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      Transformation of the education of health professionals in China: progress and challenges.

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          Abstract

          In this Review we examine the progress and challenges of China's ambitious 1998 reform of the world's largest health professional educational system. The reforms merged training institutions into universities and greatly expanded enrolment of health professionals. Positive achievements include an increase in the number of graduates to address human resources shortages, acceleration of production of diploma nurses to correct skill-mix imbalance, and priority for general practitioner training, especially of rural primary care workers. These developments have been accompanied by concerns: rapid expansion of the number of students without commensurate faculty strengthening, worries about dilution effect on quality, outdated curricular content, and ethical professionalism challenged by narrow technical training and growing admissions of students who did not express medicine as their first career choice. In this Review we underscore the importance of rebalance of the roles of health sciences institutions and government in educational policies and implementation. The imperative for reform is shown by a looming crisis of violence against health workers hypothesised as a result of many factors including deficient educational preparation and harmful profit-driven clinical practices.

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          Author and article information

          Journal
          Lancet
          Lancet (London, England)
          1474-547X
          0140-6736
          Aug 30 2014
          : 384
          : 9945
          Affiliations
          [1 ] Institute of Medical Education, Peking University, Beijing, China.
          [2 ] China Medical Board, Cambridge, MA, USA.
          [3 ] Center for Medical Education Research, China Medical University, Shenyang, China.
          [4 ] Health Human Resources Development Center, Ministry of Health, Beijing, China.
          [5 ] Harbin Medical University, Harbin, China.
          [6 ] West China School of Medicine and West China Hospital, Sichuan University, Chengdu, China.
          [7 ] West China School of Public Health and No. 4 West China Hospital, Sichuan University, Chengdu, China.
          [8 ] Guangxi Food and Drug Administration, Nanning, China.
          [9 ] Xiangya School of Medicine, Changsha, China.
          [10 ] Peking University Health Science Center, China.
          [11 ] Shanghai Medical College, Fudan University, Shanghai, China.
          [12 ] Jiujiang University Medical Center, Jiujiang, China.
          [13 ] School of Nursing, Peking University, Beijing, China.
          [14 ] Guangxi Medical University, Nanning, China.
          [15 ] Office of Educational Administration, Peking Union Medical College, Beijing, China.
          [16 ] China Center for Health Development Studies, Peking University, Beijing, China.
          [17 ] Department of Human Resources, China Medical University, Shenyang, China.
          [18 ] School of Nursing, Peking Union Medical College, Beijing, China.
          [19 ] Ministry of Education, Beijing, China.
          [20 ] Peking University Health Science Center, China. Electronic address: keyang@bjmu.edu.cn.
          Article
          S0140-6736(14)61307-6
          10.1016/S0140-6736(14)61307-6
          25176552
          Copyright © 2014 Elsevier Ltd. All rights reserved.

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