"One Core with Dual Engines, Quintessential Competency Cultivation": Reform and Practice of Medical Education Models in the New Era
Jie
Ma
1,3✉
Phone+86 13775555586
Emailjsdxmajie@ujs.edu.cn
Zhengrong
Zhou
1
Xiao
Xu
1
Xiaochun
Wang
1
Yan
Wu
1
Xiaoli
Jv
1
Aihua
Gong
2
1
Department of Laboratory Medicine, School of Medicine
Jiangsu University
212013
Zhenjiang
Jiangsu
China
2
School of Outstanding Clinician
Jiangsu University
212013
Zhenjiang
Jiangsu
China
3
A
School of Medicine
Jiangsu University
212013
Zhenjiang
Jiangsu
4
A
+86 13775369530
Jie Ma1*, Zhengrong Zhou1, Xiao Xu1, Xiaochun Wang1, Yan Wu1, Xiaoli Jv1, Aihua Gong2*
1 Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
2 School of Outstanding Clinician, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
Corresponding Author:
Aihua Gong: Email: ahg5@ 163.com
Telephone: +86 13775369530
Address: School of Outstanding Clinician, Jiangsu University, Zhenjiang, Jiangsu, 212013
Jie Ma: Email: jsdxmajie@ujs.edu.cn
Telephone: +86 13775555586
Address: School of Medicine, Jiangsu University,
Zhenjiang, Jiangsu, 212013
Abstract
ABSTRAT
Background
A
Under the strategic framework of "Healthy China 2030", medical education must transition from a "Treatment-centered" paradigm to a "Prevention-Disease-Rehabilitation" holistic health model. Traditional medical education faces six core challenges: outdated training objectives, fragmented curricula, insufficient practical innovation, weak interdisciplinary integration, inadequate humanistic cultivation, and delayed competency adaptation. To address these issues, Jiangsu University has leveraged its comprehensive university resources since 2016.
Methods
Jiangsu University developed the "One Core with Dual Engines, Quintessential Competency Cultivation" clinical talent training system, which synergizes four key components: curricular integration to break disciplinary silos, pedagogical revolution to modernize teaching approaches, learning innovation to enhance practical skills, and humanistic integration to strengthen patient-centered values.
Results
The implementation of this model has successfully achieved three key outcomes: (1) implementation of comprehensive curricular restructuring on the "cell-tissue-organ-system" continuum, which transforms 16 discrete basic medical courses (69.5 credits/1048 hours) into 15 integrated organ system-based courses (51 credits/976 hours); (2) higher graduate program matriculation rates (49.09% overall; 76.06% in clinical medicine) and National Medical Licensing Examination pass rates (94.88% in 2023, surpassing national averages); and (3) markedly improved satisfaction, as evidenced by 98% employer satisfaction and 94% "excellent" ratings for graduate competency in national surveys.
Conclusion
By aligning medical education with societal health demands, the "Jiangsu University Paradigm" provides a replicable model for cultivating holistic healthcare professionals, offering valuable insights for medical education reform in China and beyond.
Keywords:
Medical Education
Health Professions Training Model
Curriculum Integration
Quintessential Competency Cultivation
Educational Reform in Medical Training
Introduction
The Guidelines on “Accelerating Innovation and Development of Medical Education issued by the General Office of the State Council” (2020) explicitly call for a shift in medical education toward a "health promotion-centered" model [1]. However, traditional medical education systems face six critical mismatches: outdated educational philosophy: overemphasis on disease diagnosis/treatment at the expense of preventive care and rehabilitation; fragmented curriculum design: disconnection between basic sciences and clinical courses[2–3]; didactic teaching dominance: overreliance on teacher-centered pedagogy, limiting students’ self-directed learning capacity[4–6]; inadequate practical training: insufficient clinical skill cultivation and underdeveloped innovative translational competencies[7]; deficient humanistic education: lack of structured professional identity formation and empathy training[8–9]; and the faculty capability gap: clinician-educators struggle with dual competency integration, clinical expertise and pedagogical skills[10–11].
In alignment with national policy directives, Jiangsu University initiated comprehensive reforms in 2016 to implement its “One Core with Dual Engines, Quintessential Competency Cultivation” model (Fig. 1), which was designed to develop versatile medical professionals with integrated clinical expertise, innovative capacity, and humanistic compassion.
Fig. 1
The New Era Medical Talent Training Model of "One Core with Dual Engines, Quintessential Competency Cultivation"
Methods
Connotation and Logic of the “One Core with Dual Engines, Quintessential Competency Cultivation”
Health Promotion-Oriented Medical Education Transformation. Breaking away from the “traditional disease-centered” paradigm, this reform comprehensively integrates the full-cycle health concept spanning "prevention-disease-rehabilitation" throughout medical training, establishing a "comprehensive health"-oriented curriculum framework that aligns with contemporary global standards in medical education.
