From April 21 to 22, 2018 Xiangya International Symposium on Medical Education was held in Changsha, Hunan Province. It was hosted by Xiangya School of Medicine Central South University (CSU) and jointly undertaken by Xiangya Hospital, the Second and the Third Xiangya Hospitals of CSU. Prof. Tao Lijian, Executive Deputy Secretary of CPC Committee of CSU, delivered a welcome speech at the opening ceremony on behalf of Xiangya School of Medicine Central South University. Wang Qiming, Deputy Director of the Department of Higher Education of the Ministry of Education, Yu Qiurong, Deputy Director of Education, Department of Science, Technology & Education, National Health Commission of the People’s Republic of China, Qi Xuejin, Vice President of Chinese Medical Doctor Association and Director of Post-Graduation Medical Education Department, Wenkai Li, Chief Representative of Beijing Representative Office, China Medical Board (CMB), etc. delivered speeches at the symposium. Chen Xiang, Vice Chancellor of CSU, Chen Jianguo, Vice Chancellor of Huazhong University of Science and Technology, Xiao Haipeng, Vice Chancellor of Sun Yat-sen University, Wang Weimin, Deputy Director of Peking University Health Science Center, etc. attended the opening ceremony. In addition, leaders of the Higher Education Division of Education Department of Hunan Province and the Department of Science, Technology & Education of the Health Commission of Hunan Province were also present at the opening ceremony, which was presided over by He Qingnan, Executive Deputy Dean of Xiangya School of Medicine CSU.
The two-day symposium included a main forum, three sub-forums and more than 20 workshops, covering such topics as undergraduate and postgraduate medical education, standardized residency training, and medical simulation education. Over 600 clinical and teaching staff from more than 50 foreign and domestic medical schools, colleges and universities attended the symposium. Education experts from first-class colleges and universities at home and abroad gathered in Xiangya to deliver keynote speeches and have discussions on topics related to medical education, exploring new ways of medical education reform and development. The speakers were from more than 10 first-class Chinese universities such as Peking University, Sun Yat-sen University, Huazhong University of Science and Technology, Shanghai Jiao Tong University, Sichuan University, Fudan University, Wuhan University, University of Hong Kong and world-famous colleges, universities and hospitals including Harvard University, University of Pittsburgh, Weill Cornell Medicine, Cornell University, Mayo Clinic, and Sengkang Hospital (Singapore). During the symposium, China Consortium of Elite Teaching Hospitals for Residency Education and Post-graduation Medical Simulation Education Expert Committee of Chinese Medical Doctor Association also held working meetings.
Medical Education: Exploring New Modes in the Era of Artificial Intelligence and Big Data
In the topical discussion about medical education reform, experts delivered excellent lectures about the development of medical education at home and abroad and the exploration and thinking of future development trend.
In his speech entitledReflection on the Reform, Innovation and Development of Medical Education in the New Era with the Construction of "New Medicine" as the Main Theme, Wang Qiming, Deputy Director of the Department of Higher Education of the Ministry of Education, pointed out that new medicine is needed in the new era and it’s an inevitable trend to construct the new medicine. The core concept of new medicine is to strengthen the training of innovative talents in the age of AI.
Prof. Wang Weimin, Deputy Director of Peking University Health Science Center, reviewed the history of medical education, especially the history of residency training, and voiced his thinking about it. He proposed that we should innovate the application of modern educational technology in medical simulation teaching, and transform the traditional medical education mode to the new mode of “medicine + artificial intelligence / big data”.
Prof. Judith Palfrey from Harvard Medical School summarized the development course of residency training in the United States and took the pediatrics as an example to compare the training of community pediatricians with the medical education mode of training pediatricians to participate in the diagnosis and treatment of complex diseases.
Teaching Team Construction and Innovative Talents Training: Chinese and Foreign Experts Sharing Medical Education Experience
“Talent is the first resource of the health course." To cultivate qualified medical talents, we should build excellent teaching teams. In the new historical stage, with people’s growing health needs, the progress of science and technology, and the promotion of the national medical and education reform, there have emerged new opportunities and challenges for the development of international medical education. In the topical discussion about the teaching team construction and innovative talents training, Chinese and American experts shared their experience based on the actual situation in different hospitals.
