Evaluating the confidence level of Traditional Chinese Medicine in nursing undergraduates at Chinese medical university^†

Traditional Chinese medicine (TCM) originated in China and has been developed for at least 5000 years, for which time it has been continually making significant contributions to medical care and public health.^[1] Nowadays, TCM finds a high degree of acceptance among a steadily increasing number of Chinese people and even foreigners worldwide, which has been made possible owing to the relentless efforts of the Chinese government along various directions, such as formulating strategies and preparing documents conductive to TCM development. In these strategies and documents, it has been specifically mentioned that TCM undergraduates play a key role in developing TCM. They are required to undergo a comprehensive and systematic education in TCM, and once qualified, most of them will work in the medical field. Therefore, the extent to which they can make original contributions to the development of TCM will largely be determined by the extent up to which they believe in TCM.^[2]

Nursing is a highly demanded occupation, and is on the first-line of essential patient services. Hence, the quality level of nursing care may influence the extent of trust that patients place on the medical system as a whole. Most lectures designed for nursing belong to Western medicine, which is guided by nursing-study objectives.^[3] However, nursing in Shanxi Medical University has a TCM specialty, and thus all nursing students need to obtain some degree of exposure to TCM lectures.

However, the scientific research in this field is sparse, and there is a lack of data revealing undergraduates’ TCM confidence, especially that among nursing students. In the present study, the participants are nursing junior-undergraduates from Shanxi Medical University. The aim is to observe their TCM confidence level, to improve their TCM education, and finally to enhance students’ TCM contributions.

According to multiple instances of documentation in the literature, self-confidence in TCM should manifest in the form of a better understanding of Chinese traditional culture, knowledge of the unique features of TCM diagnosis and treatment, presence of a positive and acceptable emotion toward TCM, and a proper perspective on the correlation between TCM and western medicine; additionally, confidence in the future development of TCM and willingness to make original contributions to TCM are further manifestations.^[5,6,7] Based on such theories and former studies, the questionnaire of the present study was designed and checked by educational and TCM experts, and the validity index was high.

The results of the present study indicated that the cognitive level of TCM culture and theories was not high (mean score below 4), and most participants answered “know a little” and “partly know”. On the other hand, when they knew the advantages and characteristics of TCM diagnosis and treatment very well (mean score >4), about 85% participants chose “mostly agree” and “completely agree”. The reason may be that the knowledge of TCM advantages and characteristics is easy to acquire, but theories are comprehensive and relatively hard to understand.^[8] Additionally, lectures and activities related to TCM culture were sparse.

Surprisingly, about 70% of students felt “very proud” of the TCM achievements, especially in effectively preventing and treating Novel Coronavirus. The explanation may be that the students had been witnessing the rapid expansion and intensification of the Covid-19 infection spread, and also the enormous suffering that it imposed on people; subsequently, they also witnessed the problem coming under control owing to the administration of TCM, and people vastly benefitting from the same.

Generally, the participants in this current study had sensible attitudes toward the correlation between TCM and Western medicine (mean score 4.27 ± 0.99). However, in about 50% of participants, there was an absence of clarity about the characteristics and advantages of TCM when combined with Western medicine in treating diseases. This leads us to suggest that, to improve nursing students’ knowledge in and ability for advantageously combining these 2 systems of medicine in the prevention and treatment of diseases, the university needs to strengthen education on such aspects, the final result of such a measure being the provision of better medical services to the public.^[9,10]

The data of this study also showed that the nursing students were confident with regard to the development of TCM in the future, and were willing to involve in TCM related works (the mean score was around 4). Thus, results may be taken as an indication that provision of TCM education to nursing students may be a meaningful measure to incorporate within the overall task of bringing the benefits of TCM to the public by supplying them with quality TCM health care.^[11,12] Additionally, according to the results, it seems that gender, age, living place, and family background of TCM do not have an effect on the confidence concerning TCM.

The strength of the present study was that a relatively full picture of TCM confidence was obtained from 6 aspects focused on nursing students at a TCM University. The majority of the nursing students had confidence in TCM, especially in the aspects of understating TCM advantages and characteristics in diagnosis and treatment, and feelings toward TCM achievements. However, some aspects, such as the understanding of TCM culture and theories and the correlation between TCM and Western medicine, may need to be enhanced through TCM education. The limitation was that the number of participants was comparatively small. In the future, more participants with different grades and majors may need to be involved in studies to observe the level of TCM confidence.