Two-Tiered Educational Innovation. An organ-system-based curriculum was implemented, merging 14 foundational courses into 8 systemic modules to establish bidirectional knowledge chains spanning "basic to clinical" and "preventive to clinical" domains.
The "3C Educational Revolution" and the "4P Learning Model"
The “3C Educational Revolution” initiative implements a tripartite pedagogical framework to optimize clinical competency development: (1) Community-based learning expands educational boundaries through authentic early clinical exposures, where students conduct health outreach and chronic disease management in community settings, fostering population health perspectives before core clerkships; (2) Campus-based innovation requires > 10% curriculum devoted to case-based seminars while integrating virtual simulation platforms (e.g., the nationally recognized “Heart Failure Integrative Medicine Virtual Lab”); and (3) clinic-focused application leverages affiliated hospitals for enhanced bedside teaching and structured case analyses. This transformation quantitatively demonstrates the triple effects of spatial expansion (community‒campus‒clinic continuum), pedagogical modernization, and clinical immersion‒aligning with competency‒based medical education frameworks (Fig. 2).
Fig. 2
The "3C Educational Revolution" and the "4P Learning Model".
The "4P Learning Model" implements an evidence-based, multimodal pedagogy for developing autonomous learning ability and lifelong learning competencies: (1) Problem-based learning employs authentic clinical vignettes to stimulate self-directed inquiry, and (2) mutual perception-based learning integrates, in class, we deepen our understanding through visualization technologies such as VR anatomy systems and digital human systems. After class, we review and consolidate the classroom learning content through mutual physical examination and perception among students. (3) Practice-based learning engagement through open labs and innovation projects cultivates translational skills, whereas community health outreach (e.g., hypertension screening campaigns) demonstrates better participant satisfaction in service learning evaluations. (4) Project-based learning requires interdisciplinary team research that integrates basic-clinical knowledge through mentored capstone experiences, which is correlated with significantly higher collaboration competency scores (Fig. 2)[12–14].
Three-dimensional humanities cultivation framework
To bridge the gap in medical humanities education, we have developed an integrative "three-dimensional" (pandisciplinary, pancurricular, and panpractical) pedagogical framework that fosters intrinsic motivation and external engagement through emotionally resonant and knowledge-stimulating aesthetic education initiatives. This approach includes the implementation of specialized humanities courses such as narrative medicine, alongside thematic practice activities centered on the ethical imperatives of "compassion in continuity, life in perpetuity". By intertwining life education with scientific rigor and balancing knowledge assessment with value-based evaluation, this model ensures a holistic cultivation of professional competence and humanistic accomplishment, thereby enhancing the epistemological and ethical foundations of medical training while aligning with contemporary expectations of physicianhood.
Results
Curricular Integration and Restructuring
Jiangsu University has implemented comprehensive curricular restructuring on the "cell-tissue-organ-system" continuum, transforming 16 discrete basic medical courses (69.5 credits/1048 hours) into 15 integrated organ system-based courses (51 credits/976 hours) [15]. These 15 courses are as follows: Introduction to Clinical Medicine, Human Structure (I-II), Immune System, Human Function (I-II), Cell & Molecular Biology, Pathogenic Biology, Endocrine System, Nervous System, Reproductive System, Respiratory System, Urinary System, Digestive System, Circulatory System, Topographic Anatomy, and System Medical Experiment (I-III).
Human Structure I-II integrates Systemic Anatomy and histology; Human Function I-II combines Physiology, Biochemistry, Pathology, Pathophysiology and Pharmacology; Cell & Molecular Biology merges Cell Biology with Molecular Biology; Pathogenic Biology integrates medical Microbiology, Parasitology and relevant Pharmacology; the Reproductive System combines Embryology, Medical Genetics and Physiology; other system courses integrate discipline-specific physiology-pathology-pharmacology content; and the System Medical Experiment (I-III) is an integrated experimental course that is synchronized with the integration course each semester. The specific course settings are shown in Table 1.
