Special Issue: The Global Cross-cultural Integration of TCM in the Mainstream Healthcare, Medical Education and the Practice of Medicine

Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has earned his Master of Medicine in Traditional Diagnosis at the Beijing University of Chinese Medicine,and his Medical Ph.D.in Chinese and Western Integrative Medicine at the Jinan University in Guangzhou.He practices and teaches integrative clinical medicine,Jing Fang(经方TCM formulas),martial lineage acupuncture,and his personalized style of“tendon and fascia reconditioning manipulations for bone and joint disease”.

Current Situation and Improvement Strategies of Teaching Engagement by Teachers in Higher Medical Colleges Under the Background of“New Medical Education”

The“New Medical Education”is a new requirement for the development of medical education in the new era.As a key and core element of the construction of the“New Medical Education,”the engagement in teaching work of university teachers is a key issue that determines the level of teaching development of university teachers and affects the quality of talent cultivation in universities.Using the literature review method,this study analyzed 39 relevant literatures retrieved from China National Knowledge Infrastructure(CNKI)from 1997 to 2023.The concept,connotation,current situation,influencing factors,and improvement strategies of teaching engagement by university teachers were reviewed and summarized.The results showed that the issue of teaching engagement by university teachers has not received high attention in the field of higher education,especially in higher medical education,which has not yet been reported.Although the overall number of literature is not large,some of the conclusions have important implications for the next research on the influencing factors and mechanisms of double-qualified teacher engagement in higher medical colleges.

Analysis of Professional Quality Cultivation Strategies for Infant and Child Care Service Talents from the Perspective of Collaboration of Medical Care,Parenting,and Education,and Integration of Industry and Education

The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements related to the infant care industry chain.This integration targets pediatrics talent training in nine infant care positions,including nursing,infant health care and management,and child rehabilitation,to ensure that the capabilities and quality of professional talents can meet the health care needs of infants and young children.This article briefly explains the background of the“collaboration of medical care,parenting,and education,and integration of industry and education.”It analyzes the necessity of cultivating infant and child care service talents based on the perspective of“collaboration of medical care,parenting,and education,and integration of industry and education.”Based on this perspective,we conducted an in-depth study of the cultivation of professional qualities of infant and child care service talents.

Potential and limitations of ChatGPT and generative artificial intelligence in medical safety education

The primary objectives of medical safety education are to provide the public with essential knowledge about medications and to foster a scientific approach to drug usage.The era of using artificial intelligence to revolutionize medical safety education has already dawned,and ChatGPT and other generative artificial intelligence models have immense potential in this domain.Notably,they offer a wealth of knowledge,anonymity,continuous availability,and personalized services.However,the practical implementation of generative artificial intelligence models such as ChatGPT in medical safety education still faces several challenges,including concerns about the accuracy of information,legal responsibilities,and ethical obligations.Moving forward,it is crucial to intelligently upgrade ChatGPT by leveraging the strengths of existing medical practices.This task involves further integrating the model with real-life scenarios and proactively addressing ethical and security issues with the ultimate goal of providing the public with comprehensive,convenient,efficient,and personalized medical services.

Flexner has fallen:Transitions in medical education system across time,a gradual return to pre-Flexnerian state(de-Flexnerization)

The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner,his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur.He could say what other reformers could not,due to their links to the medical education community.But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students,the decline in the number and quality of investigator initiated research among clinical researchers,lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis,poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes.The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations.This de-Flexnerization trend and regression to pre-Flexnerian era standards,ideologies,structures,processes,and attitudes,are bound to beget pre-Flexnerian outcomes,for you get what you designed for.

