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  Internal Medicine is a subject combined with theory and practice. Generations of experts devote themselves and from their years of experience make the internal medicine as a distinguished course. The Teaching Department of Internal Medicine has an excellent experience in teaching internal medicine and diagnostics for long-term medical students. Teaching long-term medical students bilingually has laid a solid foundation for international students’ full English teaching of Internal Medicine since 2000. In the last decade, the teaching department of Internal Medicine has formed its distinguished features in the education of international students and brought up a series of innovations.:

 1.Set up full English teaching mode, use stable and high-qualified staffs for international students.

With China’s further development of educational internalization level and persistent elevation of national power, more and more overseas students choose to study in our country. Tianjin Medical University has been formally authorized by the Ministry of Education and becomes one of the medical undergraduate colleges that could bear the English teaching task for international students in China. Since 1997, students from various countries have got admissions, and medical undergraduate education has been started. International student teaching task has become one of the important parts of education in our university. In order to further improve the educational quality and development of education for international students , we explore and think over how to set up the teaching staff of clinical medicine and train them to teach international students in English . Teachers are the key parts in international education. Management of the university spends great efforts in selecting teachers, defining training goals and making systematic training plans. To guarantee the quality of teaching in English, we select those who have studied abroad with high level of English and education as the teachers of international college. Only by getting through the teaching practice exam  they can teach lessons to international students. Recently, many teachers of our department were sent to receive the English language training in abroad or in Beijing Foreign Languages University. Seventeen teachers have been sent to America, Britain, Germany, Japan and other countries to study advanced teaching concepts and methods of medicine, and 10 teachers to Beijing Foreign Languages University. Additionally , our teachers are encouraged to participate in demonstration teaching and English teaching competitions. The teacher Ding Kai was honored the second prize of the English group of Tianjin young teachers teaching competition in 2013. Until now, 24 teachers have passed the teaching certification exam of the international college of medical university.

 

 

 

 

 

Certificates of young teachers studying in Beijing Foreign Languages University

Visit to the University of Dundee, UK.

 

2. Edit the English version of clinical textbooks and learning guides for international students

Textbooks are the basis for teaching. Facing the difficulties, there is no special teaching programs, no standard teaching outlines and lack of systematic full English textbooks and teachers for international students, we started preparations from all aspects. Based on the international standard of undergraduate education, the disease spectrum and needs of international students’ home countries, with reference to the teaching outlines of foreign countries and English original textbooks, we arranged excellent educational experts to edit English version of clinical textbooks and learning guides. Our teaching department organized the making of English teaching outlines and guides of internal medicine for foreign students, and finished editing the 1st and 2nd English version of Internal Medicine textbooks and practical guides. Moreover, we will actively prepare and invite teachers from other universities to edit a more authoritative 3rd version of Internal Medicine textbook, and plan to cooperate with a famous publishing house to formally publish the textbook. And finally, we will try our best to declare it as a standard textbook from the Ministry of Education. The Ministry of Education edited and published the full English version of Clinical Skills and Operations (2 volumes) in video and other teaching materials, which can help teachers when they search for information.

 

 

 

 

 

 

Self editing the 2nd English version of textbook

 

 

 

English version of Clinical Skills and Operations in videos

 

3. Strengthen clinical skills and operations; improve practical abilities of international students from all aspects.

   Clinical practice is an important part of training students. Our teaching department has always been concerned with the education of foreign students’ clinical practice abilities. Our internal medicine group will give each batch of foreign interns an entrance education to let them clarify the purposes of clinical practice and strengthen their consciousness of medical ethics before they really get into their practice. We mean to make the foreign students realize that clinical practice is a key stage of deepening and confirming accepted knowledge and involve them into practice, during which independent working ability can also be developed. We pay attention on developing students’ abilities of clinical thinking, analyzing questions, solving problems together or even independently, and shifting the vertical thinking mode into lateral thinking. Teachers can train the student’s lateral thinking pattern by asking questions and analyzing patients’ condition during ward rounds, or carrying out case discussions. Thus foreign students can not only consolidate their theoretical knowledge, but also gain the skills of clinical thinking. We finally reach the goal of training foreign students.

    Foreign students are demanded to receive the intensive training of physical exercises before they start their clinical practice. Only those who pass the exam can get into their clinical practice. Those who fail in the exam need to receive training again and can get into their clinical practice when finally pass the exam.

