A system-oriented curriculum in which basic medical courses and clinical subjects are integrated and reformed is a new trend for medical education in China. In order to train and enhance the comprehensive clinical competency, thirty-two excellent medical students who formed a observation group from grade 2010 in Jinan University were selected to participated in this study. Three different exploratory and heuristic pedagogies, which employed the flexible application of case-based learning (CBL), problem-based learning (PBL), and team-based learning (TBL), were explored and implemented in cardiovascular, respiratory, and digestive teaching sections. The effects of these exploratory and heuristic pedagogical approaches based on the flexible application of the CBL, PBL, and TBL methods with clinical scenarios in system-oriented curricula are satisfactory. Accordingly, these teaching methods and experiences had been summarized and promoted to mainland and non-mainland medical students from grade 2014 in Jinan University. Teaching and learning effects are also satisfactory. In addition, different characteristics in conducting these courses between two types of university students are further compared and analyzed for the improvement of all system-oriented curricula in the future.

History taking is an extremely important skill for medical students to master. In China, medical students usually have opportunities to practise this skill on real patients after they have learned diagnostics and basic relevant theoretical knowledge. Today, however, several factors, such as increased enrolment of medical students and the need to ensure patient safety in avoiding stressful doctor-patient relationships may increase both the difficulty and the importance for medical students to develop this skill. In view of these situations, the aim of this study was to introduce one specific teaching method, i.e., role-play activity, in order to help medical students cultivate and practise history-taking and related skills. 52 third-year medical students were divided into two groups. Students in observation group received role-play activity training before interviewing with real patients. Students in control group were taught by traditional methods without the new method intervention. The teaching effects of role-play activities were evaluated via medical records, tests of history taking and theoretical exams, and questionnaire for the observation group. The scores of seven medical case records for each student in the observation group were analysed and were found to be higher than those in the control group. These results showed no significant differences between the two groups in the first and second interview records with real patients in the hospital, but statistically significant differences were found from the third time. The scores on history-taking tests with a standardized patient (SP) were higher in the observation group than in the control group. No significant difference was found between the two groups in their theory exam scores. Results indicated that role-play activity is an effective method for medical students to improve their history-taking skills.Keywords: medical students, history taking, role-play activity, clinical skills, standardized patient, medical education BackgroundHistory taking is considered a basic clinical skill for clinicians. Data obtained from history taking are essential and important for making an accurate diagnosis (Haring, Cools, van Gurp P, van der Meer, & Postma, 2017;Jose, 2012). However, this skill is difficult for students to learn and develop in the beginning (McKenna, Innes, French, Streiberg, & Gilmour, 2011). Lack of time, lack of training and lack of resources are barriers preventing students from improving in this basic skill (Goncalves et al., 2016;Troncon, 2009). Therefore, various teaching methods are introduced to teach students to take a complete medical history. These methods include lectures, using simulated patients, engaging in role-play activity and using videotape to record students' interviews (Keifenheim et al., 2015;Yu et al., 2017).In China, history taking is taught in the fifth or sixth semester of education for a 5-year or 6-year clinical medicine major (Zhang, Cheng, Xu, Luo, & Yang, 2015;Pan, Cheng, Zhou, Li, & Yang, 2016). The current...

Purpose: To develop a novel method for closely and effectively integrating simulation scenarios and clinical practices to improve clinical skills training in the concepts of translational medicine.Methods: Forty-two and 38 third-year medical students in the classes of 2010 and 2009 at Jinan University were selected as an observation group and a control group, respectively. The former group was taught according to a new, integrated mode, while the latter received traditional methods. Students' scores on practical tests in physical examination, internal punctures, and case analysis; theory-based exams on diagnostics and internal medicine; and questionnaire surveys were compared and analyzed. In addition, system-oriented curricula were explored and implemented.Results: A novel mode that closely and effectively integrates theory and practice in the observation group had been established although there were no statistically significant difference (P>0.05) between Grade 2010 and Grade 2009 in clinical basic skills training scores. However, there were statistically significant differences (P<0.05) in scores on practical tests of physical examination and internal punctures among the diagnostic, internal medicine and internship periods in the class of 2010 but no statistically significant difference (P>0.05) in case analysis scores. Therefore, system-oriented curricula were initially designed and explored in excellent students from Grade 2010 to reinforce clinical thinking. Conclusion:The novel program integrating simulation scenarios and clinical situations for training students in diagnostics and internal medicine skills can improve medical students' clinical comprehensive abilities and achieve effects that are similar to those of the traditional method. This program is more popular with students and ensures patient safety as well. In addition, different characteristics of clinical skills training have been compared for the further exporation of system-oriented curricula.

To explore an efficient training program based on an analysis in organizing seven sessions for the National ClinicalSkills Competition in China. Each year, 6-12 excellent medical students of our university are selected as anobservation team. Comparisons of the teaching characteristics were performed in this study. An optimal curriculumimplementation, specific clinical teaching scenarios and evaluation methods were gradually obtained and improved.Teaching effects were satisfactory. Among seven sessions, the eighth session was the best. Curriculum constructionand training team building are formed synchronously through this National Clinical Skills Competition. Clinicalskills training should be designed and evaluated effectively in order to increase the comprehensive capacities ofmedical students.

To identify the optimal clinical skills training programme for internal medicine residents by reflecting upon and analysing the usual training plan and arrangement, and practical tests according to the national standardized resident training policies and requirements. The 3-year-rotation and training plan of the 2013 and 2014 internal medicine resident cohorts, the basic skills and case analysis scores on the basic entrance examination and final graduation examination were reflected, summarized and compared with the ultimate purpose of evaluating standardized resident training. This knowledge was used to perfect a competency-oriented training system that integrated clinical theory, clinical scenarios, clinical skills, bedside teaching, learning, etc. After a 3-year programme of standardized training, the residents' clinical skills were significantly improved. Statistically significant enhancements (P<0.05) were observed in the case analysis and clinical skills test scores between the basic entrance and graduation examinations of the trainees in both the 2013 and 2014 cohorts. No significant differences (P>0.05) were observed between the trainees in the 2013 and 2014 cohorts in their graduation scores on the clinical skills and case analysis tests, suggesting that both cohorts achieved the same level of mastery and reached the standardized training target, which also reflected the homogeneity of the residency training programme. While this study indicated that the training method was effective, exploring better models in the future is warranted. In conclusion, as a national policy, continuously incorporating reflection and exploration is necessary for designing a reasonable programme for standardized resident training. In this study, analysis of the basic entrance and graduation examinations of comprehensive clinical skills were important for developing an effective standardized resident training programme and training team with satisfactory teaching effects. By this way, implementing and starting new training methods gradually will be improved and especially carried out from 2015 cohorts. Therefore, the residents' clinical competence will be enhanced and also for undergraduates' and postgraduates' education as well. At last, the national education criteria for residency will be met.