Path Breakthrough of Medical Humanities Education From the Perspective of“All-Staff,Whole-Process,and All-Round Education”

Medical education is an important cornerstone for the development of healthcare,and medical humanities education,as an integral part of medical education,plays an irreplaceable role in cultivating people’s health guardians with high medical ethics.We adopted the method of stratified random sampling to select 309 students and 107 faculty members from three independent medical colleges in Sichuan province as the research subjects and distributed questionnaire surveys investigating in three dimensions:overall cognition of medical humanities,evaluation of medical humanistic qualities,and the current situation of medical humanities education,supplemented by an in-depth literature review and interviews with subject matter experts.We found that“tech-centrism”still has a great influence,the self-evaluation of medical students’humanistic quality is generally not high,the educational concept of“emphasizing professional skills over morality”of faculty and staff is still quite prevalent,and there is still the“last mile”phenomenon in medical humanities education.In order to promote the integrated development of“new medicine”and“new liberal arts”and break the barriers of“tech-centrism”and“instrumental rationality,”it is necessary to change the educational concept and strengthen the education of all employees,break through the bottleneck of internships and strengthen the whole process of education,integrate educational resources and strengthen all-round education,improve the incentive mechanisms,strengthen the assessment methods,and provide Chinese wisdom and Chinese solutions for the development of medical humanities education.

The applications of ChatGPT in medical education

Dear Editor,The application of ChatGPT in medical education has made remarkable progress,such as automated scoring,teaching assistance,personalized learning,research assistance,quick access to information,generating case scenarios and exam questions,content creation for learning facilitation and language translation.As a result,a subset of the medical school faculty has swiftly embraced these innovations[1,2].

Population aging, medicalization of death and death education in China

Wuhan University,the development of death education in China has a history of more than 30 years.But it has lacked the clout it deserves in China.However,in recent years,death education has begun to attract more and more attention from the medical community.Various lectures and pieces of training related to death education held by the government and medical institutions,as well as related academic salons,seminars,workshops and“Death Cafes”held by the people have appeared and become popular.Death education has been developed in China for more than 30 years,why has it suddenly become popular and even popular in recent years?This has an important relationship with China’s aging population and the medicalization of death.

Learning by Living: Empathy Learned through an Extended Medical Education Immersion Project

Introduction: Medical student training and experiences in nursing homes are often viewed as negative;however, long-term care services represent a growing aspect of our medical system that receives little attention in medical education. The University of New England College of Osteopathic Medicine Learning by Living Nursing Home Immersion Project accelerates students learning about older adult care and the importance of empathy. Methods: Learning by Living applies qualitative ethnographic/autobiographic research methods to answer the question: “What is it like for me to live the life of an older adult nursing home resident?” Two first year medical students (female, 25 y/o & male, 27 y/o) were “admitted” into two different nursing homes for 11 days each. The students were wheelchair reliant from their assigned diagnoses of dominant-side paralysis secondary to stroke and aspiration pneumonia;requiring standard procedures of care experienced by older adults residents with similar conditions. Data were collected in the form of journal notes for pre-fieldwork, fieldwork, and post-fieldwork and included subjective and objective reporting of observations, experiences, and resident encounters. Analyses included journal review and thematic categorization and coding through content analysis. Results: Four themes of significance intersected for the two medical students: 1) control;2) quality of life;3) communication;and 4) isolation. Being immersed in nursing home life provided the students with firsthand experiences of loss and challenges faced by nursing home residents. This aided students’ learning about empathy and communication as key components of providing health care. Conclusion: This experience imparted knowledge to the medical students’ about aging, dignity, and the importance of making meaningful connections in order to thrive. These insights provided a gateway to establish a model of patient-centered care that is comprehensive and empathic for the older adult population.

Chinese medical service and medical education in urgent need of reform in the context of public welfare-based medical reform

After six years'medical reform,about 7.8 billion person-times of medical service has been achieved by2014,and the number of persons covered by basic medical insurance for urban employees,basic medical insurance for urban residents,and new rural cooperative medical insurance exceeded 1.3 billion,of which the coverage ratio reached as high as over 95%,establishing the largest basic medical security network in the world.

