Integrating traditional Chinese medicine into Chinese medical education reform: issues and challenges

Integrating traditional apprenticeship and modern educational approaches in traditional Chinese medicine education

BACKGROUND

The traditional apprenticeship system and modern educational models both contribute to traditional Chinese medicine (TCM) education in unique ways. This study aims to evaluate the advantages and disadvantages of these approaches and investigates their potential integration for optimal TCM teaching.

METHODS

The study employs a comprehensive literature search strategy with specific keywords through Boolean Operators, focusing on articles discussing TCM education, sourced from the databases PubMed, Scopus, and CNKI. For comparative analysis, the study analyzes the advantages and disadvantages of three distinct approaches-traditional, modern, and hybrid-in TCM education. Finally, we use a spider plot methodology to visually evaluate across 11 critical educational aspects for these approaches.

RESULTS

A comprehensive review of 70 articles on TCM education highlights the value of both conventional and modern approaches. Conventional methods often emphasize teacher-centered clinical training that aligns well with the apprenticeship model, serving to bridge formal academic learning with hands-on experience. Modern methods incorporate elements like technology and formal accreditation but caution that the absence of traditional apprenticeship could dilute core TCM principles. One recurring theme across multiple studies is the enduring importance of apprenticeship-a pedagogical cornerstone rooted in TCM's historical and cultural context-as well as its tension with modern methodologies that incorporate online resources and scientific frameworks. An integrated approach attempts to harmonize these strengths but reveals a gap in interactivity, suggesting that incorporating apprenticeship could offer a practical, hands-on method to improve student engagement.

CONCLUSIONS

Conventional methods in TCM education emphasize teacher-centered clinical training akin to apprenticeship, modern methods incorporate technological advances and formal accreditation; however, the absence of traditional apprenticeship could compromise core TCM principles, and an integrated model, though striving to harmonize these elements, still falls short in the area of student interactivity.

Evaluation of the knowledge of and attitudes towards pharmacovigilance among healthcare students in China: a cross-sectional study

BACKGROUND

Knowledge of pharmacovigilance (PV) and adverse drug reactions (ADRs) are the core competencies that healthcare students should acquire during their studies. The objective of this study was to assess attitudes towards and knowledge of PV and ADRs among healthcare students in China.

METHODS

An online, cross-sectional survey was conducted nationally among healthcare students in China from April through October 2023. Knowledge of PV and ADRs was assessed using a questionnaire based on current PV guidelines. We performed logistic regression analysis to determine the potential factors related to knowledge of and attitudes towards PV and ADRs.

RESULTS

A total of 345 students were included in the analysis. Among the healthcare students who participated in the survey, 225 (65.22%) students correctly defined PV, while only 68 (19.71%) had a correct understanding of ADRs. Among all respondents included in the analysis, only 71 (20.58%) reported having taken a PV course. Pharmacy students were more likely to have taken PV courses at a university and to demonstrate superior knowledge compared to other healthcare students. The logistic regression model revealed that the significant predictors of a higher level of PV knowledge were being female (odds ratio [OR]: 1.76; 95% confidence interval (CI): 1.06-2.92; P value: 0.028) and having previously taken PV-related courses (OR: 2.00; 95% CI: 1.06-3.80; P value: 0.034).

CONCLUSIONS

This study revealed that healthcare students' knowledge of PV and ADRs is unsatisfactory. However, there were a limited number of universities providing PV education. Given the vital role of healthcare professionals in identifying and reporting ADRs, our findings raise significant concerns. Hence, more efforts should be made to enhance PV education for future healthcare professionals.

Inconsistency between physicians' attitudes and behaviors toward TCM: A questionnaire survey in Chengdu

Although Western Medicine is considered as the mainstream medicine in China, Traditional Chinese Medicine (TCM) still has its own advantages and characteristics. The attitudes and behaviors to TCM are divided, some West Medicine Doctors prefer TCM during treatment, while others consider it not effective. The objective of this study is to find out the attitudes and treatment behaviors of Chengdu physicians toward TCM, and identify factors associated with their attitude and behaviors. A representative sample of 2049 Chengdu physicians were recruited online to investigate their attitudes and behaviors toward TCM. During this research, previous Integrative Medicine Attitude Questionnaire were referred and modified, and adjusted questionnaire was made based on the actual situation of TCM in Chengdu. This questionnaire contains 3 distinct parts. The first part aimed at the attitudes of respondents toward TCM, and contains 15 questions in 3 sections, Holism, Knowledge, and Evidence. The second part tried to determine the behaviors toward TCM in terms of self-use, recommendations, as well as prescriptions. In addition, 6 modalities including Chinese Patent Medicine, Chinese Herbal Medicine, Acupuncture, Massage & Bone Setting, Qigong, and TCM diet were introduced in the behavioral part. In the third part, we aimed to collect personal, professional, and structural factors that may significantly influence TCM attitudes and behaviors. Physicians hold positive attitudes toward TCM in general, all the mean/highest possible subscales scores value of Holism (90.53%), Knowledge (63.77%), and Evidence (62.73%) domain were over 60%. On the other hand, physicians were more positive on self-use (49.40%) and recommendation (55.98%) of TCM than giving TCM prescriptions (36.60%) to patients. The attitudes and behaviors toward may not be consistent, which means physicians may not give prescriptions to patients even they have good attitudes to TCM. Education and self-use of TCM are important positive factors that influence the behaviors of physicians.

