https://orcid.org/0000-0003-3431-1109
Figures
Abstract
Background
Acupuncture has gained global recognition as complementary and integrative therapy, but standardized education and training methods have not kept pace with its increasing application. Studies on systematic and effective acupuncture training approaches remain limited. We implemented and evaluated a newly designed acupuncture training program using a rapid prototyping instructional systems design (RPISD) model.
Methods
An acupuncture training program was developed using the RPISD model through needs analysis, prototype design, and development, and was then implemented with undergraduate Korean Medicine students (n = 88) in 2022/2023. Program effectiveness was evaluated through a mixed-methods design incorporating pre- and post-program assessments using a satisfaction survey, the Korean self-efficacy questionnaire measuring clinical communication skills (KSE-12), students’ practical examination score, and in-depth interviews. Quantitative and qualitative findings were integrated through a convergent mixed-methods approach to provide a comprehensive evaluation of educational effectiveness and to identify areas for improvement.
Results
Satisfaction was high, with 97.8% of 45 respondents expressing positive reactions to the program. Thirty-five students completed the communication questionnaire, with the total KSE-12 score significantly increasing after the course (p = 0.028). Students especially valued the hands-on practice and peer role-play, which improved their competencies in point location and clean needle technique. Interview findings also revealed areas for improvement, including allocating more time for practice and adopting a more gradual increase in learning content.
Conclusion
The acupuncture training program improved students’ clinical competencies including clean needle technique, point location finding, and communication skills. This systematic approach to acupuncture education offers a replicable model for integrating traditional practices with evidence-based instructional design. The findings support broader implementation in acupuncture education programs and warrant investigation of long-term skill retention and cross-cultural applicability to advance global acupuncture training standards.
Citation: Cho E, Nam Y, Hong J, Han Y, Kim J-H (2026) Implementing a competency-based acupuncture training program in Korean Medicine education. PLoS One 21(3): e0345289. https://doi.org/10.1371/journal.pone.0345289
Editor: Jenny Wilkinson, Endeavour College of Natural Health, AUSTRALIA
Received: August 28, 2025; Accepted: February 26, 2026; Published: March 20, 2026
Copyright: © 2026 Cho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting Information files.
Funding: This paper was funded by Wonkwang University in 2024. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors declare that they have no conflicts of interest.
Introduction
Acupuncture involving the insertion and manipulation of fine needles into specific points on the body has gained popularity worldwide as an integrative and complementary treatment in medical practice [1]. Systematic reviews have revealed various therapeutic areas of acupuncture therapy, including neurological disorders, connective tissue disorders, mental health, gastrointestinal disorders, and cancer [2]. Acupuncture is practiced not only in East Asian countries including China, Korea, and Japan, but also by physicians and professional acupuncturists in Europe according to regulations and insurance systems for acupuncture [3]. In the US, acupuncture by licensed acupuncturists and physicians for indications such as pain and allergies is covered by insurance in multiple states [4].
As acupuncture becomes increasingly institutionalized across global healthcare systems, growing attention has been directed toward how acupuncture is taught and learned. Recent literature has highlighted several structural limitations in existing acupuncture education, including fragmented curricula, lacking standardized competency frameworks, and limited opportunities for contextual and interactive learning [5,6]. Such challenges indicate the need for more systematic, learner-centered, and clinically grounded training models that can cultivate essential practical competencies.
In East Asia, acupuncture has traditionally been embedded within formal education systems of traditional medicine. [7]. Among these, South Korea offers a nationally accredited six-year Korean Medicine (KM) curriculum in which acupuncture is taught as a core component during one or two intensive years. Licensed KM doctors who complete this curriculum are authorized to practice acupuncture with national insurance coverage [8], and acupuncture remains one of the most commonly used treatment modalities in KM clinical practice [9]. However, despite its centrality in KM education, well-developed instructional methodologies for systematically cultivating clinical acupuncture competencies remain limited.
Within this curriculum, meridian and acupuncture point practice—where students gain foundational experience in palpation, point location, and basic needling—plays a crucial role. However, conventional practice sessions largely rely on instructor-centered demonstrations and basic point-location exercises, resulting in insufficient structured guidance, limited iterative practice, and inconsistent feedback mechanisms. In our prior analysis within the initial RPISD stages, we identified recurring challenges such as difficulty in locating acupoints, low confidence during needling, inadequate adherence to clean needle technique, and insufficient communication and coordination among students during practice [10,11].
