History and status quo of higher public health education in China

Job preference of preventive medicine students during the COVID-19 pandemic: a discrete choice experiment survey in Shandong Province, China

BACKGROUND

Public health workers are a crucial part of the health workforce, particularly during the coronavirus disease (COVID-19) pandemic. They play an important role in achieving universal health coverage and sustainable development goals. Human resources in public health in China are in short supply, their distribution is unequal, and their turnover rate is high. A discrete choice experiment (DCE) was applied to investigate preventive medicine students' preferred job choice criteria and trends in trade-offs by calculating the marginal rate of substitution between these criteria. This study identified the properties of jobs primarily selected by preventive medicine students and estimated the monetary value of each attribute.

METHODS

Based on discussions and in-depth interviews with preventive medicine students and a literature review, we developed a DCE that assessed how students' stated preferences for a certain choice were influenced by several job attributes, including location, salary, bianzhi, career development opportunities, working environment, and workload. We applied this DCE to preventive medicine students in Shandong Province, China, using a brief, structured questionnaire. Conditional logit models were used to estimate the utility of each job's attributes. Willingness to pay (WTP) was estimated as the ratio of the value of the coefficient of interest to the negative value of the cost attribute.

RESULTS

A total of 307 respondents completed the questionnaire, and 261 passed the internal consistency test. All the attributes were statistically significant. Career development opportunities and work locations were the most important factors for the respondents. Preference heterogeneity existed among respondents, e.g., 3-year medical education college students placed a higher value on jobs with bianzhi compared to 5-year medical education college students. Furthermore, rural students' WTP for a job located in the county or city is much lower than that of urban students.

CONCLUSIONS

The heterogeneity of attributes indicates the complexity of job preferences. Monetary and nonmonetary job characteristics significantly influenced the job preferences of preventive medicine students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both job incentives and the backgrounds of preventive medicine graduates.

Responsibility of education in improving medical college students' ability to prevent and respond to public health emergencies in China - A systematic review

Background

The outbreak of coronavirus disease 2019 (COVID-19) has highlighted the critical importance of sufficient preparedness for public health emergencies. This places higher requirements on the ability of medical staff to deal with such emergencies. Nonetheless, education courses on public health emergencies in China are usually aimed at public health students, and not at all medical college students. Importantly, these medical students will become medical workers who are generally the first-contact personnel and play an irreplaceable role in responding to most public health emergencies. Therefore, it is urgent to strengthen educational courses to enable these students to adequately prevent and respond to public health emergencies.

Objectives

The purpose of this systematic review was to reveal the current unsatisfactory status of Chinese medical college students' knowledge and skills in dealing with public health emergencies and their training needs.

Methods

We searched EMBASE, PubMed, Google Scholar, Web of Science, CNKI, Wan Fang, and VIP Information Network for all associated original studies written in English and Chinese from the inception of these databases until March 12, 2022.

Results

This systematic review screened out 15 eligible studies that met the inclusion criteria. These studies demonstrated that Chinese medical college students generally have a low ability to deal with public health emergencies. Most students believe it is essential to master coping with public health emergencies and desire to acquire this knowledge. But the participation rate is low, and only a few students actively seek relevant knowledge.

Conclusion

The findings of this review illustrate the importance of improving medical college students' education to prevent and deal with public health emergencies. It is necessary to improve medical college students' education in responding to public health emergencies.Systematic Review Registration: PROSPERO, Identifier [CRD42023467374].

Application of flipped classroom combined with case-based learning in Introduction to Environmental Health Science

Objectives

To explore the effect of flipped classroom combined with case-based learning in Introduction to Environmental Health Science for the Master of Public Health (MPH).

Methods

The MPH Master's class of 2022 was selected as the experimental group at Guilin Medical University from September to December 2022, and the flipped classroom combined with the case-based learning was adopted. The class of 2021 was the control group, and we taught them with the traditional teaching method. A self-designed questionnaire and academic performance were used to evaluate the teaching effects of the two groups.

Results

There was no difference in the paper score between grades 2022 and 2021, and the design question score of grade 2022 was higher than that of grade 2021. The difference was statistically significant (p < 0.05). The students in grade 2022 had a high overall recognition of the teaching effect of the flipped classroom combined with case-based learning in Introduction to Environmental Health Science.

Conclusion

The teaching method of the flipped classroom combined with case-based learning is more suitable than the traditional teaching method in the Introduction to Environmental Health Science for MPH. It can stimulate the independent learning ability of MPH students and improve their ability to use knowledge and an innovative spirit.

The effect of training medical students in the community area in the midst of the Covid-19 pandemic in China: a community-based study

BACKGROUND

Community practice training is an important part of education in medicine, public health, social medicine, and other disciplines. The objective of this study is to explore the effect and importance of the community practice of Master of Public Health graduates on community residents' health during the Coronavirus Disease 2019 pandemic.

METHODS

This study used a pretest-posttest design. A total of 152 participants with age ≥ 60 years were selected using a multistage sampling method from Hangzhou in China. Baseline and endline data were collected using structured questionnaires by face-to-face interviews. All psychological and behavioral measurements were performed using standardized instruments and showed good reliability and validity. A total of 147 participants were included in the analysis. The chi-square and rank sum tests were used to compare the difference between baseline and endline for categorical variables. Binary logistic regression analysis was used to evaluate the association between community practice training and changes in psychology and behavior.

