| Preliminary teaching preparation | Before teaching, the teachers selected the typical clinical cases according to the requirements of the Suggestions of General Office of the State Council on Reforming and Improving the General Practitioner Cultivation and Employment Incentive Mechanism (GFB [2018] No. 3) and the contents & rules of general resident standardized training and by combining their clinical practice experience, special cases and problems, difficulties of major diseases, and trainee problems in the previous training. | ||
| Training mode | Training subject/contents | Training pattern | Minimum case number |
| SOAP teaching | 1) SOAP teaching was inserted in the whole training process, its place was determined according to the condition of cases, and its purpose was to improve the general medicine clinical thinking, clinical operation skills (clinical bases and grass-root practice bases), clinical cooperation, and doctor-patient communication skills. a) For conventional cases, the discussion was dominant in combination with teaching demonstration and practice, and it could be conducted in several forms according to the actual situations, including classroom teaching, outpatient clinic teaching, and ward teaching. b) For typical cases, the trainees finished the history collection, physical examination, medical record writing, and treatment measure planning in a team way (4 persons/team). | Case discussion, case review, case simulation (1 times/week) | 2 cases/times |
| 2) SOAP teaching was implemented for the previously selected “typical clinical cases” in the training process. a) The cases and the adverse outcomes caused by improper operations, knowledge shortage and incomplete case information were both analyzed using “Swiss Cheese Model” theory b) Collection of subjective data (S)—The subjective data were collected by the patients’ chief complaint and clinically asking the patients’ age, disease development, current symptoms, personal history and familial history. The trainees should make clinical reasoning through thinking and integrating the information provided by the patients during clinical inquiry. The clinical inquiry was implemented under the guidance of teachers, and the trainees were allowed to propose some questions. c) Collection of objective data (O)—The objective data (e.g., symptoms and signs) of patients were collected by systematic examination, physical diagnosis, X-ray examination, CT, ECG, biochemical test and other auxiliary examination under the guidance of teachers, and the trainees were allowed to participate in the discussion about the interpretation of auxiliary examination results. d) Patient assessment (A)—The analysis, differential diagnosis and prognosis evaluation were performed according to the abovementioned subjective and objective data under the guidance of teachers; the teachers properly put forward to some relevant questions and the trainees participated in the discussion. e) Treatment plan (P)—A comprehensive treatment plan was made for cases by combining the above three steps of S, O and A under the guidance of teachers. The teachers proposed some special questions for the cases, and the trainees worked out the treatment plans and wrote the medical records. f) The teachers assessed the cases analyzed independently by trainees and then the trainees with qualified performance entered into the scenario simulation step. | Note: In the case discussion or case review process, the teacher/trainee ratio was 2/1, i.e., the teachers gave a classroom lecture by SOAP teaching for 1/2 case and put forward to some questions to be answered by trainees; the trainees independently analyzed 1/2 case, and then the teachers assessed, supplemented and corrected the analysis results. | ||
| 3) Scenario simulation a) For 2 cases discussed previously, 4 trainees simulated the patients in turn, the remaining trainees participated in the treatment, and the teachers controlled the scenario simulation workflow and time to make sure that all trainees joined in such scenario simulation and required the trainees to work out the treatment measures within the specified time. b) After all trainees completed the scenario simulation, the teachers provided a summary assessment according to the scenario simulation, treatment measures, doctor-patient communication and clinical cooperation of trainees. | 2 scenarios/week | ||