|
Basic courses of clinical medicine before integration
|
Basic courses of clinical medicine after integration
|
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|
|
Course Name
|
Credit
|
Hour
|
Class
|
Experiment
|
Course Name
|
Credit
|
Hour
|
Class
|
Experiment
|
|
|
Cell Biology
|
4.0
|
60
|
45
|
15
|
Introduction to Clinical Medicine
|
1.0
|
16
|
14
|
2
|
|
|
Medical Genetics
|
2.5
|
38
|
30
|
8
|
Human Structure I
|
2.5
|
48
|
32
|
16
|
|
|
Systemic Anatomy
|
4.0
|
60
|
60
|
0
|
Human Structure Ⅱ
|
4.5
|
96
|
48
|
48
|
|
|
Embryology
|
3.0
|
45
|
45
|
0
|
Human Function Ⅰ
|
4.0
|
68
|
68
|
0
|
|
|
Pathology
|
4.0
|
60
|
60
|
0
|
Human Function Ⅱ
|
2.5
|
40
|
40
|
0
|
|
|
Biochemistry
|
5.0
|
75
|
55
|
20
|
Cell & Molecular Biology
|
4.0
|
72
|
56
|
16
|
|
|
Molecular Biology
|
2.5
|
40
|
25
|
15
|
Pathogenic Biology
|
5.0
|
96
|
64
|
32
|
|
|
Physiology
|
5.5
|
82
|
82
|
0
|
Endocrine System
|
2.0
|
32
|
32
|
0
|
|
|
Pathophysiology
|
3.0
|
45
|
45
|
0
|
Nervous System
|
3.5
|
56
|
56
|
0
|
|
|
Pharmacology
|
5.0
|
75
|
75
|
0
|
Reproductive System
|
2.0
|
32
|
32
|
0
|
|
|
Medical Immunology
|
4.0
|
60
|
45
|
15
|
Respiratory System
|
2.0
|
32
|
32
|
0
|
|
|
Pathogenic Biology
|
4.0
|
60
|
60
|
0
|
Urinary System
|
2.0
|
32
|
32
|
0
|
|
|
Topographic Anatomy
|
5.0
|
75
|
37
|
38
|
Digestive System
|
2.0
|
32
|
32
|
0
|
|
|
Morphological experiment
|
9.0
|
135
|
0
|
135
|
Circulatory System
|
4.0
|
64
|
64
|
0
|
|
|
Functional Experiment
|
6.5
|
100
|
0
|
100
|
Immune System
|
2.5
|
52
|
36
|
16
|
|
|
Pathogen experiment
|
2.5
|
38
|
0
|
38
|
Topographic Anatomy
|
3.0
|
64
|
32
|
32
|
|
|
System Medical Experiment I
|
1.0
|
32
|
0
|
32
|
||||||
|
System Medical Experiment II
|
1.5
|
48
|
0
|
48
|
||||||
|
System Medical Experiment III
|
2.0
|
64
|
0
|
64
|
||||||
|
Total
|
69.5
|
1048
|
664
|
384
|
Total
|
51.0
|
976
|
670
|
306
|
|
The curriculum incorporates preventive medicine courses (e.g., epidemiology, public health, and global health) and integrates chronic disease management and epidemiological principles into clinical case-based teaching. This pedagogical approach cultivates medical students' awareness of the "prevention-first" philosophy in healthcare, emphasizing the fundamental importance of disease prevention and health promotion.
Significant improvement in talent cultivation outcomes
The School of Medicine has demonstrated sustained educational excellence, with three years of data revealing progressive improvements in key outcomes. Matriculation rates into graduate programs have increased annually, reaching 49.09% overall (76.06% in clinical medicine) among students in the class of 2025, with significant placement at elite institutions, including Peking Union Medical College, Peking University, and Shanghai Jiao Tong University (Fig. 3A). The performance of China's National Medical Licensing Examination consistently ranked in the top 20% nationwide, with 2023 practical skills pass rates peaking at 94.88%—exceeding national averages across all exam components (theory, clinical skills, and overall) (Fig. 3B). External validation through MyCOS surveys revealed exceptional employer satisfaction (98%) and 94% "excellent" ratings for graduate competency. The scholarly achievements included > 50 provincial/national discipline competition awards, 24 National College Student Innovation Training Program projects, and more than 60 peer-reviewed publications. These metrics collectively demonstrate the vertical integration of academic rigor, clinical preparedness, and research capability development within our educational paradigm.
Fig. 3
Longitudinal analysis (2020–2023) of postgraduate admission rates (A) and physician licensure examination performance (B).
Optimization of Educational Resources and Faculty Development
The institution has cultivated stable, specialized, and internationally oriented faculty, with 65.1% of full-time instructors holding doctoral degrees, including 50 doctoral supervisors and 350 master’s supervisors, 70.1% of whom possess overseas academic training experience. Faculty competencies have been substantially enhanced, as evidenced by 20 provincial/national teaching competition awards and the emergence of nationally recognized model educators distinguished for teaching ethics and medical professionalism. Active engagement in pedagogical research has yielded three Medical Education Branch projects (Chinese Medical Association), three Ministry of Education industry-academia collaborations, three Jiangsu Province teaching reform initiatives, and over 50 peer-reviewed education innovation publications. Through integrated medical education governance and refined administrative mechanisms, the school has established more than 20 advanced teaching bases, including five affiliated hospitals, two national community health training sites, and more than 50 provincial/national key clinical specialties.
