Chinese University of Hong Kong Faculty of Medicine

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Chinese University of Hong KongFaculty of
Medicine
No endeavor worth doing can be completed without
cooperative effort D Johnson
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Tomorrow's Doctor
The necessary . . .
Knowledge
Skills
Attitudes
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The revised medical curriculum

• Faculty owned (vs departmentally developed)
• Design
• Scope and topics
• Timetabling
• Lecture materials vetted by Faculty to reduce
• Duplication
• Omission
• Compression
• Assessment

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System-based, integrated knowledgeEnhanced
skills affective development
Core curriculum is designed delivered by
11 system panels
3 skills panels
clinical modules
Attitudes Ethics professionalism
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Active learning

• Small group sessions (gt 2/3 of student contact
  time)
• Life long learning skills
• Computer literacy
• Evidence-based medicine
• phrasing clinical questions, electronic library
  search, critical appraisal, integrate research
  findings into clinical decision making
• Web-enhanced learning
• Selective study modules 30 of curriculum
• networking, organizational independent research
  skills

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Percent
Passive Active Passive
Active
Curricula
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Early clinical contact smoother transition to
internship

• Early clinical contact yr 1
• Ward visits
• Clinical skills laboratory
• Real patient contact
• Transition to internship
• Pre internship end of yr 5

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Faculty-owned student assessment

• Continuous assessments
• Tutorials, Seminars, Practicals
• Debates
• Family follow-up project
• Formative assessments
• Web-based MCQs
• Summative assessments
• Skills
• OSCEs OSPEs
• Poster verbal presentations (SSM)
• Knowledge
• end of panel
• end of yr integrated paper

• Continuous assessment used
• to facilitate learning
• to monitor progress
• by panels
• by self
• to reduce stress
• contribute to final grade

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Year 1 Year 2 Year 3 Year 4
Year 5
Jr Med Surg Clerkship
Sr Med Surg Clerkship Med
Surg Subspecialties
CF Med OG Paed Psy AE
Selected Study Modules
Skills communication, clinical, life long
learning
Cardio-resp, GI-Nutr, Health-Soc, Homeostasis,
Musculoskeletal
Foundation

Haem- Inf- Imm, Mechn Disease Neuroscience
Reproduction, Sex, Development Growth
Human Structure
Language, IT, PE
3rd Prof Exam II
1st Prof Exam
2nd Prof Exam
3rd Prof Exam I
Pre-internship
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Proportional allocation to knowledge, skills
attitudes across years
Yr 1 Yr 2 Yr 3 Yr 4 Yr 5
Yr 1 Yr 2 Yr 3 Yr 4 Yr 5
Basic Medical Clinical Sciences
Attitudes
Clinical Skills
Clinical Skills
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Structured Interview

• Personal aspiration and motivation for
  expectation of a career in medicine.
• General knowledge about medicine
• the science, the profession, the health care
  system.
• Appreciation of moral ethical issues.
• Social cooperative spirit
• teamwork and community involvement
• Communication language skills.

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Selection Criteria for Interview

• JUPAS applicants
• HKCEE results 5As 2Bs
• HKALE results
• School Principals Nomination Scheme
• Sports Excellence Scheme
• Self-nomination Scheme
• Disabled Student Scheme

• EAS applicants
• HKCEE results 7As

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Selection Criteria for Interview

• Non-JUPAS applicants
• GPA gt 3.5
• First class honour
• GCE O-level 6As
• GCE A-level 4As

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Selection for Admission

• JUPAS applicants
• 60 on WGPA
• 40 on interview score

• EAS applicants
• Interview score only

• Non-JUPAS applicants
• Interview score only

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Ongoing Review of Admission Process

• Workshop at annual faculty curriculum retreat
• review discuss current issues
• Improve interview validity reliability
• briefing and instructions for new interviewers
• structured interview, independent marking
• decrease variability of panel performance
• statistical review of individual performance
• On-going statistical comparisons
• entry scores and undergraduate performance

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Selections Admissions

• 8-10 applicants per available place in MED 1
• Initial selection based on academic results
• 3 interviewed for each place
• JUPAS minimum standing approx HKCEE 5A2B
• Non JUPAS minimum standing. GPA gt 3.5 O levels
  6A
• 450-500 interviews per yr

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Admissions Interview

• Same structured interview for all short listed
  applicants
• Two interviewers, 15 min, in English
• motivation for expectations of medicine
• knowledge of health care
• appreciation of moral and ethical issues
• sociability, teamwork community service
• communication ability language

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Interview rating by WGPA
Best Interview Score 50, Best WGPA 1 (A1)
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Ranking for Admission

• JUPAS
• 60 WGPA and 40 interview
• Non-JUPAS
• interview only
• difficult to compare the different entry
  qualifications
• EAS
• interviewed first time 2002
• under review

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Ongoing Review of Admissions