Prof. Tao Lijian, Executive Deputy Secretary of CPC Committee of CSU, reviewed the development of medical education in comprehensive universities and concluded that “first-class medical schools are generally found in first-class universities” through data analysis. At present, universities know little about the special laws of medical education while medical schools have inadequate knowledge about running a university. We should, on the basis of respecting higher education and universal education, respect medical education, further optimize the reform of their internal management system, pay more attention to balancing the teaching organization, teaching resources and teaching effects and cultivate high-quality medical talents. At the same time, it is important to learn from international experience and give full play to our own advantages, so that we may create our own medical education with Chinese characteristics.
Prof. Mark Swartz from Clinical Competence Center of New York took the process of cognition with pictures as an example to interact with the audience present. He believed that when students are making a diagnosis, the teacher should encourage them to reflect and build critical thinking with clarity, accuracy, precision, relevance, depth, breadth, logic and fairness. Prof. N. G. Patil from University of Hong Kong also elaborated on the education and training courses for medical undergraduates and residents based on the experience of the hospitals in Hong Kong.
Chancellors’ Forum: the Development of Medical Education in Comprehensive Universities against the Background of “Double First-Class Construction”
In the dialogue chaired by Chen Xiang, Vice Chancellor of CSU, Xiao Haipeng, Vice Chancellor of Sun Yat-sen University, Chen Jianguo, Vice Chancellor of Huazhong University of Science and Technology, Tao Lijian, Executive Deputy Secretary of CPC Committee of CSU, Wang Weimin, Deputy Director of Peking University Health Science Center and other leaders of some major Chinese universities in charge of teaching had heated discussions with the participants about how to promote the development of medical disciplines and internationalization of medical education in comprehensive universities against the background of the “double first-class construction” (construction of first-class universities and disciplines).
Vice Chancellor Xiao Haipeng introduced the experience of Sun Yat-sen University. Based on the original medical education, Sun Yat-sen University arranged for medical students to participate in scientific research, clinical and social practice in an early stage and carried out clinical skills competitions and teachers’ teaching competitions and took measures to strengthen the connection between medical disciplines and other disciplines.
Vice Chancellor Chen Jianguo introduced that Huazhong University of Science and Technology established an international medical center, laying a good foundation for the internationalization of medical education. He believed that disciplinary construction should be based on teaching, scientific research, teaching team, talent cultivation and social effects.
Wang Weimin, Deputy Director of Peking University Health Science Center, proposed two concepts, “blending” and “integration”. Medical schools should be blended into universities. In addition to integration with other disciplines, clinical medicine and basic medicine, and disciplines within clinical medicine should also be integrated.
Prof. Tao Lijian, Executive Deputy Secretary of CPC Committee of CSU, said that comprehensive universities should provide a broad platform and excellent resources for medical schools and colleges so that they can better cultivate medical students and contribute to the society. On this basis, medical schools and colleges should strengthen international cooperation and exchanges, broaden their vision and make more specific designs for the cultivation of medical talents. At the same time, it should be taken into consideration that grassroots doctors are needed in the poverty-stricken rural areas. In addition to emphasizing undergraduate education, graduate education and residency training should be combined to lay a good foundation for the future development of medical education.
At the same time, the experts discussed with participants the definition and standard of “internationalization”, how to transit from undergraduate education to graduate education and issues about international exchanges and cooperation of medical schools and colleges in the Q＆A session.
Simulation-based Medical Education: Exploring New Internationally Advanced Fields
Simulation training has been applied in medical education in western countries for more than 100 years and China has adopted it in recent years. With the deepening of national medical talent training strategy and the innovation of modern educational technology, simulation has become a rapidly developed new field in China’s medical education as an important means.