The impact of COVID-19 lockdown on nursing higher education at Chengdu University

BACKGROUND

To combat/control the COVID-19 pandemic, a complete lockdown was implemented in China for almost 6 months during 2020.

PURPOSE

To determine the impact of a long-term lockdown on the academic performance of first-year nursing students via mandatory online learning, and to determine the benefits of online teaching.

METHODS

The recruitment and academic performance of 1st-year nursing students were assessed between 2019 [prior to COVID-19, n = 195, (146 women)] and 2020 [during COVID-19, n = 180 (142 women)]. The independent sample t test or Mann-Whitney test was applied for a comparison between these two groups.

RESULTS

There was no significant difference in student recruitment between 2019 and 2020. The overall performance of the first-year students improved in the Biochemistry, Immunopathology, Traditional Chinese Medicine Nursing and Combined Nursing courses via mandatory online teaching in 2020 compared with traditional teaching in 2019.

CONCLUSION

Suspension of in-class learning but continuing education virtually online has occurred without negatively impacting academic performance, thus academic goals are more than achievable in a complete lockdown situation. This study offers firm evidence to forge a path for developments in teaching methods to better incorporate virtual learning and technology in order to adapt to fast-changing environments. However, the psychological/psychiatric and physical impact of the COVID-19 lockdown and the lack of face-to-face interaction on these students remains to be explored.

Epigenetic Studies of Chinese Herbal Medicine: Pleiotropic Role of DNA Methylation

Accumulating knowledge has been achieved on DNA methylation participating in numerous cellular processes and multiple human diseases; however, few studies have addressed the pleiotropic role of DNA methylation in Chinese herbal medicine (CHM). CHM has been used worldwide for the prevention and treatment of multiple diseases. Newly developed epigenetic techniques have brought great opportunities for the development of CHM. In this review, we summarize the DNA methylation studies and portray the pleiotropic role of DNA methylation in CHM. DNA methylation serves as a mediator participating in plant responses to environmental factors, and thus affecting CHM medicinal plants growth and bioactive compound biosynthesis which are vital for therapeutic effects. Furthermore, DNA methylation helps to uncover the pharmaceutical mechanisms of CHM formulae, herbs, and herbal-derived compounds. It also provides scientific validation for constitution theory and other essential issues of CHM. This newly developed field of DNA methylation is up-and-coming to address many complicated scientific questions of CHM; it thus not only promotes disease treatment but also facilitates health maintenance.

An evaluation survey of traditional Chinese medicine learning among international students majoring in conventional medicine: a study from a university in China

Background

Traditional Chinese medicine (TCM) has gained increasing acceptance and popularity by the global community. The current study aimed to investigate self-reported evaluations of learning TCM and opinions about TCM courses among undergraduate international students majoring in conventional medicine at a university in China.

Methods

A cross-sectional survey was conducted at the Zhejiang University School of Medicine. A self-reported questionnaire was administered to international undergraduates who were enrolled in the TCM course during the 2018 and 2019 academic years (n = 157). The course employed a student-centered, multiform learning model. Demographic data and self-reported evaluations of TCM learning background and TCM learning course were obtained to conduct the analysis.

Results

A total of 133 students responded to the questionnaire. Among the respondents, 21.0% had some TCM-related knowledge, and 51.1% were interested in learning TCM before the course. Ninety-six students (85.7%) were from Asia. Students from Thailand showed significantly more interest in learning TCM than did students from other Asian countries (p = 0.025). After the course, 77.2% of students agreed that the course had brought about many benefits, 86.4% were satisfied with the course content, and 77.3% were satisfied with the teaching method. Students expressed their willingness to further learn acupuncture and to obtain more skilled practice through more visualized learning methods.

Conclusions

The majority of the international students we surveyed agreed that the TCM course improved their interest in and understanding of TCM. It is thus suggested that TCM education should be directed toward students’ learning barriers and needs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-020-03174-1.

The evaluation of online course of Traditional Chinese Medicine for MBBS international students during the COVID-19 epidemic period

Background

During the COVID-19 epidemic period, Traditional Chinese Medicine (TCM) course for international students of Medical Bachelor, Bachelor of Surgery (MBBS) program in Zhejiang University has shifted from traditional classroom to online environment. This study aimed to investigate MBBS international students' perception on online TCM course, and to assess the online learning efficacy.

Methods

A total of 84 MBBS international students attending course of "Basic Traditional Chinese Medicine" during 2020 academic years at Zhejiang University were enrolled in this study. A quantitative questionnaire was respectively completed before and after the TCM course using a pretest-post-test design. By means of two online learning platforms, Learning in ZJU and DingTalk, TCM course was broadcast in both live and archived format to students.