To address these limitations and enhance students’ acupuncture proficiency, we adopted an instructional system design model from the field of educational technology and created a novel training program. The rapid prototyping instructional systems design (RPISD) model allows iterative and simultaneous development of educational materials through stakeholder feedback, in contrast to traditional linear models. Its flexible and feedback-driven structure makes it suitable for developing competency-based clinical training programs [12]. The present study aims to evaluate the implementation and effectiveness of a novel acupuncture training program designed using the RPISD model in KM education context. The findings will provide evidence-based teaching and learning strategies that can be applied in various acupuncture education settings.
Materials and methods
This study applied the RPISD model to design and evaluate an acupuncture training program. The model includes five overlapping phases: analysis, design and usability testing of early prototypes, development, implementation, and evaluation [12]. Rather than proceeding sequentially, these phases were conducted iteratively, with continuous refinement based on feedback from students, faculty, and subject matter experts. The early phases of analysis, design, and prototype development were previously described in detail [10,11]. This study focuses on the subsequent implementation and evaluation of the training program. Fig 1 outlines how each phase was applied in this study.
Design and development of the program
In the analysis phase, we conducted needs and task analyses to identify gaps between the current status (as-is) and ideal educational situation (to-be) regarding students’ knowledge, skills, and attitudes. Data was collected through student feedback, interviews, and direct classroom observations. Identified key performance gaps included inadequate infection control practices, low confidence in point location and needling techniques, and poor communication between the physician and patient role students. The resulting educational solutions incorporated individual CNT procedure performance, structured role-play guidelines for physician-patient-observer interactions, and peer-based assessment strategies [13]. Additionally, through task analysis, five learning objectives were established: 1) measure vital signs of the patient, 2) accurately locate acupuncture points on the 14 meridians, 3) perform acupuncture procedures hygienically and safely, 4) appropriately utilize medical tools and devices required for the procedure, and 5) accurately record the procedural details.
We designed the first prototype lesson plan using peer role-play, George’s five methods for teaching clinical skills [14], and the Objective Structured Clinical Examination (OSCE) as instructional strategies. The initial prototype was developed for the topic of ‘auricular acupuncture’, and usability testing was conducted through interviews with clients, students, and subject matter experts. After the usability testing, the revised lesson plan included more specific roles for doctors and observers in each class session [10].
Incorporating client requirements, the 1-year acupuncture training program was organized into four major topics: Clean needle technique and needling techniques, Measuring vital signs, Locating acupuncture points and needling, and Acupuncture techniques. Subsequently, we developed teaching and learning manuals including lesson plans for each of the four topics, class guidelines, and equipment utilization protocols [15]. Clean needle technique and needling techniques and measuring vital signs are covered in the early part of each semester, with locating acupuncture points and needling on the 14 meridians comprising the majority of the curriculum. Additionally, various acupuncture, moxibustion, and cupping techniques are addressed (S1 File).
Implementation of the acupuncture training
The program was implemented as a regular one-year course at the College of Korean Medicine, Wonkwang University, South Korea. The course was conducted over two semesters: the second semester of 2022 (45 students) and the first semester of 2023 (43 students), with different student cohorts participating in each semester. The two cohorts did not differ significantly in baseline characteristics, including age (p = .767), gender (p = .546), and overall GPA in the preceding semester (p = .158).
Manuals were provided via Google Classroom, and paper versions were provided in class. Students watched a video lecture with hands-on demonstration before class and took notes on the tasks they would perform during class. Roles were assigned in each class: one observer, at least one patient, and the rest physicians.
Each class session was structured into three phases: introduction, development, and wrap-up. In the “introduction” phase, students did preparations: washing their hands, putting on bed sheets, placing the group supplies near the bed, and obtaining informed consent from the patient. The teacher presented the class’s learning objectives. In the “development” phase, the teacher demonstrated the procedure for finding acupuncture points and performing acupuncture, following which students practiced finding acupuncture points and performing acupuncture in groups (Fig 2). Students then conducted peer OSCE to check their performance and receive feedback from students acting as observers, teachers, and teaching assistants. In the “wrap-up” phase, students cleaned up, organized the supplies used, and completed a post-procedure checklist. After class, each group was given practice notes that included the results of the observer’s hygiene and safety checks, how the physicians found and needled each acupuncture point, and the patient’s experience (Fig 3).