  When starting the clinical practice, the difficulty that foreign students initially come across is to communicate with patients. Since the language limitation, it is not easy for foreign students to study in clinic. To solve the problem, we organize the foreign students and the seven-year students to form a “one to one mutual help pair”. On one hand, foreign students can get a better understanding of patients’ condition and what doctors say during ward rounds, which benefits their study and practice. On the other hand, the communication and exchange of ideas between Chinese interns and foreign interns can help both of them discover and solve more problems in clinical study, which promotes them to make progress together. Meanwhile, each branch of internal medicine will recommend a doctor who has high level of English knowledge to instruct foreign students’ clinical study. Furthermore, the teaching department will arrange different internal branches to hold lectures on special topics or case demonstrations once a week in each round of clinical practice by the attending physician of the ward.

  Under the clinical atmosphere nowadays, patients’ self-protect consciousness gets improved, which limits foreign students’ opportunity to check or operate on the patients personally. In order to avoid affecting the teaching quality, the teaching secretary takes foreign students to practice all kinds of clinical skills and operations in the clinical technique center one week before they get into the clinical practice. During practice, every student is required to finish various operations as many as possible, such as bone marrow puncture, thoracic puncture, abdominal puncture, blood drawing from vein and intramuscular injection. If someone cannot finish all the operations required because of some reasons, they can ask the teaching secretary to take them to the technique training rooms for practice.

 

 

“One to one mutual help”study between foreign student and the seven-year student.

 

 

Foreign students skills training.

  


 

Physical examination training.

4. Application of inquiry to standardized patients (SP) in full English teaching.

  Inquiry is a history taking process by consulting patients or related people systematically. The occurrence and development of disease, related diagnosis and treatment, past healthy status and illness can all be gained through inquiry, which takes an important role in the diagnosis and treatment of current diseases. The traditional teaching mode is very limited in the education of clinical inquiry. Thus, we introduced the SP pattern in the training of inquiry skills. Students can get systematic trainings in inquiry, and master the subjects and skills of it, as well as help set up the patients-centered clinical thinking method during early stages. Moreover, SP can also play sufficient roles in the feedback and evaluation of teaching. SP belong to one of the medical simulation techniques. SP pattern can play three aspects of functions in playing patients, serving as evaluators and educational instructors.

  It is difficult to select SP from non-medical areas because of money, personnel, professional problems and other reasons. Our teaching department selects teachers with years of experience to serve as the SP, which lays a good foundation for the inquiry of students. Teachers serving as the SP can give students sensory perceptions of inquiry, help them get a deeper understanding of the method and skills about inquiry, and get a good comprehension of the inquiry subjects. By practicing, they can show confidence when inquiring patients at their bedside, as well as better use the methods and skills of inquiry, and finally get a relatively complete and correct history. By this means, teachers can find problems in time and instruct students accordingly, which lays the groundwork for students’ clinical practice in the future. On the basis of traditional teaching method, teachers are chosen to play the SP, which can ease the short of clinical teaching resources. Compared with simply using the traditional teaching method, SP pattern can obviously improve students’ ability of inquiry and clinical thinking. Moreover, we also train some seven-year students to serve as SP. Teachers can create learning environment based on needs and arrange study and training anywhere and anytime. In our education of inquiry, the teacher designs a standard case to simulate the clinical condition. Students are divided into several groups to practice inquiring the SP. During this process, students can change their roles from students to doctors. By the evaluation and feedback from SP and repeated training, students can master the subjects and skills of inquiry, particularly the skills of communication . Some special conditions can also be simulated, such as fear, anxiety, anger, hostility, incorporation, etc. We aim to train students to cope with any special conditions of inquiry; instruct them how to observe patients, comfort patients and eliminate their doubts, and to respect patients’ secrets, gain their trust, and finally set up a good relationship with them. On the basis of practicing inquiring SP systematically, we take students to the hospital and let them ask history from patients in order to avoid them feeling nervous when contacting with real patients in the future.

  There are many difficulties exist in the training of inquiry ability in full English practical education for foreign students. Foreign students cannot get a good communication with patients. To solve this problem, we ask every group of wards to recommend a doctor with relatively high level of English to instruct foreign students’ clinical practice and help them solve questions during ward rounds. And also, we organize foreign students and the seven-year interns to form a “one to one mutual help pair”. They can communicate with each other conveniently during theirs practice. On one hand, foreign students can get a better understanding of patients’ condition and what doctors say during ward rounds, which benefits their study and practice. On the other hand, the communication and exchange of ideas between Chinese interns and foreign interns can help both of them discover and solve more problems in clinical study, which promotes them to make progress together. This pattern of practice shows more obvious effects than the single practice pattern.

The full English education for international students is an advanced pattern to be in line with international standards, and also a symbol of internationalization of college education. By bearing the internal medical full English teaching task for international students, we elevated our level of medical undergraduate education in China to an international level. Moreover, the English level of clinical teachers has been improved, and a team with full English teaching ability has also been trained, which promotes the bilingual and full English teaching task and the overall construction of internal medicine.