Results

A total of 48 participants completed both baseline and follow-up questionnaires. The majority of participants preferred face-to-face classroom learning (26, 54.17% of total) when compared with online learning. Students felt that the course had brought in much benefits (mean 3.88, SD 0.87), and they were satisfied with the course content (mean 3.83, SD 0.95). Students' TCM related knowledge and their behaviors of discussion and consulting were significantly improved by online TCM course (all P < 0.001). Students' awareness of the necessity of TCM education and their feeling of difficulty in learning TCM were significantly strengthened (P = 0.042, 0.025, respectively).

Conclusion

Online learning is a good alternative for TCM course of MBBS international students when classroom learning is suspended, whereas it cannot replace the need for onsite and face-to-face learning.

A Survey on Perceptions of Complementary and Alternative Medicine among Undergraduates in China

In recent years, complementary and alternative medicine (CAM) is more widely known and used globally. This study was the first to investigate undergraduates' attitude toward CAM, and influencing factors and barriers for students to use CAM. Students of five different grades in six universities of China were selected for this study from February to May 2019. First, the participants were divided into two groups based on their majors and fulfilled a previously validated 10-item CAM Health Belief Questionnaire (CHBQ) to evaluate their attitudes toward CAM. Second, the chi-square test was used to analyze the differences between the groups, and correlation analysis was conducted to investigate the relationship of the data between the two groups. Third, we used frequency analysis to identify the types that students wanted to study and the barriers to use CAM. The overall mean score of the CHBQ was 48.87 ± 8.594, which was higher than that in other countries. The students in lower grades had a stronger desire to learn CAM than those in higher grades (89% vs 83%, p < 0.05). “Too time-consuming and bad tastes,” “Western medicine was enough,” and “lack of relevant knowledge” were found to be the main interruptions for students to use CAM. 82.3% of students wanted CAM to be incorporated into the curriculum and desired to learn more about CAM. 72.3% of the students who had never learned CAM wanted to know more about CAM. 55.5% of the students were willing to recommend CAM. Most undergraduates desired to learn more about CAM. It is necessary to introduce or integrate CAM courses into the present curriculum, and it should be started in the lower grades. We hope this study can provide evidence for the authority in China to make appropriate changes and integrate CAM into the college curriculum.

Establishment of a basic medical science system for Traditional Chinese medicine education: A suggestion based on the experience of BIOCERAMIC technology

The aim of this review study is to present an integrated and systematic approach to meridian channels and Ashi acupuncture points based on scientific evidence. We herein establish a framework of basic medical science to explain meridian channels based on the(1) Concepts of Traditional Chinese medicine(TCM) approach using physics and physiology: (i) the physical theory of pulse sound and cardiovascular physiology: resonance of harmonic sounds and the specific frequencies arising from heartbeats, which form pathways of different meridian channels to enhance microcirculation; (ii) standing wave hypothesis to explain meridian channels; (iii) Ashi acupuncture or trigger points caused by ischemia due to inappropriate harmonic resonance of standing waves; and (2)the TCM concept strengthened by BIOCERAMIC technology: (i) ‘wave-induced flow characteristics of meridians’; (ii) the ‘Propagated sensation along meridian’ phenomenon; (iii) clinical observations of the different chief complaints of candidates in which sensation was induced along specific meridian channels; (iv) generates ‘biofield’ phenomenon composed of virtual channels of interconnecting ‘feet-hands-ears’ to different internal organs/tissues that support the principles of reflexology.

Horses Referred to a Teaching Hospital Exclusively for Acupuncture and Herbs: A Three-Year Retrospective Analysis

Equine acupuncture and herbal medicine are increasingly popular and have been anecdotally used in the treatment of a number of conditions. There is, however, a lack of data on the most commonly treated conditions in horses. The medical records of 164 horses presented exclusively for acupuncture and herbal therapy over a three-year period from October 2012 to October 2015 were evaluated from a mixed animal integrative medicine service at a veterinary academic teaching hospital. Horses were presented primarily for musculoskeletal conditions (62.0%), gastrointestinal disorders (9.5%), and anhydrosis (6.1%). Nearly half of all treated horses were geldings, and the mean age of treatment was 10.7 ± 6.5 years. The most common breeds were Warmbloods (28.2%), Quarter horses (20.2%), Thoroughbreds (17.8%), and Arabians (8.0%). Treatments included acupuncture (90.2%), herbal supplements (79.8%), electroacupuncture (69.9%), B12 injections (pharmacoacupuncture, 29.4%), or administration of autologous blood at acupuncture points (hemoacupuncture, 8.0%). Thirty-eight (38) different herbal formulas were recommended during the study period. Horses that were not provided herbal recommendations were more likely to present with gastrointestinal complaints (odds ratio = 11.2). Sex, breed, and presenting complaint had no or minimal impact on the types of treatments performed during the visit. However, data regarding patient characteristics and presenting complaints provide novel information which can be used to design prospective clinical trials.