Students are divided into groups with assigned roles: observers (who evaluate performance using checklists), patients (who provide feedback on communication and comfort), and physicians (indicated as ‘doctor’ in the figure, who practice acupuncture point location and needling techniques). This role rotation system allows all students to experience different perspectives while developing clinical competencies in a safe learning environment.
The one-year acupuncture training program (3 hours/week, 15 weeks/semester, 2 semesters) follows a systematic approach with pre-class online learning, structured in-class activities, and post-class portfolio submission. Each class session includes three phases: introduction (preparation and meditation), development (teacher demonstration followed by peer role-play practice), and finish (peer OSCE assessment and wrap-up). Communication skills were assessed using the Korean Self-Efficacy questionnaire before and after the program, with practical examinations conducted at semester end. Student reactions and feedback were collected through surveys and interviews to evaluate program effectiveness.
Evaluation of the acupuncture training program
This study was approved by the Institutional Review Board of Wonkwang University (WKIRB-202208-SB-069). All participants were recruited via student representative announcements and provided written informed consent prior to participation. The recruitment periods for survey participants were August 30, 2022 (the second semester of 2022, conducted over a single day), and March 7, 2023 (the first semester of 2023, conducted over a single day), while the recruitment period for interview participants was from July 1 to July 12, 2023. A convergent mixed-methods research design was employed to evaluate whether the training program achieved its intended learning objectives. We used Kirkpatrick’s reaction evaluation [16] to judge the program’s effectiveness by conducting surveys and interviews to acquire both overall and in-depth responses. Written informed consent was obtained from students who participated in surveys and interviews.
Data collection and analysis
To collect students’ reactions to the program, we used survey items from previous literature, adapted to suit the present study [13,17,18]. The survey included 27 multiple-choice (program’s usefulness, adequacy of learning materials, etc.) rated on a 5-point Likert scale (strongly agree to strongly disagree) and five open questions (S2 File). Surveys were done at the end of each semester with participants. Responses with missing items were excluded for reliability. The internal consistency of the instrument was high (Cronbach’s α = .923).
Communication skills were assessed using the validated Korean version of the self-efficacy questionnaire (KSE-12) [19], administered in the first and last weeks of each semester for pre-post comparison. Axboe et al.’s SE-12 questionnaire [20] measures healthcare providers’ communication skills during patient interactions. The 12 items in KSE-12 are rated on a scale of 1–10 (1 = very uncertain, 10 = very certain). The internal consistency of the KSE-12 in this study was high (Cronbach’s α = .934). A paired t-test or Wilcoxon signed-rank test was used to compare KSE-12 scores before and after class.
To determine our program’s effectiveness, we examined students’ scores of practical examination pre- and post-implementations. Although the test was conducted at the same grade level using the same checklist, the results were only used as reference data due to the different target students. All quantitative data were analyzed and presented using R statistical software (version 4.2.2, R Core Team, 2024) and GraphPad Prism (version 10.2.2; GraphPad Software, Boston, MA, USA).
For qualitative interviews, purposeful sampling initially selected participants representing diverse academic performance levels and program engagement, followed by snowball sampling to recruit additional participants with varied backgrounds. This combined approach was employed to ensure varied perspectives on the training experience. The main interview questions were set as “What are the strengths of this course?” and “What are the weaknesses and improvements of this course?” In-depth, one-on-one interviews were conducted online, each lasting approximately one hour. All interviews were audio-recorded and transcribed verbatim with participants’ informed consent.
The interview data were analyzed according to Braun and Clarke’s six steps of thematic analysis: Familiarization of data, generation of codes, combining codes into themes, reviewing themes, determining significant themes, and reporting of findings [21]. In the event of disagreement among researchers when generating codes or themes for the interview data, the codes were revised through discussion and consensus.
Finally, qualitative and quantitative results were integrated and compared in accordance with the objectives of this program.
Results
Satisfaction with the program
Overall satisfaction with the program reached 97.8%, with most items receiving positive responses above 80%, including usefulness of learning materials, appropriateness of learning activities, and communication in class. However, positive responses were fewer than 50% regarding the adequacy of time allocated to each training stage and pre-class videos (Table 1). Open-ended responses on reasons for satisfaction included the class being “well organized,” “writing practice notes,” and it would be “helpful in clinical practice.” Regarding the effectiveness of the teaching method, students stated they were “able to practice efficiently through flipped learning” and they favored “the practice based on the professor’s demonstration.” Almost 98% of respondents agreed that the purpose and content of the acupuncture training were in line with the objectives. For improvement, “more time for students to practice in class” was recorded.
