measuring the Professional Competence of Clinical Undergraduates. International Journal of Environmental Research and Public Health. 2019; 16(21):4119. https://doi.org/10.3390/ijerph16214119
Chicago/Turabian StyleCheng, Xueyan, and Jing Chen. 2019. "An Exploration of Medical Education in Central and Southern China: Measuring the Professional Competence of Clinical Undergraduates" International Journal of Environmental Research and Public Health 16, no. 21: 4119. https://doi.org/10.3390/ijerph16214119