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In the past times, doctors used to do “look, smell, ask and touch” four steps skills based on traditional Chinese medicine theory when they do diagnosis to the patients. But now, auscultation and palpation are necessary for clinical basic skills and they are also important and difficult for teaching in diagnosis teaching of medical schools, which is my opinion through my many years medical teaching experience.

In 1950s China, students learnt auscultation and palpation in traditional ways that theory teaching was taught in class firstly, then students did the practice of auscultation and palpation to learn normal signs each other in the terms of two person- one team, and for learning pathological and abnormal signs, they would go to the affiliated hospitals or teaching hospitals to learn from typical patients. However, with patients’ legal minds and self-protection ideas promoting, more and more patients are starting to refuse students to do practice on their bodies. Since that only ventriloquist, auscultation audio and video recording are instead. Take precordial thrill palpation for example, it is like the feeling of vibratory sensation while touching cat neck and feeling cat breathing, which is also called “purring thrill”. Totally speaking, it is very difficult to learn auscultation and palpation and create qualified and good doctors. To solve this problem, based on American medical teaching experience of using simulators to do training, we, with China Medical University and Beijing Medical University professors’ help, have collected mass of typical patient cases and developed hundreds of Lung, heart and abdominal auscultation and palpation simulators with computers, which are used popularly in hundreds of China medical schools and hospitals. From then on, while computer technology developing, we spent two years to finish thoracic and abdominal comprehensive teaching system developing with the support by experts of China Northeast University and Dalian Technology University, which is of many 2D, 3D carton demonstration pictures for thoracic and abdominal inspection theory teaching and lung, heart and abdominal auscultation and palpation training. It is completely close to clinical diagnosis. 

At that time, these simulators were recommended highly by Mrs. Qinping, Zhao who was minister of China Education Ministry and Mr. Jun Lu who was Secretary-general of China Physicians Association. Under the support by China government, China Education Ministry made a policy that “practical teaching must be necessary to improve the teaching level”. Nowadays, all medical universities have set up clinical skills training labs in China and government allocates a large of funds to purchase these lab equipments every year. 

First of all, such labs were started at Beijing,China Medical University and Tianjin Medical University.

At universities’ Labs, teacher console and 25 students consoles are needed. And teacher can guide the students to learn theory and do the auscultation and palpation skills training and gives students internet test directly by teacher console. The system also can be attached with a projector to give students a vivid lesson with pictures, contents, audios and videos. Now we also have developed wireless simulators with laptops which are more convenient and full the variety of China medical teaching.



Reference list:

1: 《诊断学》 作者:　陈文斌。 人民卫生出版社 出版时间:2013年03月 《 Dignostics》 by Wenbin Chen



2:　《诊断学》临床技能培养的现状与对策　　　作者:王宏天　(河南中医学院)　发表于“中国科教创新导刊”　2014年No2 (China Education Innovation Herald, 2014 No2)



3: 中医学专业《诊断学基础》技能操作教学的现状与思考 作者: 周艳丽 李英琴 (黑龙江中医药大学佳木斯学院)发表于 “科学论坛”



4:《临床诊断学》 作者:欧阳钦 人民卫生出版社 出版时间:2010年7月

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