Communication self-efficacy
The average KSE-12 total score significantly increased from 82.43 ± 17.09 before the course to 88.89 ± 13.27 after the course (p = 0.028). The mean scores for each of the 12 items all increased after the course, but the statistically significant results were shown in items 5 (“encourage the patient to express thoughts and feelings”’) (p = 0.029), 6 (“structure the conversation with the patient”) (p = 0.015), and 10 (“check patient’s understanding of the information given”) (p = 0.044) (Table 2, S3 File).
Changes in practical examination scores
The total score on the practical examination was higher after implementing the newly designed program, although different students took the test. Items that increased after the program included the process and accuracy of acupuncture point location, safety of the patient, and communication with the patient. Specifically, the total practical examination score increased from 48.47 ± 10.10 to 54.63 ± 8.28. The most substantial improvements were observed in the process of acupuncture point location (13.76 ± 3.59 to 16.09 ± 3.24, p < 0.001) and accuracy of acupuncture point location (13.45 ± 3.41 to 16.30 ± 3.01, p < 0.001). Notable enhancements were also seen in communication with the subject (3.13 ± 1.06 to 3.80 ± 0.48, p < 0.001) and safety of the subject (3.16 ± 0.98 to 3.75 ± 0.49, p < 0.001), indicating improved clinical competencies aligned with the program’s learning objectives (Table 3, S4 File).
Qualitative results
Thematic analysis of the interviews revealed four main themes related to the strengths of the course and four themes concerning weaknesses and suggested improvements (Table 4).
Strengths of the course. First, students experienced self-reflection in various roles. Observers watched and recorded other students’ performance, enabling them to ascertain what others did well or not, which stimulated reflection on their own practices. Students who played the role of ‘patients’ realized the importance of communication, such as providing reassurance to help them relax during treatment.
I thought it was really important to relax the patient when I am doing acupuncture as a physician, so I thought a lot about the importance of communicating with the patient, so I tried to do a lot more of that. (Student 3)
Second, students’ ability to locate acupuncture points and perform acupuncture improved due to hands-on practice. Repeated practice in a safe, supervised environment appeared to enhance their clinical performance.
Actually, I think the biggest benefit of the practice is that we’ve never held a needle before, so it’s good to be able to practice the most basic acupuncture skill, and (...) I think I was really nervous at first putting the needle on someone else’s body, but I think it’s good to be able to practice it over and over again and get a little more comfortable with it. (Student 2)
Third, the learning was well structured by the course’s learning manual. Students said that, since this was their first experience with acupuncture practice, they might have been confused about the practical steps they should perform. The manual assisted them to optimize their performance because it was organized systematically.
I felt very strongly that everything was programmed in a very structured way, so I think that was a huge benefit. I think that (the manual) allowed us to do more standardized and optimal practice in a way. (Student 6)
Fourth, students established hygiene and safety habits. An objective of the course was “to be able to perform acupuncture procedures hygienically and safely.” Students had to check and confirm their compliance with hygiene and safety management (hand sanitizing, wearing lab coats, preparing and organizing supplies, etc.). The students reported that these habits were naturally formed through repeated hygiene and safety management activities, and that they felt confident with the Clean Needle Technique (CNT).
Now I know what it takes to do a procedure on a patient in a more stable environment, I can do it if I follow the same steps as in the practice settings (...) It’s a great way to learn more about CNT. (Student 2).
Limitations and solutions of the class. Four suggested weaknesses and improvements of the course have been received from students. First, more time was needed to practice acupuncture point finding and acupuncture. Sometimes, 20 acupuncture points had to be found in a single class, leaving insufficient time for all students to practice it. Reducing the time spent on other class activities and increasing time for acupuncture practice was identified for improvement.
I think we were a little more pressed for time because we were discussing and trying to figure out where to put the needle. I think we’re running out of time. (Student 3)
Second, it is necessary to gradually increase the volume of learning content per week. Students were at first unfamiliar with the practice, so activities such as CNT took a long time. Toward the end of the course, they have adapted to the relevant practices. Students consequently suggested reducing the amount of learning content at the beginning and increasing it toward the end. Thus, more time should be allocated for preparation and adaptation to the practice of acupuncture at the beginning of the course and the extent of learning content should be increased toward the end of the course.