From nuclear submarines to graduate medical education: applying David Marquet's intent-based leadership model

L.David Marquet,a decorated Navy Captain,transformed an under performing submarine crew by empowering his subordinates to be leaders and reach their full potential.He called this intent-based leadership(IBL).What would happen if Marquet’s model were implemented in Graduate Medical Education(GME)?In this letter to the editor,we summarize the potential of the IBL model in graduate medical education as opposed to the traditional leaderfollower method.IBL harnesses human productivity toward the shared goals of GME,which are patient care and trainee learning.This shift in mindset could lead both teachers and trainees to focus more on the real reason that we undertake GME and change behaviors for the better.We suggest that IBL can and should be adopted in GME and propose that both patients and providers will benefit from this action.

Continuing professional development:progress beyond continuing medical education

Continuing medical education(CME)is rapidly evolving into competency-based continuing professional development(CPD)and this is driving change in self-directed CPD programs undertaken by individual practitioners as well as CPD programs or frameworks offered by CPD educators.This progression is being led by many factors including the rapid change in medical knowledge and medical practitioners along with changes in patients and society,healthcare systems,regulators and the political environment.We describe our experiences primarily concerning low-resource environments,in creating the International Council of Ophthalmology(ICO)Guide to Effective CPD/CME and in developing a CPD program for the Cambodian Ophthalmological Society(COS)twinned with the Royal Australian and New Zealand College of Ophthalmologists(RANZCO).At the conclusion of the project,47(100%)Cambodian practicing ophthalmologists were registered in the CPD program and 21(45%)were actively participating in the online COS-CPD program recording.We discuss challenges in CPD,propose solutions to overcome them and recommend developing research in CPD as needed to effectively enhance educational activities with impact in public health.

Current State of Affairs with Regard to Continuing Medical Education for Technicians in Radiology in Francophone West Africa

Background: This study aimed to determine the level of continuing medical education (CME) of medical imaging technicians in French-speaking West Africa. Materials and methods: This opinion survey was administered to radiology technicians in French-speaking West Africa from 1st June to 31st October 2020, i.e. over a period of 5 months concerning their level of CME and their need for CME. Results: Out of 100 technicians, 69% were men. The mean age was 40 years, with extremes ranging from age 23 to age 57. The majority of technicians (64%) worked in the public sector and 78% had work experience of less than 11 years. Most technicians were holders of a Bachelor’s degree (73%). The types of CMEs they knew were congresses, seminars, and modular training in 46% of the cases. The most available CMEs were seminars (63%). All technicians agreed on the need for CME and 96% said it had an impact on the delivery of radiology services. Technicians who had received CME at least once represented 61%. For 90% of technicians, the specific CME sought was management in radiology (33.33%) and radiation protection (25.81%). Conclusion: The need for CME is increasingly indisputable to radiology technicians in French-speaking West Africa;however, it remains a luxury for them, due to its scarcity and its high cost.

The future of simulation in medical education

Dear Editor:Simulation has made significant in-roads into the provision of medical education over the past twenty years^([1]).Simulation made its first impact in specialities such as emergency medicine and anaesthetics;however,it is now being used as an educational modality in a diverse range of specialities-from general practice to psychiatry.Perhaps the greatest pointer of the success of simulation is that it is now increasingly being seen as embedded in medical education and no longer some-

The Department of Otolaryngology Head and Neck Surgery,PLA General Hospital (national key academic unit) The PLA Institute of Otolaryngology (PLA key laboratory for acoustic trauma) The PLA Medical College Department of Deafness Education Key Laboratory

Led by four generations of leadership from late Prof.JIANG Sichang(academician,Chinese Academy of Engineering),Prof.YANG Weiyan(Honorary President,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association),Prof.HAN Dongyi(President Elected,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association)to now Prof.YANG Shiming(President,Division of Otolaryngologists,

Situation and Development Path of Humanistic Education in Medical Colleges and Universities in China

