Search

Despite widespread reforms in medical education across China, nationally there has been no mandate or movement toward systemically incorporating geriatrics into curricula. To what degree medical students are trained and have exposure to geriatric topics remains unclear. We surveyed 190 medical students during their final year of medical school at a Chinese medical university, graduating from reformed and also traditional curricula. The survey was comprised of a subjective assessment of attitudes and reported knowledge, as well as an objective assessment of knowledge via a multiple choice test. Student attitudes were favorable toward geriatrics, with 91% supporting the addition of specialized clinical experiences to the curriculum. Students generally reported low exposure to geriatrics, with no statistically significant differences between reform and traditional curricula. There was a statistically significant difference in performance on the multiple choice test between curricula but at a degree unlikely to be practically significant. Students had very favorable attitudes toward geriatrics as a field and specialty; however scored poorly on competency exams, with the lowest performance around diagnosis and treatment of specific geriatric conditions. Our results suggest that there is a need and desire for increased geriatric-oriented learning at Chinese medical schools. [ABSTRACT FROM AUTHOR]

Background: Hospital culture is a crucial aspect of residents' training. However, the mechanisms related to stakeholder culture (SC) and teacher‐resident interaction remain unclear. The study investigated the relationship between hospital culture and training performance of residents. Also, it explored the mediating effect of teacher‐resident exchange and the moderating effect of the teacher's transactional leadership style within a Chinese context. Methods: Based on stakeholder and leadership member exchange theories, we constructed a composite model. Data were collected from 296 residents from five tertiary hospitals in China. Hierarchical moderated regression analyses were used to test the hypotheses. Results: (a) Both the employee‐orientation culture (EOC) (β =.14, P ≤.05) and patient‐orientation culture (POC) (β =.47, P ≤.001) in the hospital were significantly related to residents' training performance. (b) Teacher‐resident exchange fully mediated the relationship between EOC and training performance and partially mediated the relationship between POC and training performance. (c) The moderating role of transactional leadership style (TLS) in the relationship between EOC and leader‐member exchange (LMX) (β = −.17, P ≤.05) was negative; it was not significant in the interaction between POC and TLS (β =.06, P >.1). Conclusion: The results suggest that trainers should consider the value of multiple cultures and ensure balance among stakeholders rather than focusing on a single one. Furthermore, a positive interaction improves teacher‐student relationship and training performance. Most importantly, educational departments should pay attention to establishing assessment tools, using rewards and incentives in residents' training. [ABSTRACT FROM AUTHOR]

China formally established a system of national standardized medical residency training in 2014, which affects the health of its 1.4 billion people. Accompanying this system were new guidelines and standards for internal medicine residency training. However, the majority of the standards focused on process measurements, such as minimum case requirements of diseases and procedural skills, rather than describing broader physician competencies in the domains of professionalism, patient care, communication, teamwork, quality improvement, and scholarship. While China has taken a large step forward with standardization of certain aspects of internal medicine residency training, the next step should focus on outcome measures and creating a system that is competency-based. [ABSTRACT FROM AUTHOR]

Background 357 million people between the ages of 19 and 49 are infected each year with a sexually transmitted infection (STI). Wuhan, China is a unique setting for STI intervention as it has over 900,000 college students, a population at high risk for contracting HIV. Cultural attitudes toward premarital sex and homosexuality and poor sexual education are barriers to lowering STI rates. Additionally, 90% of Chinese healthcare is provided at large public hospitals with minimal privacy. Anonymous STI screening outside of the public hospital setting is highly desired by young adults and MSM populations. Methods Study investigators partnered with dating app Blued to advertise a nontraditional testing site where high-risk individuals were offered anonymous STI/HIV screening. With the assistance of the regional CDC and a community-based organization (CBO), rapid STI results were provided in a convenient and nonjudgmental setting. Information on sexual behavior and knowledge of STIs was surveyed for future public health interventions. Results Of 200 individuals screened for HIV, syphilis, gonorrhea, and chlamydia, 51 (25.5%) had a positive test result. Over 10% of rectal and pharyngeal tests were positive, compared with 1% of urine tests. 3/200 (1.5%) of had positive rapid HIV test results; all were connected to treatment. Among 41 (20.5%) who learned about the study through Blued, STI prevalence was higher (31.7% vs. 23.9%, P = 0.3), compared with participants recruited through advertisement by the CBO. Most (67.5%) identified as MSM. Survey data confirmed low underlying knowledge of STI transmission and risk factors, especially regarding pre-exposure prophylaxis (PrEP). Conclusion A discreet screening service at a nontraditional site, facilitated through dating application and social media advertisement, was well received by young adult and MSM communities in Wuhan, China. Triple-site STI screening found a significant number of infections among this population and should be routinely offered by public health services. The use of real-time, convenient diagnostic testing presents an opportunity to lower HIV incidence in Wuhan, a city with a large at-risk population. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

This article was migrated. The article was marked as recommended. COVID-19 has disrupted traditional forms of clinical practice in both inpatient and outpatient settings. This novel, potentially-fatal infection proliferated to such a degree that many patients with mild disease had to engage in self-care at home. This disruption to clinical services has also upended in-person clerkship education across the country, leading to sustained periods of student furloughing. We developed a telehealth service-learning opportunity for COVID-19 patients who were advised to self-care in their homes. The service was staffed by medical students in their clinical training years, providing triage advice to patients, their families, and co-habitants until their symptoms improved. Callers set patient education around red flag symptoms as their first priority, but also offered counsel on home infection control and self-isolation strategies, composed work letters, offered resources regarding home management issues such as food and sanitation, and attended to the mental health needs of the patients and their families. An attending was on-call daily to assist and educate students about issues relating to clinical decision-making and the social determinants of health. A survey assessed medical students' opinions on the service. Student respondents found the service valuable, with 100% agreeing or strongly agreeing that the service was worth their time and important. Respondents reported learning important telehealth skills such as triage and patient education. Overwhelmingly, students found emotional connections with patients to be the most meaningful aspects of the service. Our telehealth service allowed students to learn from patients in a longitudinal manner, while remaining safely away from clinical settings. This service may prove a useful model for others in the case of another outbreak, particularly when medical students are furloughed. We hope to develop more clinical experiences in telehealth for medical students moving forward., (Copyright: © 2021 Server S et al.)