In the beginning it can be time consuming with the CNTs, but we get more comfortable with the CNTs and the phases of practice towards the end of the course, so I would like them to be a little bit flexible and elastic with the time, for example reducing the number of acupuncture points at the beginning of the course and increasing it a little bit towards the end of the course. (Student 6)
Third, more opportunities for students to observe instructor demonstrations should be allowed. Further to instructors’ demonstration, students wanted to observe instructors’ demonstrations up close. For optimal practice, instructors and tutors should rotate among groups to demonstrate procedures and provide detailed feedback based on individuals or groups’ learning needs.
When we practiced on our own, we felt stuck, but when the professor held our hands and placed the needles, the needles really went in, so I think if the professor helped us more at the side, we would have gotten better at placing the needles. (Student 1)
Fourth, strategies to facilitate pre-class learning are required. Students watched instructional videos and filled out practice notes as pre-class learning activities. These pre-class learning activities were not included in the assessment score, and students were encouraged to learn on their own. However, students who lack self-directed learning skills may perform poorly in pre-class learning, so it is necessary to develop special strategies such as quizzes and rewards for pre-class learning. The volume of pre-class learning should be adjusted so that students do not feel overburdened, but pre-class learning should be encouraged by promoting students’ internal or external motivation.
I think if there was an assignment to make sure that everyone had done their pre-class learning, it would have made the practice go smoother (...) Sometimes I couldn’t watch the video and I was a little bit unprepared, so I wish there was something to do pre-class learning before the practice. (Student 5)
One respondent said of peer OSCE: “There were a lot of things I didn’t realize, and I was able to get feedback on a lot of things from a peer’s perspective, which helped me fill in the gaps.” (Student 1). The practice notes they recorded after classes were helpful because students were provided with “an objective evaluation of their performance, communication, and attitude” (Student 2) by their peers, and the feedback and reflection helped them understand what they needed to improve (S5 File).
Data integration
Integration of quantitative and qualitative data revealed convergent, enhancing, and mixed findings across the three main objectives of the training program (Fig 4). First, the ability to ‘identify the acupuncture point location on the meridian’ was confirmed to be achieved based on both in the survey and interview. Second, improvements were seen in the outcomes on ‘performing acupuncture procedures hygienically and safely’, indicating that the program was effective in teaching students to perform acupuncture in hygienic and safe ways. Third, the findings on the ‘ability to use tools and devices’ were mixed, with neutral responses and small score differences.
Discussion
This study aimed to provide an in-depth understanding of the implementation methods, effectiveness, and future improvements of a novel acupuncture training program in South Korea. The integrated findings show that the program is especially effective for performing hygienic and safe acupuncture. It is the first study to evaluate the effectiveness of a program developed using an instructional systems design model in undergraduate KM education. The findings of this study may provide an essential reference for future acupuncture training curricula.
The program included several strategies: flipped learning, a 5-step model for teaching procedural skills, peer role-play, and peer OSCE. Flipped learning is necessary for efficient skill training and hands-on practice in intensive healthcare curricula [22]. Our pre-class learning videos focused on finding acupuncture point locations, clean needle techniques, and acupuncture procedures. The survey results indicate overall satisfaction with the flipped classroom. In class, George’s 5-step model was used except for step 4 (“Students talk through the skill”) [14] to account for insufficient practice time. Breaking down each part of a skill into smaller units and teaching them sequentially in structured steps [23] has been effective in teaching clinical skills in KM education [24,25].
In acupuncture training, practice with human subjects is essential because using a model provides limited authenticity [26]. Therefore, we established groups comprising students as patients and observers to ensure adherence to procedures. This role-playing experience encouraged students to engage in self-reflection. We used peer OSCE to relieve anxiety associated with OSCE and to allow eight groups to work simultaneously with only one teacher [27]. Our interviews suggest that peer OSCE enables students to “fill the gaps” from peers’ viewpoints. This supplements traditional apprenticeship methods for skill acquisition by learning from both teachers and peers [28].
Another major benefit of the program is that it could enhance students’ communication skills. Communication skills are essential in acupuncture practice as practitioners are required to effectively explain procedures, obtain informed consent, provide reassurance during treatment, and establish therapeutic relationships with patients. Since inadequate communication between students in physician and patient roles emerged as a major performance concern in our ‘analysis’ phase, we evaluated communication self-efficacy at the beginning and end of the semester. Total communication self-efficacy scores improved after the course. Notable improvements were seen particularly in three areas: encouraging the patient to express thoughts and feelings, structuring the conversation with the patient, and checking patient’s understanding of the information given. These specific enhancements indicate that patient-physician role-play effectively develops essential communication skills required throughout the overall clinical encounter [29]. The mean total score (88.89 ± 13.27) in our study was similar to those measured in a previous study of senior students at the same university who had clinical practice training by peer role-play (89.37 ± 15.22) [30]. This is because students learn to communicate respectfully through role-playing [31,32], which becomes habitual, and they continually reflect on their attitudes.
