Evidence-based assessment of acupuncture skills using a newly developed simulation-based test:A validation study

Objective:Acupuncture is an efficient treatment modality for many different training,but the technique can be challenging to master.Identification of the different acupuncture points can now be practiced in a standardized and patient-safe simulation-based environment.We aim to gather additional evidence regarding simulation-based training of acupuncture skills and hope that the simulation-based test developed and will be used for simulation-based mastery learning in future develop.Methods:The aim of this study was to develop a test of acupuncture skills using the TCM(Traditional Chinese Medicine) Meridians & Acupoints Anatomy Teaching Platform and gather validity evidence using Messick’s framework.Novice medical students without prior experience in acupuncture(n=43),intermediate medical students who had finished the mandatory acupuncture course(n=24),and skilled acupuncture doctors(n=17) were included in the study.One-hundred and seven acupuncture points were presented to the participants in identical randomized order and they were asked to identify each point by touching the correct anatomical location on the simulator.The simulator automatically registered the accuracy of participants’ answers.Results:The reliability of the final test(66 acupuncture points) was at a high level with a Cronbach’s alpha of 0.98 and only 16 acupuncture points were needed to ensure a reliability of 0.90.The test could discriminate significantly between all three groups and a credible pass/fail-score of 34 points was determined which resulted in eight out of 43(19%) novices passing the test and only two out of 17(12%)experienced failing the test.These consequences were statistically significant(P <0.001).Conclusion:Based on Messick’s framework we demonstrated strong validity evidence for a newly developed simulation-based test of acupuncture points localization skills.The test can be used as an aid to decide when trainees are ready to progress to more advanced training and clinical practice.Compared with the traditional point-point test,the point-point evaluation of the simulator can be more objective and reduce the effort of teachers.

Comparative research between acupuncture and Climen in treatment of menopausal hot flashes:A randomized controlled trial

Objective:To compare the therapeutic effect on menopausal hot flashes between acupuncture and Climen so as to provide a new approach to the treatment of this disease.Methods:A total of 80 cases in line with inclusion criteria were randomized into a treatment group(treated with acupuncture) and a control group(oral administration with climen),40 cases in each one.The treatment for 1 month was as 1 course and lasted consecutively for 2 courses.Before and after treatment,the contents of serum estrogen(estradiol,E_(2)) and 5-hydroxytryptamine(HT) and the scores of the attack frequency and severity scale of hot flashes and sweating,domestic modified Kupperman scale and traditional Chinese medicine(TCM) symptom scale were observed,and the clinical therapeutic effect was evaluated in the two groups separately.Results:Before treatment,there was no difference in the content of E_(2) and 5-HT,the score of hot flashes and sweating,Kupperman score and TCM symptom score in the patients between two groups,indicating the comparability(all P>0.05).Compared with the data before treatment,the contents of serum E_(2)(treatment group vs control group:22.24±11.02 vs 33.12±1.01;22.11±10.19 vs 25.29±2.23) and5-HT(treatment group vs control group:96.12±8.21 vs 131.21±30.21;96.98±7.99 vs 108.29±22.08),the score of hot flashes and sweating(treatment group vs control group:8.24±1.02 vs 3.12±1.01;8.11±1.19 vs 5.29±2.23),Kupperman score(treatment group vs control group:26.12±2.21 vs11.21±0.21;26.98±1.99 vs 18.29±2.08) and TCM symptom score(treatment group vs control group:18.97±3.87 vs 10.12±0.16;19.01±2.29 vs 15.61±2.89) were statistically different after treatment in the two groups(all P<0.05).After treatment,the contents of serum E_(2) and 5-HT,the score of hot flashes and sweating,Kupperman score and TCM symptom score in the treatment group were all different statistically compared with the control group(all P<0.05).There was statistical difference in clinical therapeutic effect in the patients between two group,in which,the therapeutic effect in the treatment group was better than that in the control group(90% vs 77.5%,P<0.05).Conclusion:Acupuncture effectively reduces Kupperman score and TCM symptom score in the patients and its therapeutic effect is better than climen.Regarding relieving hot flashes symptoms in menopausal patients of kidney yin deficiency and improving in attack frequency and severity of hot flashes and sweating,the effects of acupuncture are superior to Climen.Acupuncture obviously increases the contents of serum E_(2) and 5-HT.