In the topical discussion about simulation-based medical education, Prof. Richard B. Schwartz from Medical College of Georgia, Augusta University, Prof. Paul Phrampus from WISER of University of Pittsburgh, Prof. Sabrina Koh from Sengkang Hospital, Prof. Dong Yue from Mayo Clinic and other experts shared their internationally advanced experience and introduced the applications and development of simulation-based medical education in details.
Standardization of Residency Training: Focusing on the Cultivation of Professional Spirits
Standardized training of residents is an important part of post-graduation education for medical students. It is very important for training high level clinicians and improving medical quality. It is also one of the important topics of this symposium.
In his speech entitledTraining of Residents’ Professional Spirits and Xiangya’s Practice, Vice President Lei Guanghua of Xiangya Hospital, CSU, pointed out that doctors should focus on patients instead of diseases. The cultivation of residents’ professional spirits is closed related to the improvement of humanistic qualities. As a result, the education of humanities should be included in medical education. Xiangya Hospital emphasizes the continuity in the cultivation of residents’ professional spirits and designs corresponding training and evaluation for each stage in each process, strengthens the cultivation of professional spirits in a variety of forms including teaching, practice, competition and debate; consolidates residents’ professional spirits through cultural influence and emotional encouragement, the teaching of clinical tutors by precept and example and the dialogue between famous doctors and residents. "The tutor stands by the residents to help them make progress and motivates them through trust."
Assistant Prof. Emie L. Esquivel from Weill Cornell Medicine, Cornell University, introduced that standardized training of residents was a process of continuous improvement of their sense of responsibility and the establishment of mutual trust between tutors and residents. Teaching should enable students to build a learning system on their own, be student-oriented, and foster good qualified residents with good trust-dominated tutor-resident relationship as the starting point.
Sino-US dialogue: Development of Medical Education towards Internationalization
During the dialogue between Chinese and American experts presided over by Prof. Chen Lizhang from CSU and Prof. Zhang Liming from UPMC, Chinese representatives including Xing Liying, Deputy Director of the Department of Post-graduation Medical Education of Chinese Medical Doctor Association, Fan Peizhen, Associate Professor in Psychiatry of National Yangming University School of Medicine, and Prof. Lei Guanghua, Vice President of Xiangya Hospital, CSU, explored the concept of standardized residency training in China and the United States and discussed how to improve the standardized residency training from the perspective of differences between China and the United States with American representatives including Assistant Prof. Emie L. Esquivel from Weill Cornell Medicine, Cornell University, Associate Professor Lin Jin of Pediatrics from Mount Sinai School of Medicine at NYU and Timothy Stephrns, M.D. of University of Kansas Medical Center and Chief Physician of Haikou People’s Hospital.
The Chinese representatives mentioned that improving standardized residency training required universities and hospitals to cultivate basic medical talents as well as high-end medical talents. It is important for Chinese education to link closely with the international community. It not only makes higher requirements for the training of residents, but also makes homogenization requirement for clinical tutors.
In the training of residents in the United States, balance between workloads and learning is emphasized. The American representatives noted that residents should improve their independent thinking and clinical abilities, realize their limits, know when to solve problems by themselves and when to seek help from their tutors. The tutors, fully trusting their students, should also correctly judge the residents’ ability to work independently and handle medical issues through careful observation. All of this is to ensure medical safety.
Sub-forums: All Schools of Thoughts Contribute to the Development of Medical Education
At the three sub-forums, China Consortium of Elite Teaching Hospitals for Residency Education Forum, Undergraduate Medical Education Forum and Simulation-based Medical Education Forum, experts from well-known colleges and universities at home and abroad delivered wonderful lectures on the construction of standardized residency training bases, cultivation of medical talents, and the practice and quality management of residency training; the development and challenges as well as the practice and exploration of medical education; the construction and management of medical simulation centers, the practice and exploration of simulation-based medical education in combination with the actual conditions of each hospital.
Participants said they benefited a lot from these lectures and the relevant knowledge based on the successful experience of various hospitals.