RESULTS

The result of chi-square test revealed a statistically significant difference in participants' eating habits from baseline to endline. Participants reported that the self-perceived health status was different between endline and baseline by the rank sum test. The results of logistic regression analysis showed that community practice training was significantly associated with increased self-efficacy scores, cognitive function and eating habits, with odd ratios of 1.08, 0.90 and 1.93, respectively.

CONCLUSIONS

Community practice training was associated with changes in health behavior and psychology of community residents. Our results suggested enhanced community practice training for students under the Master of Public Health program.

Transnational public and global health education in China

Transnational public and global health programs in China have rapidly expanded over the past 20 years, and have potential to make important contributions to China's global health workforce. However, there has been sparse if any literature specific to transnational public and global health higher education in China. In response, this perspective article aims to: (1) outline current transnational public and global health programs in China, and (2) delineate opportunities and challenges for transnational public and global health programs to enhance China's global health workforce. Based on internet searches, eight active transnational public and global health programs in China were identified in September 2022 (one Bachelors; four Masters; three doctorate). Degree awarding institutions are located in Australia, Portugal, the United Kingdom, and the United States. Courses for stand-alone transnational programs were co-delivered by faculty from the Chinese and foreign sponsoring institutions. The earliest and latest programs were respectively established in 2001 and 2022, and the average year of establishment was 2013. The endurance of some programs (three programs operating ≥ 10 years) indicates the potential sustainability of transnational public and global health programs in China. However, opportunities for cross-cultural engagement appear to be constrained by lack of English (or other language) requirements in some programs, limited recruitment of international students, pandemic travel restrictions, and a dearth of funding for global health research outside China. In addition, students enrolled at transnational universities in China are currently ineligible for China Scholarship Council funding. As China's need for global health capacity grows amid a rapidly shrinking population of younger citizens, strategic investments in transnational public and global health programs may be of increasing value.

Growth and challenges of China's nursing workforce from 1998 to 2018: A retrospective data analysis

BACKGROUND

Nurses play a vitally important role in promoting equitable and essential care. China undertook bold reforms in its education and healthcare systems since 1990s. The effect of these reforms on the nursing workforce has not been assessed systematically.

OBJECTIVE

This study aims to assess the changing trends and the underlying challenges of the nursing workforce in Mainland China in the period of 1998-2018.

DESIGN

Retrospective data analysis.

METHODS

Data were acquired from the National Health Statistics Yearbook from 1999 to 2019. Descriptive statistics were used to analyze the nature of the nursing workforce in terms of quantity, quality, and structure. Non-parametric tests were used to compare doctors and nurses in terms of number and work experiences. Global Moran's I index and hotspot analysis were applied to compare the equity in distribution of nurses at national and provincial levels.

RESULTS

From 1998 to 2018, the number of nurses increased from 1.22 to 4.10 million with an average rate of increase of 6.3% per annum. The ratio of doctors to nurses changed from 1: 0.61 to 1: 1.14, reaching 1: 1 in 2013. The main educational level of registered nurses elevated to associated degree (48.9%), and nurses with advanced titles increased at the most rapid rate. In 2018, 60.3% of nurses were younger than 35 years old. The Global Moran's I index ranged from 0.211 to 0.198 (Z > 1.96, P < 0.05). Hotspot analysis showed the distribution of nurses was unequally concentrated in the northern region and with the highest distribution in Beijing.

CONCLUSIONS

Great improvement on the scale and the quality of nursing workforce over the past 20 years has been witnessed in China. However, the shortage of nurses, outflow of younger nurses and the imbalance distribution of nursing workforce among the country are emerging challenges. Plans should not be ignored on continuously cultivating more qualified nurses, retaining younger nurses, attracting nurses to work in rural areas and the northeast region. Tweetable abstract: Numbers of Chinese nurses finally outstrip the number of doctors but do limited educational opportunities limits their contribution to the nation's health? New article in @ijnsjournal.

Knowledge, Attitudes, and Social Responsiveness Toward Corona Virus Disease 2019 (COVID-19) Among Chinese Medical Students-Thoughts on Medical Education

Purpose: To assess knowledge, attitudes, and social responsiveness toward COVID-19 among Chinese medical students.

Methods: Self-administered questionnaires were used to collect data from 889 medical students in three well-known Chinese medical universities. The questionnaire was comprised of three domains which consisted of demographic characteristic collection, seven items for knowledge, and eight items for attitudes and social responsiveness toward COVID-19. Data from different universities were lumped together and were divided into different groups to compare the differences, including (1) students at the clinical learning stage (Group A) or those at the basic-medicine stage (Group B) and (2) students who have graduated and worked (Group C) or those newly enrolled (Group D).

Results: Medical students at group B had a weaker knowledge toward COVID-19 than did students at group A, especially in the question of clinical manifestations (p < 0.001). The percentage of totally correct answers of COVID-19 knowledge in group C was higher than that in Group D (p < 0.001). There were significant differences between groups C and D in the attitudes and social responsiveness toward COVID-19. Surprisingly, we found that the idea of newly enrolled medical students could be easily affected by interventions.

Conclusions: In light of this information, medical education should pay attention not only to the cultivation of professional knowledge and clinical skills but also to the positive interventions to better the comprehensive qualities including communicative abilities and empathy.