Exploratory Study On Teaching Situation And Teaching System Of Rural Demand-oriented Medical Undergraduates In Yunnan Province

Objective:The purpose of this study was to understand the teaching situation of the rural demand-oriented medical undergraduates(RDOMU)and find out the problems in three universities of Yunnan Province.After summarizing and analyzing the basic situations,the setting of theoretical curriculum,practical teaching arrangement,and influencing factors of these components,we explored the teaching system of the RDOMU to adapt to the situations in Yunnan Province,based on the general practitioners standardization training needs and the demand of rural medical and health work.This study also aimed to regulate and promote the training work of the RDOMU in Yunnan Province to provide feasible countermeasures and suggestions.Methods:We selected universities with the RDOMU for the research sites,which included Kunming Medical University,Dali University,and Kunming University of Science and Technology.The use of cluster sampling and occasional sampling methods to extract 1673 students and 121 teachers as questionnaires,select 7 managers,10 teachers,62 students as the interview object.Collect informartion on site.by using the questionnaire survey,personal interviews and the collection of existing information.The survey included information of the RDOMU and teachers,evaluating the training objectives,curriculum,teaching arrangements,practical teaching and other content of the rural demand-oriented medical students.Personal interviews include RDOMU,teachers,managers about related policies,curriculum,teaching management and other content of the views,the difficulties and recommendations of rural demand-oriented medical students.The existing data and interviews were summarized using the induction method,Questionnaires were using Epidata3.1 to establish a database,and import the data into the SPSS 22.0,a statistical software package,for χ2 test,rank sum test,binary unconditional logistic regression and other statistical analyses after the data were checked and sorted.Results:1.Training project of the RDOMU in Yunnan Province had been launched for many years.But the organization and implementation of teaching was less standardized.Kunming Medical University and Dali University were the first to train the rural demand-oriented medical undergraduates in 2010,setting out separately training objectives,curriculum system and teaching content,practical teaching arrangements and other content of the order oriented medical students.Standardized training program for resident doctors in Yunnan Province had been carried out.Standardized training content for general practitioners had been also gradually improved.But these two universities did not re-plan teaching system of the rural demand-oriented medical students according to the project.And individual universities even did not develop a separate teaching system,training objectives,teaching content and practice teaching arrangements,which were consistent with those for ordinary clinical medical students.2.Some 61.75%of the RDOMU believed that teaching situations of rural demand-oriented medical students were good in Yunnan Province,which could enable people to work in the grassroots health care institutions in the future.Influence factors of the teaching situations included gender,grade,type of study,household registration and employment,awareness of training objectives,the curriculum for grass-roots health work,teaching materials for the needs of knowledge-obtaining,curriculum assessment form,and learning expectations.In terms of training objectives,58.47%of the teachers and 57.84%of the students knew the training objectives,92.75%of the teachers and 78.14%of the students believed that the training objectives were reasonable.In terms of curriculum structure and teaching content,89.46%,77.50%of students respectively were satisfied with the curriculum content of compulsory module setting and elective course content arrangement.Around 96.61%of the teachers and 92.19%of the students believed that being responsible for teaching/rural demad-oriented courses offered by the university could help to engage in grassroots health work in future,81.36%of the teachers 86.86%of the students thought that it was necessary to set up RDOMU course modules according to the requirements of medical licensing examination.84.75%of the teachers and 86.48%of the students thought that it was necessary to set up RDOMU course modules according to standardized training of residents.In terms of teaching methods,91.01%of the students were satisfied with the teaching method of the course of rural demand-oriented medical students,while 88.14%of the teachers believed that case study could be one of the most popular teaching methods.In regard to curriculum assessment,91.13%of the students were satisfied with the way of assessment,and 52.54%of the teachers thought that the most suitable method for course assessment for RDOMU was a combination of written test,practice exam,and oral test.In terms of practical teaching arrangements,84.13%of the students were satisfied with the clinical practice skills training.87.85%of the students were satisfied with arrangements for clinical practice in general hospitals.85.86%of the students were satisfied with community-based health care centers.3.The RDOMU,teachers,and managers in Yunnan Province shared their own views on the curriculum and teaching content,curriculum assessment form,clinical practice teaching arrangements and other content.Most Interviewees claimed that the theory course content arrangement was consistent with the general clinical medicine,but did not take into account the local characteristics,only adding some general medical aspects of the content.The following information should be set up or added to the curriculum:national customs and cultural categories,endemic diseases such as diagnosis and treatment,diagnosis and treatment technology in traditional Chinese medicine and other professional elective courses.At the same time,career planning courses should be provided for the rural demand-oriented undergraduate students from the first grade to the fifth grade in different ways.It is also useful to adjust content and time arrangements of the practical teaching,and focus on cultivating comprehensive ability of students.In addition,the ways of curriculum assessment should be diversified,paying attention to multi-station assessment.4.Based on the theoretical research,field research and expert consultation of the RDOMU in Yunnan province,we explored the teaching system of the RDOMU in Yunnan province.Conclusions:① Teaching organization implementation for the RDOMU training project is not standardized;②Training related policies for the RDOMU are not in place;③ Curriculum system and teaching content arrangement for the RDOMU is unreasonable;④Teaching and assessment methods for the RDOMU need to be improved;⑤Practical teaching system for the RDOMU is not perfect;⑥There are some deficiencies in the teaching management for the RDOMU.Suggestions:①Standardize the teaching organization and management of rural demand-oriented medical students in the universities;②Develop training objectives for the RDOMU according to the characteristics of talent training of the province;③Take the job responsibility and competency as the orientation,and optimize curriculum system for the RDOMU;④Use a variety of teaching methods and assessment methods to improve the quality of teaching;⑤DOptimize the practice of teaching arrangements and content further;⑥Appropriate increase probation or internship time for primary health care institutions;⑦Pay attention to teaching staff construction for the rural demand-oriented medical students;and⑧Establish the teaching quality control system of rural demand-oriented medical students.