Many medical schools in Taiwan have adopted a dignified “silent mentor” initiation ceremony to strengthen student’s medical humanity and increase their learning attitudes. This ceremony consists of introductions of the body donor’s conduct and deeds, wreath-laying, and a tea party. However, few empirical studies have examined the influences of the ceremony and dissection on medical humanity. This study explored if the initiation ceremony and the course can help students care more about others, develop more positive attitudes toward death, improve learning effectiveness in the course, and decrease negative emotions the first time they see a cadaver. The Attitudes Towards Death and Love and Care subscales of the life attitude inventory, Learning Effectiveness of Gross Anatomy Laboratory Scale (LEGALS), and Emotional Reactions Towards Cadavers Scale were adopted to examine differences before (T1) and after (T2) medical students attended an initiation ceremony at a university in northern Taiwan. Whether these effects lasted to the end of the semester (T3) was also tested. After the ceremony, students’ attitudes towards death increased, negative emotions towards cadavers decreased, but love and care and the LEGALS did not significantly change. Data from T3 showed a similar pattern, but high-level emotions (e.g., being respected, cherished, and grateful) and the LEGALS were significantly higher than those at T1. The initiation ceremony, which showed a body donor’s deeds and attitudes toward life and death when they were alive, could help medical students gain more mature attitudes towards death and decreased negative emotions. Learning between T2 and T3 might have caused significant changes in high-level emotions and the LEGALS at T3. Arranging reflective writing with guided discussion by a teacher before and after the ceremony is highly recommended.

Background: The COVID-19 pandemic brought a new challenge to medical education—health-care students had fewer opportunities to interact with and treat real patients in clinical settings. Interpersonal communication skills are often developed through human interaction and communication in person, and few studies have proposed feasible digital solutions to develop learners’ communication skills. Consequently, understanding how medical teachers facilitate and implement online training programmes, with feasible instruments, to enhance students’ learning effectiveness when in-person training is not possible is critical. Methods: By using a convenience sampling method, we recruited 26 health-care students from seven medical schools in Taiwan. Through semistructured interviews and the thematic analysis technique, we analysed the latent learning factors from the experience of implementing the technology-enhanced experiential e-learning tool ‘mPath’. Results: Three themes were generated: A) transferring theory into practice, B) increasing authenticity with analytical features, and C) maintaining autonomy with nondirective learning. The features accessibility, flexibility, intractability, and visualisation with the characteristics of remote accessibility and flexibility, repetition and retrospect, feedback requesting, and visualised analytical reports were considered to enhance learning outcomes. Conclusion: This study indicated how online training using technology could develop the participants’ person-centred communication skills and what features influenced the learning outcomes of social distancing. mPath may be a feasible online learning approach and has provided inspiration for developing health-care students’ communication skills when in-person training is not possible.

Early clinical exposure (ECE) is viewed as a way to provide contexts of basic science and highlight its relevance to medical practice. However, very few studies have specifically looked into how the ECE experience contributes to students’ academic performance. The purpose of this study was to investigate whether ECE experiences (external cause) or students’ learning attitudes (internal cause) more closely correlated with medical students’ academic performance. Subjects who participated in the study comprised 109 s-year students at Taipei Medical University. Fifty of the 109 study participants were enrolled in an elective ECE program. The dependent variable in this study was the test score of a systems-based basic sciences (SBBS) course. Independent variables of the study included students’ attitudes and test anxiety towards the SBBS course, engagement/length of time spent in ECE, and the ECE learning environment. Data of students’ engagement in ECE, levels of their motivational beliefs and test anxiety, differences in the ECE learning environment, and the SBBS final test scores of these 109 respondents were collected for hierarchical multiple regression (HMR) analyses. Results of the HMR analyses revealed that students’ test anxiety towards basic science and also the learning environment of the ECE had significant positive predictive power on their SBBS test scores. This study discovers that medical students’ academic performance in basic science correlates not only with their anxiety to testing, but even more so with the clinical environment they are exposed to. Hence we suggest including further investigations about different learning environments on ECE experiences in future studies.