The significant improvements in practical examination scores, particularly in point location accuracy and communication skills, align directly with the core learning objectives of our designed program using RPISD model. The convergent findings (Fig 4), where quantitative improvements correspond with qualitative reports of enhanced point location competency and safety practices, suggest these changes reflect systematic training effects rather than random variation. While different student cohorts in this study present a limitation, the specific pattern of improvements in areas directly targeted by our structured training approach supports the program’s effectiveness.
Student satisfaction survey revealed specific strengths and areas for improvement in program implementation. High satisfaction rates for learning material usefulness (91.1%) and appropriateness of learning activities (93.4%) indicate that the designed content effectively met students’ educational needs. The positive responses to peer OSCE activities (97.7%) and communication quality (84.5% for instructor-student, 88.9% for student-student) validate the collaborative learning approach in our design.
Notably, students did not have sufficient time to practice. This finding is supported by satisfaction scores for time allocation during different class phases, where only 42.2% of students found the introduction session time adequate, while 20% felt the group exercises and wrap-up time was insufficient. To address this issue, teachers’ demonstrations and explanations must be completed within the allocated time. As some students felt hands-on training in a group was more effective than demonstrations to the whole class, demonstration and hands-on practice should be balanced.
While most students indicated that the content alignment between pre-class and classroom learning was appropriate and enhanced their understanding of the classroom practice, 26.6% responded that the average class time for online learning (typically over one hour per session) was inadequate. Furthermore, 15.6% found the learning videos insufficiently engaging to facilitate learning, and interviews revealed similar concerns about pre-class motivation. These responses suggests that practical content should be redesigned into shorter microlearning modules to reduce student burden while enhancing engagement [33]. Future designs should segment content into 5–10 minute modules focusing on anatomical regions, where each video demonstrates point location techniques for related acupoints within the same body area, with interactive gamified quizzes between modules to reinforce learning and reduce cognitive burden [34]. This approach aligns with evidence showing microlearning effectiveness for novel skill acquisition [35].
Although this study provides valuable insights into the effectiveness and areas for improvement of a novel acupuncture training program, its limitations are acknowledged. A limitation of the study is that the effectiveness of the training program was evaluated using different student cohorts. Accordingly, future studies should follow the same cohort of students to more accurately examine whether individual students’ procedural competencies genuinely improve as a result of the program. Furthermore, future longitudinal studies should investigate long-term skill retention and clinical application of the competencies acquired through this training program. Follow-up assessments during students’ clinical rotations would provide valuable evidence regarding the transfer of learned skills to actual patient care settings.
Despite these limitations, this study presents an educational model and strategies that can be utilized in acupuncture curricula and general clinical skills training. It is recommended that experts and stakeholders review the validity of this model. Objective evaluations of students’ performance would be required. As acupuncture continues to gain global acceptance, establishing standardized yet culturally appropriate training methodologies becomes increasingly important. This study demonstrates that systematic instructional design can enhance traditional teaching methods without compromising their essence. Further research is needed to assess the feasibility and effectiveness of the program when applied to other regions and professions that use acupuncture.
Conclusion
This novel acupuncture training program supports the development of core competencies for acupuncture in clinical practice. However, the primary contribution of this study lies not in demonstrating effectiveness per se, but in detailing how an acupuncture curriculum was systematically designed, implemented, and iteratively refined using the RPISD framework. Through surveys and in-depth interviews, we demonstrated that the program facilitated the establishment of hygiene and safety practices and enhanced students’ communication skills and competency in locating acupuncture points. The design principles and implementation insights presented in this study may be useful for acupuncturists, traditional Chinese medicine practitioners, and conventional physicians who require additional training in acupuncture.
Supporting information
S1 File. Lesson plans and manuals for teachers and students.
https://doi.org/10.1371/journal.pone.0345289.s001
(DOCX)
S2 File. Survey questionnaire and script of semi-structured interview.
https://doi.org/10.1371/journal.pone.0345289.s002
(DOCX)
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