Humanistic education,as the“internal structure”of medical education,attempts to cultivate medical students’humanistic knowledge,ability,and comprehensive quality as well as makes adjustments with the evolvement of medical education.The global medical education reform has undergone three stages:expert medicine,clinical practice medicine,and public service medicine.Public service medicine,which took place in the 21st century,is a system-based and competency-oriented education,highlighting the construction of a health service system with medical and educational cooperation as well as the cultivation of medical students’comprehensive quality.China’s medical education started late and has a weak foundation with many twists and turns.Through the rapid development of reform and opening-up,China has narrowed the gap with international medical education and established a perfect medical curriculum system.China has successively promulgated a number of documents,such as the“Outline of Reform and Development of Medical Education in China”and the“Opinions on Strengthening the Collaboration between Health Departments and Education Departments to Implement the Doctor of Excellence Education Training Program 2.0,”with the goal of cultivating high-quality excellent medical talents.Medical students in colleges and universities are senior talents in medical training,health care services,and medical research.Their humanistic quality is not only related to the growth of medical talents,but also the quality of medical services.This paper analyzes and discusses the problems encountered in improving humanistic education and looks forward to providing reasonable as well as effective solutions to the difficulties faced by humanistic education in the new era through comparative research.

Current Situation of the Teaching of Ophthalmology in General Practice Medical Education and the Application of TBL

Ophthalmology is an integral part of general practice education,and it is of great significance to have some knowledge on ophthalmology even if the general practitioner is not an ophthalmologist.The subject characteristics,the traditional mode of teaching,and the cognitive deviation of students have greatly influenced its teaching quality.The application of team-based learning(TBL)in ophthalmology education responds to the demand of modern medical education.Building a team,designing questions that combine theory and clinical practice,as well as employing a fair scoring system can stimulate students’learning interest and improve their learning autonomy and ability to ask questions and solve problems.

Financial Sustainability of the Japanese Medical Payment System: Analysis of the Japanese Medical Expenditure for Educational Hospitalization of Patients with Type 2 Diabetes

Japanese medical expenditures have increased rapidly in recent years and are predicted to continue rising. Indeed, it remains uncertain whether the current Japanese medical system can be sustained. In this paper, we analyzed the medical expenditures for educational hospitalization of patients with type 2 diabetes. A dataset of 6173 patients from 36 hospitals was used in the analysis. The sample period was from July 2008 to March 2012. We analyzed the medical expenditures in two ways. First, we analyzed the length of hospital stay (LOS). Next, we analyzed the daily expenditure per patient. The Box-Cox transformation model was used in the first analysis and the ordinary least squares method in the second. Comorbidities and complications prolonged LOS and increased daily expenditures. The LOS was significantly different among hospitals. On the other hand, the differences in daily expenditures among hospitals were relatively small, such that LOS was the main determinant of medical expenditures. Previous studies suggested that LOS could be shortened without degradation of medical quality. Moreover, LOS could be controlled by introducing proper critical paths and improving and standardizing educational programs. Hence, it would be possible to control the medical expenditures for this disease.

Evaluation of Length of Hospital Stay Joining Educational Programs for Type 2 Diabetes Mellitus Patients: Can We Control Medical Costs in Japan?

Diabetes has become a growing concern in Japan, both medically and financially. The medical cost of diabetes was estimated at 1215 billion yen for fiscal year 2011. We analyzed the length of stay (LOS) in a hospital for type 2 diabetes mellitus patients who participated in educational programs to determine factors affecting LOS. Data on 991 patients obtained from 28 Red Cross hospitals in 2008 were used. For the analysis, we used the Box-Cox transformation model and Hausman test. The results revealed that patients aged 75 years and above and those with comorbidities and complications were prone to longer LOS. The analysis also revealed significant differences in LOS across the hospitals, even after controlling for patient characteristics. Finally, we applied the least squares method to determine the effects of hospital and regional factors and revealed that patients’ LOS was affected by the region’s average LOS. Regional corporations and networks appeared to be important in improving educational programs.