In Taiwan, there are three major dentist occupation problems: a surplus of dentists, an uneven regional distribution of dentists, and a concentration of dentists in the metropolitan areas. The purpose of this study was to evaluate the distributions of the population and dentists in each city or county in 2001, 2010 and 2019 to further analyze the changes of regional distributions of dentists 9 years after the implementation of postgraduate year training program for dentists (PGYD) in 2010 in Taiwan. This study collected the data of population, the number of dentists in each city or county in 2001, 2010 and 2019, and the numbers of dentists and dental institutions from 2001 to 2019 for evaluating the changes of regional distributions of dentists 9 years after the PGYD implementation in Taiwan. Nine years after the PGYD implementation, the uneven distribution of dentists persisted. The number of dentists still increased and dentists were more concentrated in municipalities than in non-municipalities in Taiwan. Moreover, the number of dental institutions increased slowly, but dental institutions tended to become larger. Because the PGYD system is not mandatory, dentists choose their practice locations as driven by the market factors. The increase in the average number of dentists in dental institutions is also driven by the market factors. The market-driven movement of dentists to the people-concentrated municipalities finally persist the imbalance of dentist distribution in Taiwan. This situation also enables the development of large-scale dental institutions in municipalities in Taiwan.

Dental care has been officially incorporated into the hospital accreditation system in Taiwan since 2015. The geographical distribution of dentist manpower still remains in an unbalanced status as shown by the dentist-to-population ratio. This study tried to assess the dental manpower issue in terms of the status of hospital dentistry, and hence provided two organizational-level suggestions with their policy implications. This study utilized the secondary data analysis to evaluate the dental manpower in dental departments of medical centers, regional hospitals, and district hospitals in different regions of Taiwan in October 2019. Our results found that the dental manpower including the numbers of general dentists and dental specialists was highest in medical centers, followed by regional hospitals and district hospitals. Moreover, the dental resources and manpower were mostly concentrated in the northern region of Taiwan, followed by the central and southern regions of Taiwan, the eastern region of Taiwan, and offshore islands. The hospital dentistry in Taiwan develops toward large-scale and specialization. Both hospital general dentists and dental specialists are concentrated in the medical centers, especially the medical centers in the northern region of Taiwan, indicating the problem of oversupply in the northern Taiwan and unbalanced distribution of dentists among the regions in Taiwan. Therefore, the responsibilities of the hospitals in metropolitan areas are to develop the elderly and disabled dentistry and to assist with oral health promotion and oral disease prevention in remote areas to reduce the urban-rural gap in dental resources in Taiwan.

Taiwan is facing a huge urban-rural gap in the human resources of dentists between cities and counties. Although the postgraduate year training program for dentists (PGYD) was implemented in Taiwan in 2010, the uneven distribution of dentists is still a serious problem. The purpose of this study was to evaluate the distributions of overall dentists and dental training institutions and their dentists (so-called institutional dentists) in each city and county in 2019 to further analyze the regional distributions of overall dentists and institutional dentists in Taiwan. This study collected the numbers of dentists, dental training institutions, and institutional dentists in each city and county in 2019 for evaluating the regional distributions of dentists and institutional dentists in Taiwan. The numbers of dentists and institutional dentists in municipalities were significantly higher than those in non-municipalities in Taiwan, respectively. The coefficient of variation was greatest for dentists in the single-system institutions (1.72) and program-management institutions (1.87). The coefficients of correlation between the dentist index and institutional dentist index were R2 = 0.9805 (P < 0.001) for municipalities, R2 = 0.4523 (P < 0.01) for non-municipalities, and R2 = 0.7691 (P < 0.001) for nationwide. The dentist manpower and dental training institutions are concentrated in municipalities of Taiwan. The quantitative and qualitative improvement of collaborating institutions in the PGYD system may have an influence on the distribution of new-entry dentists and contribute to establishment of an effective regional dental health care service.