On The Current Situation Of Curriculum Structure Of Clinical Medicine In Undergraduate Education In China

Objective: Through the investigation and analysis of the training programs of five-year undergraduate clinical medicine in 31 colleges and universities in China in recent 8 years,we aim to compare the similarities and differences of the curriculum structure of different colleges and universities,and the impact on the training quality,so as to provide theoretical support and practical reference for the curriculum reform of clinical medicine.Methods:1.Literature research: consulting and studying a large number of Chinese and foreign literature helped to form a scientific understanding of the facts.With the help of the academic journal network and the full text database of excellent doctoral and master dissertations in China,this study surveyed the academic articles on medical curriculum structure at home and abroad,summarized the development status and the latest achievements of the curriculum structure of undergraduate clinical medicine in various colleges and universities,and found theoretical support and feasible suggestions for the implementation of this study to draw lessons from.At the same time,we obtained the ranking information of clinical medicine specialty of the targeted colleges in 2020 published on its network platform by Shanghai Ruan ke Education Consulting Company.2.Questionnaire survey: according to regional distribution,31 colleges and universities(accounting for 20% of the eligible colleges and universities)were selected from 149 colleges and universities currently cultivating five-year clinical medicine undergraduate students in China.According to the standard curriculum plan of the Ministry of education,a semi open questionnaire was developed to carry out the survey in three ways: 1)on-the-spot investigation by investigators,2)assisted investigation by the educational administration of the investigated colleges’ and universities’ Management personnel,and 3)individual investigation conducted through e-mail or other electronic media.3.In depth interview: through the indepth interview with insiders of the investigated institutions,firstly to obtain the pass rate of the 2019 clinical medicine graduates in the national licensing examination,and secondly to understand their views on the curriculum structure.4.Statistical analysis: Excel software was used to establish the database.SPSS twenty-three software was used for data processing and analysis,including general statistical description,rank sum test,etc.The significance level of the difference was 0.05(α = 0.05).Results:1.31 the common structure of the five-year clinical medicine program of the31 institutionsThere are five common features in the five-year curriculum structure of clinical medicine in the 31 insititutions: 1)In the course setting,26 courses are opened for 100% of the institutions,including three categories: public foundation,medical foundation and medical specialty.2)In terms of curriculum structure,87.10% of the institutions’ curriculum settings basically follow the traditional curriculum mode,namely,subjected-centered curriculum,whereas the differences between the institutions are not big,and12.90% of the institutions have integrated courses mode.3)In the aspect of theory and practice courses,most colleges and universities focus on the teaching of theoretical knowledge in classrooms,with theoretical courses accounting for 66.39% and practical courses 33.61%.4)In the compulsory and elective courses,the average time ratio of compulsory elective courses is1:0.25;5)medical humanities courses are relatively few,accounting for6.21%.2.31 differences in the curriculum structure of five-year clinical medicine specialty in 31 institutionsThe curriculum structures of five-year undergraduate clinical medicine in the 31 colleges and universities show five differences.1)In the aspect of curriculum mode,four colleges and universities have carried out curriculum structure reform and implemented integrated curriculum mode.The other 27 institutions still offer three-stage subject-based curriculum models.2)In terms of curriculum categories,the proportion of four major courses is different,with public basic courses accounting for 28.09%,medical basic courses32.19%,medical courses 33.51%,and medical humanities courses 6.21%.3)In terms of the length of the curriculum,in 12.90% of the institutions,medical courses take 2441-2970 hours,in 51.62% of the institutions,courses take2971-3500 hours,and in 35.48% of the institutions,3501-4030 hours.4)In terms of curriculum credits,in 41.93% of the institutions,medical courses altogther are awarded with 131-170 credits,in 35.48% of the institutions,171-200,and the rest 22.58% institutions,201-230.5.In terms of the number of courses,16.13% of the universities have 30-45 courses,67.74% of them have 46-60,and the rest 16.13% inversities have 61-85.3.The Characteristics of curriculum structures that designate different pass rates in the license examination3.1 16 Middle and high-level institutions present mixed curriculum structure mode,that is,integrating curriculum with traditional curriculum structure mode;5 low-level institutions show subject-based curriculum structure mode,that is,traditional curriculum structure mode.3.2 The curriculum structure has no effect on the passing rate of the examination.4.Characteristics of curriculum structure in different major ranking4.1 The top 20 institutions show mixed curriculum structure mode,that is,integrating curriculum with traditional curriculum structure mode;the top 11 institutions show discipline-based curriculum structure,that is,the traditional curriculum structure mode.4.2 The ranking of clinical medicine majors is affected by the number of theoretical courses,and the ranking presents a "U" distribution.At the same time,the number of theoretical course hours of the top professional institutions is the most.Conclusions:1.Overall characteristics: There is a big difference between the theory course and the practice course,and the practice link is weak;There is a big difference between compulsory courses and elective courses,and the setting of elective courses needs to be strengthened;The medical humanities curriculum is insufficient.2.The integration of curriculum structure has become the main curriculum model of clinical medicine in some colleges.The weight of medical humanities in clinical medicine courses has increased,and practice courses such as practice experiments have been further strengthened.3.The course structure has an impact on the quality of training.The ranking of clinical medicine majors is affected by the number of theoretical courses,and the ranking presents a "U" distribution.At the same time,the number of theoretical course hours of the top professional institutions is the most.