With the changing disease spectrum of the population and the advancement of the national tiered diagnosis and treatment system, general practitioners play a vital role in disease diagnosis and treatment. At the same time, the continuous updating of medical knowledge and the ongoing changes in the health service demands of the residents necessitate the ongoing participation of general practitioners in continuing education and training. This ensures they can make the best diagnostic and treatment decisions and manage diseases effectively for their patients.
To analyze the current developments, training quality and research quality of continuing education research of general practice in China in the past ten years (2013-2022) .
In January 2023, eight Chinese and English databases including PubMed, Cochrane Library, Embase, CINAHL, ERIC, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and China Biology Medicine Literature Service System were used as data sources to obtain research on the training of continuing education for general practitioners in China. The literature was read, analyzed, organized, and summarized, with the search period ranging from January 2013 to December 2022. The Medical Education Research Study Quality Instrument (MERSQI) was utilized to comprehensively evaluate the quality of the literature.
This review included a total of 49 articles, of which 11 were in English and 38 in Chinese. The themes of continuing education training focused on cardiovascular and cerebrovascular diseases (22.4%), emergency-related content (6.1%), and mental health (6.1%). The training formats were relatively singular, mainly based on traditional expert lectures (69.3%), with only 6.1% adopting the form of skill training, and 4.0% of the studies using problem-based learning (PBL) or team-based learning (TBL) training formats. There was usually a lack of rigorous evaluation: 31 studies (63.2%) used questionnaires to assess the effectiveness of the training, of which 19 had not undergone validity and reliability testing. In the study design, the largest proportion was single-group pre-post comparison (53.1%), followed by randomized controlled trials with pre-post measurements (26.5%), and the smallest proportion was controlled pre-post comparison (4.1%). Only 9 studies (18.3%) explicitly mentioned ethical approval, while the majority of studies (81.7%) did not undergo ethical review. The evaluations focused on the enhancement of knowledge and skills of general practitioners before and after trainin (85.7%), with less coverage of actual behavioral changes (14.2%) and benefits to patients and healthcare facilities (22.4%) .
In the past decade, the attention to general practice continuing education research has been insufficient, but there is significant room for development. In the future, it is necessary to expand training themes and adopt diverse training methods based on actual needs. Utilizing assessment tools with good validity and reliability, and focusing on the actual behavioral changes brought about by training, will benefit patients and enhance the quality of continuing education for general practitioners in multiple dimensions.
In order to change the shortage of general practitioners in primary care, China has been implementing a rural order-oriented medical student training program in 2010. Currently, the overall performance intention, performance situation and retention intention of order-oriented medical students in China still remains unclear and need to be supported by more reliable evidence.
To systematically evaluate the performance intention rate, actual performance rate and retention intention rate of order-oriented medical students in China and analyze its influencing factors.
From January to June 2022, CNKI, Wanfang Data, VIP, PubMed and Embase databases were searched to collect literature related to service intention, performance intention and retention intention for primary care of order-oriented medical students in China with a time period from 2010 to 2021, and the language of the literature was limited to Chinese and English. Two investigators independently screened literature and extracted data independently to evaluate the risk of bias of the included studies. Meta-analysis of single-group rates was performed using RevMan 5.4 software.
A total of 49 papers were included with a survey period of 2010-2020, involving 22 413 order-oriented medical students. The performance intention rate of order-oriented medical students was 62% [95%CI (55%-69%) ], the performance rate was 95% [95%CI (93%-96%) ], the retention intention rate was 16% [95%CI (13%-19%) ]. The results of subgroup analysis showed that the performance intention rate of the literature published in 2011 [90%, 95%CI (84%-96%) ] was higher than the other years (P<0.01), the performance intention rate was higher in North China [87%, 95%CI (84%-90%) ] than the other regions, the performance intention rate of college students [68%, 95%CI (67%-69%) ] was higher than the residents in standardization training (P<0.01) ; the performance rate of the published literature in 2020 [99%, 95%CI (99%-100%) ] was higher than the other years (P<0.01), and the performance rate [100%, 95%CI (99%-100%) ] in Central China was higher than the other regions (P<0.01) ; the retention intention rate of the literature published in 2015 [36%, 95%CI (2%-70%) ] was higher than the other years (P<0.01), the retention intention rate [23%, 95%CI (4%-41%) ] was higher in South China than the other regions (P<0.01), the retention intention rate of the college students [18%, 95%CI (13%-22%) ] was higher than the residents in standardization training and primary care providers performing contracts (P<0.01) .
The actual performance rate of order-oriented medical students in China is high, but the performance intention rate and retention intention rate are low. Region, time and medical education stage are the influencing factors.
Games are an emerging pedagogical tool in medical education, and they are recognized as a potentially attractive form of complementary learning. Research on the application of games in medical education has gradually increased in recent years, but the development of related research in China has been slow. Reviewing the research literature related to the use of games in medical education and gaining a comprehensive understanding of the current status and hotspots of the development of this field will be conducive to promoting the development of the research field of medical education in China.
To analyze the current status of the research on the application of games to medical education, and to provide reference and information for future research related to the application of games to medical education.
From February to April in 2023, with the help of CiteSpace 6.1R6 and Microsoft Excel 2019 software, we searched the relevant literature from Web of Science Core Collection database (WoSCC) from 2013-01-01 to 2023-02-26 with the theme of "game" and "medical education", and analyzed the number of publications, authors, countries/institutions, and the number of articles.
Finally, 652 English-language articles were included. There was a general upward trend in the number of publications in the last 11 years, with the United States being the top country in terms of the number of publications (201), centrality (0.48), and the annual number of publications, and Canada (67, centrality 0.15) and the United Kingdom (56, centrality 0.47) in the second and third places, respectively. The University of Toronto, Canada was the institution with the highest total number of articles with 21 articles. High-frequency keywords included medical education, education, serious games, simulation, and performance. The keyword with the highest level of emergence in the keyword emergence analysis was serious games (emergence intensity 3.4) .
Currently, the application of games in medical education has attracted more and more attention from scholars, and the research hotspots mainly focus on the role played by different games in the process of talent cultivation, but there is no high-quality evidence to provide educators with evidence-based recommendations. China still needs further exploration in this field, and educators need to apply more in the teaching process to better validate its effectiveness and promote the development of medical education.