Workshops: Situational Experience and Omni-directional Presentation
During the symposium, more than 20 workshops were set up in Xiangya Hospital, the Second and the Third Xiangya Hospitals of CSU, including Design and Operation of Scenario Simulation Education in Gynecology and Obstetrics, Internet-based Virtual Standard Patient Development and its Application in Training and Evaluation of Clinical Thinking, Integration of Simulation Courses about Physical Examination of Cardiac Function , Informatization Management and Operation of Practical Skills Training Center, Application of Debriefing in Medical Simulation Education, Application of Integrated Teaching in the Evaluation of Clinical Skills Training, Integration and Application of Scenario Simulation Course in Undergraduate and Residency Education , Application of Special-Effect Makeup and Recreation of Simulation Models in Medical Education, Improve Teachers’ Skills with Microteaching, How to Improve Teamwork of Residents with Scenario Simulation Training, Application of SP in Scenario Medical Education, How to Conduct High-Quality Debriefing in Medical Simulation Teaching, How to Conduct Single Clinical Skill Training for Residents, A Key Step in Resident Management: Faculty Assessment and Motivation, Design and Application of Simulation Education in Course "Choose Which Respirator Mode", Design OSCE and Experience Workshop, Design of Simulation Course for Comprehensive Clinical Skills Training , Selection and Application of Assessment Tools for Medical Simulation Teaching, Design and Implementation of a Comprehensive Scenario Simulation Training Course - Emergency Care for Critically-ill Patients, Interactive Teaching of Doctor-Patient Communication - Train the Trainer (TTT), PBL Design and Application.
The workshop teams, composed of experts, professors and lecturers, used various teaching methods to present situational simulation teaching in a full and three-dimensional way through practical operation and situational experience. From design to operation, and then to discussion and feedback, the open teaching methods demonstrated the application of simulated training courses in medical education, and brought new inspirations to the participants.
Xiangya Education: The Kingdom of Chu, the Cradle of Talents
As one of the pioneers of medical education in China, Teaching at Xiangya, deeply rooted in the fertile soil of Xiangya spirit in the past 100 years, has realized the good pattern of the synchronous development of clinical practice, teaching and scientific research, and formed the unique teaching culture of Xiangya.
According to Prof. Tao Lijian, Executive Deputy Secretary of CPC Committee of CSU, Xiangya School of Medicine of CSU (formerly known as Xiangya Medical College) was the first medical school jointly founded by China and the United States. Since its inception in 1914, it has adhered to the strict and truthful attitude towards education and the humanitarian spirit of healing the wounded and rescuing the dying, and fulfilled its social responsibility of benefiting the people. It has trained a lot of great educationists as well as high quality medical talents. As an important medical treatment, education and research center in the central and southern region of China, it has made outstanding contributions to the development of China’s health cause and earned the reputation of “South Xiangya”, which translates as “the best hospital in Southern China”.
Since its establishment, Xiangya School of Medicine of CSU has cultivated tens of thousands of excellent medical talents including 12 academicians of the Chinese Academy of Sciences and Chinese Academy of Engineering. The results of undergraduates who were admitted to Xiangya School of Medicine in 1977, 1978 and 1979 in the national qualification examination for medical practitioners had ranked the first in China for three consecutive years. The results of its undergraduates in the national medical examination taken by 17 medical colleges and universities in China organized by the then Ministry of Health in 1994 once again ranked the first. From 2012 to 2017, its students had won the “special prize” for five times in the National Clinical Skills Competition for Medical Students. Starting in 2004, it has carried out the 8-year medical education program approved by the Ministry of Education and selected 50% of the 8-year program students to study in world-famous universities such as Yale University, Emory University, Cornell University, University of Pittsburgh, University of Southern California. In terms of scientific research, it carries out hundreds of research projects, and undertakes or participates in almost 100 research projects supported by 863 Program, 973 Program, and the National Key Technology R&D Program every year.
This symposium is characterized by large scale, high quality, rich contents and various highlights. Both the guests and participants said that it had set up an international communication platform for medical education, deepened the synergy of health care and medical education and promoted the reform and development of medical education. The symposium carried forward the spirit of Xiangya medical education and embodied the essence of “South Xiangya”.