Impact of Educational Innovations
The institution's integrated curriculum reform has garnered significant recognition, with expert evaluations confirming its alignment with fundamental medical education principles, robust support of program objectives, and forward-looking design. Transformative achievements in health sciences translation have been profiled in “China Science Daily” and “Science Daily”, whereas “China Education Daily” highlights the exemplary integration of ideological-political education within medical training—demonstrating broad societal validation of pedagogical outcomes. Notably, the virtual simulation project "Heart Failure: An Integrated Medical Approach", developed through this curricular innovation, was designated among China's inaugural first-class undergraduate courses, with external learner engagement exceeding 3,000. The pedagogical model has been adopted by multiple medical schools, including Guangzhou Medical University, Zunyi Medical University, and Hainan Medical University, to achieve precision sharing of high-quality educational resources across institutions.
Discussion
Since 2016, Jiangsu University has pioneered a scientifically grounded and forward-thinking medical education paradigm anchored on the "prevention-diagnosis-rehabilitation continuum" within comprehensive health frameworks. Through sustained pedagogical implementation leveraging Jiangsu University's academic strengths, we have established an interdisciplinary platform that synergizes multicultural and cross-specialty elements to foster clinician-scientist development. This ecosystem facilitates the cognitive integration of knowledge, technical competencies, critical thinking, and medical humanities among trainees, ultimately driving health promotion-focused capability transformation—a paradigm that has demonstrably enhanced overall education quality metrics.
The School of Medicine pioneered the "3C + 4P" collaborative teaching mechanism, bridging community, campus, and clinical learning environments. This model expands students' educational scope beyond traditional classrooms into community and clinical, enhancing spatiotemporal learning dimensions while fostering population engagement and societal service competencies. A project-based approach facilitates problem-based knowledge conversion, where students implement solution-oriented tasks through iterative cycles of sensory perception, experiential immersion, and innovative reflection—transcending passive "instructor-led, student-receptive" models. The paradigm cultivates active participation, peer collaboration, and exploratory innovation, advancing cognitive processing from foundational memorization and comprehension to higher-order analysis, synthesis, and creation. This pedagogical architecture demonstrably enhances self-directed and lifelong learning capacities.
The School of Medicine addresses the persistent "technical proficiency over ethical cultivation" dilemma in medical training through its “Quintessential Competency Cultivation”, systematically integrating professional expertise with humanistic formation. Pedagogical innovations include Narrative Medicine modules to enhance clinician–patient empathic attunement, coupled with an aesthetic education paradigm employing "endogenous cultivation, exogenous integration" and "affective–cognitive synergy" mechanisms. This dual approach leverages visual/performing arts to stimulate metacognitive development during preclinical training, achieving synergistic development of students' technical mastery and ethical professionalism.
Conclusion
Jiangsu University has established an integrated "One Core with Dual Engines, Quintessential Competency Cultivation" clinical talent development system. This model facilitates the transition from a traditional closed learning environment to an open, multidimensional educational paradigm by implementing curricular integration and restructuring, the "3C Educational Revolution", the "4P Learning Model" and a comprehensive "Three-Dimensional Humanities Cultivation Framework” that connects community, campus, and clinical learning spaces [15–16]. Empirical evidence indicates that multiscenario rotational training enhances clinical competency development, while the fusion of professional and humanistic education is critical in shaping medical students' professional identity [17–18].
Moving forward, efforts will focus on deepening medical‒educational collaboration by strengthening resource coordination between affiliated hospitals and community training bases through a tripartite "hospital‒community‒university" management platform. Further innovation will involve developing intelligent course modules for clinical medicine, integrating artificial intelligence (AI) into curricula to reinvigorate teaching methodologies and advance digital education [19–21]. These initiatives aim to enhance students’ competencies in whole-cycle health management and cultivate a new generation of physicians proficient in prevention, diagnosis, and rehabilitation—ultimately contributing to the "Healthy China" initiative.
Conflict of interest statement
There are no competing interests to report by the authors of this work.
Acknowledgements
Jie Ma and Aihua Gong: conception or design of the work, final approval of the version to be published, Zhengrong Zhou: drafting the work, Xiao Xu and Yan Wu: revising the work, Xiaochun Wang and Xiaoli Jv: acquisition, analysis, or interpretation of data for the work.
Declaration of interest
statement
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
A
Funding
This work was supported by the Jiangsu Provincial Higher Education Reform Research Project under Grant 2025JGZZ014 and the Higher Education Reform Research Project of Jiangsu University under Grants 2025JGYB136 and 2023JGYB029.
A
Data Availability
The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
A
Author Contribution
Jie Ma and Aihua Gong: conception or design of the work, final approval of the version to be published, Zhengrong Zhou: drafting the work, Xiao Xu and Yan Wu: revising the work, Xiaochun Wang and Xiaoli Jv: acquisition, analysis, or interpretation of data for the work.
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