Effects of the Education and Training Programme for Excellent Physicians in China on medical students' academic performance: a cross-sectional study

Abstract

Objectives: To evaluate the effect of the Education and Training Programme for Excellent Physicians in China on medical students' academic performance.

Design: This study is a secondary analysis of data from a cross-sectional survey of China Medical Student Survey (CMSS, 2021) and administrative data of the first-stage Medical Licensing Examination-the Standardised Competence Test for Clinical Medicine Undergraduates (the Test, 2021). CMSS used a stratified sampling process, with all undergraduate clinical medicine students participating voluntarily.

Setting: This programme is implemented at the class level within reformed medical schools, targeting undergraduate students in 5-year clinical medicine in China. The reformed medical schools run pilot classes and traditional classes simultaneously. The analytic sample was a total of 12 243 observations from pilot and traditional classes in 34 medical schools which implemented the reform across 19 provinces in China.

Methods: This study applied the propensity score matching method to estimate the effect of the reform by comparing the scores of the Test between pilot and traditional classes within the same medical schools. We further explored the potential mechanisms driving the effect from two facets of the Test: medical knowledge modules and cognitive levels.

Results: Pilot classes outperformed traditional classes by 0.104 SD on the Test (95% CI 0.037 to 0.171). Improvements were seen in basic medicine and clinical medicine modules (0.109 and 0.101 SD, respectively) and cognitive levels of memorisation and application (0.116 and 0.111 SD, respectively).

Conclusion: These results suggest that the reform had a significant positive impact on medical students' academic performance. Based on the components of this reform and the potential mechanism analysis of the two facets, this study indicates that curriculum reform in integrated learning and teaching methods reform in the adoption of problem-based learning may have been the possible drivers of this positive impact.

Keywords: health economics; health policy; medical education & training.

Figure 1

Standardised mean differences (SMDs) of all control variables in the unmatched and matched samples. The SMDs of table 2 are shown in this figure. ISEI, International Socio-Economic Index of occupational status; NCEE, National College Entrance Examination.