• Workshop at annual faculty curriculum
• review discuss current issues
• Improve validity and reliability of interview
• briefing and instructions for new interviewers
• structured interview, independent marking
• decrease variability of panel performance
• statistical review of individual performance
• Ongoing analyses
• entry scores and undergraduate performance

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Ensuring Clinical Competence

• Early clinical exposure
• Clinical skill laboratory
• Log-book
• Interactive web-based clinical case study
• Pre-internship program
• Intern education

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System-based Integrated Curriculum
1 2 3 4 5
Nervous Disorder
Medicine
Basic Clinical Skills
SPS
SSM
Surgery
Child Health
Human structure
SPS
SSM
SPS
Medicine
Reproductive Medicine
Subject Panel Study
Selected Study Module
Surgery
Mobility
SSM
Clinical Experience
Clinical Experience
Final MB
ENT/Eye/ Skin/ID
Pre-intern training
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Early Clinical Exposure
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Clinical Skill Lab
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Teaching in Clinical Skill Lab
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Logbooks (hard soft copy versions)
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(8) New Entry
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(4) Summary Count
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(2) Module 4 Logbook
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(10) View Grand Round List
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An Interactive Web-based Clinical Case Scenario
Fracture Through A Cyst Does this look like a
cyst there is a periosteal reaction? Is it
common to have such a reaction with a simple cyst
?
Students cannot move on to the next stage unless
they submit their answer
Teacher assesses individual student responses
provides guidance
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Pre-internship Program 2002
11 April (Pre-test)
25 May (Post-test)
HOLIDAY
24 May
1 July
17 April
4 May
7 May
Module 1
Module 2
5 weeks
3 weeks
3 weeks
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Pre Internship Activities (17 April to 24 May
2002)
Mon Tues Wed Thurs Fri Sat
AM Ward Rounds Practicing Basic Procedures Ward Rounds Practicing Basic Procedures Ward Rounds Practicing Basic Procedures Ward Rounds Practicing Basic Procedures Ward Rounds Practicing Basic Procedures
PM 4S APEP 4S 4S
400-500 Patient and Family Communication Patient and Family Communication Patient and Family Communication Patient and Family Communication Patient and Family Communication
Ward Rounds Practicing Basic Procedures
4S APEP 4S 4S
Patient and Family Communication
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Pre-internship
Pre- Post Assessments
Cross Matching
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Internship Training

• Orientation
• Supervisors
• Logbook
• Practice tips workshops
• Mock interview

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Blood Taking
Hospital Phlebotomists
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Averaged Quarterly Assessments of Interns Skills

• 1996 - 2002

Percentages
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Monitoring Evaluation
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Benching Marking

• Locally
• International schools of high repute

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Comparing CUHK, UAlberta Licensing Groups

CUHK
Alberta
Licensing Group
100
90
80
70
60
50
40
30
20
10
0
Surgery
OG
Basic Science
Total
Components of Licensing Examination using
UAlbertas MCQs
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Comparing CUHK, UAlberta Licensing Groups
Percent
Section of the Examination Using Albertas Items
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Comparing CUHK, UAlberta Licensing Groups

Sections of the MCQ Examination Using Albertas
Items
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Randomized Controlled Educational Trials

• Determining impact of newly introduced pedagogy
• e.g. web-based enhanced learning

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Difference between Intervention Control Groups
Statistically Significant
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Pre and Post Trials (Historical Cohorts)

• Performance of interns compared
• 2 alumni groups prior to curriculum revisions
• 1 alumni group following changes in yr 5
• 3 week professional enhancement module
• 6 week pre internship

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Mean of Overall Performance in ALL Hospitals
Difference is statistical significant at ?
0.05.
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Clinical Judgement in ALL Hospitals
Difference is statistical significant at ?
0.05.
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Pre and Post Trials (Historical Cohorts)

• Performance of students compared
• 3 yrs prior to curriculum revisions
• 1 group following changes in yr 1

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I deepened my interest in the subject matter of
this course item 120
Strongly Agree Agree Slightly
Agree Slightly Disagree Disagree Stro
ngly Disagree
Percentile Points for all Class Medians for
Medical Year One Only
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The objectives of the course were clearly
defined item 276
Strongly Agree Agree Slightly
Agree Slightly Disagree Disagree Stro
ngly Disagree
Percentile Points for all Class Medians for
Medical Year One Only
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Overall, I am satisfied with the course item
812
Strongly Agree Agree Slightly
Agree Slightly Disagree Disagree Stro
ngly Disagree
Percentile Points for all Class Medians for
Medical Year One Only
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Monitoring

• Regardless of directions found
• an evidence-based approach
• has informed curriculum instructional designs
• will continue to do so

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Chinese University of Hong KongFaculty of
Medicine
No endeavor worth doing can be completed without
cooperative effort D Johnson