BackgroundInterprofessional learning is gaining momentum in revolutionizing healthcare education. During the academic year 2015/16, seven undergraduate-entry health and social care programs from two universities in Hong Kong took part in an interprofessional education program. Based on considerations such as the large number of students involved and the need to incorporate adult learning principles, team-based learning was adopted as the pedagogy for the program, which was therefore called the interprofessional team-based learning program (IPTBL). The authors describe the development and implementation of the IPTBL program and evaluate the effectiveness of the program implementation.MethodsEight hundred and one students, who are predominantly Chinese, participated in the IPTBL. The quantitative design (a pretest-posttest experimental design) was utilized to examine the students’ gains on their readiness to engage in interprofessional education (IPE).ResultsThree instructional units (IUs) were implemented, each around a clinical area which could engage students from complementary health and social care disciplines. Each IU followed a team-based learning (TBL) process: pre-class study, individual readiness assurance test, team readiness assurance test, appeal, feedback, and application exercise. An electronic platform was developed and was progressively introduced in the three IUs. The students’ self-perceived attainment of the IPE learning outcomes was high. Across all four subscales of RIPLS, there was significant improvement in student’s readiness to engage in interprofessional learning after the IPTBL. A number of challenges were identified: significant time involvement of the teachers, difficulty in matching students from different programs, difficulty in making IPTBL count towards a summative assessment score, difficulty in developing the LAMS platform, logistics difficulty in managing paper TBL, and inappropriateness of the venue.ConclusionsDespite some challenges in developing and implementing the IPTBL program, our experience showed that TBL is a viable pedagogy to be used in interprofessional education involving hundreds of students. The significant improvement in all four subscales of RIPLS showed the effects of the IPTBL program in preparing students for collaborative practice. Factors that contributed to the success of the use of TBL for IPE are discussed.Electronic supplementary materialThe online version of this article (10.1186/s12909-017-1046-5) contains supplementary material, which is available to authorized users.

Despite advances in artificial intelligence-based diagnostics, ophthalmic clinical skills remain an important acquisition during medical school. Simple ophthalmic examination techniques allow future non-ophthalmic physicians to make timely referrals to ophthalmologists for sight-threatening diseases. Currently, the coronavirus disease 2019 (COVID-19) pandemic poses a serious public health crisis worldwide and an immediate challenge to traditional methods of medical education. With the present threat of disease transmission, face to face small group tutorials are not feasible, especially in the context of ophthalmic clinical skills, which requires close contact between the examiner and the patient.Prior to the outbreak, we introduced ophthalmic clinical skills to second-year pre-clinical undergraduate medical students in the form of face to face demonstrations of techniques by a clinical tutor. A recent published study reported that, video-based materials and written materials were synergistic in enhancing ophthalmic clinical skills and knowledge acquisition in an undergraduate medical programme. 1The objective of our adaption was to introduce video-based and written materials to precede and complement Zoom™ (Zoom Video Communications Inc., San Jose, CA, USA) platform-based small group tutorials. Our aim was to identify advantages and difficulties with this new approach as a necessary replacement for traditional face to face small group clinical demonstrations during the COVID-19 pandemic. | WHAT WA S TRIED?We taught ophthalmic clinical skills to second-year undergraduate medical students, including the visual acuity assessment with near Snellen chart, pupil examination, confrontation test for visual field, extraocular movement examination and direct ophthalmoscope examination. In order to replace face to face 2-hour group tutorials during the COVID-19 outbreak, we devised a three-pronged approach to provide an effective learning experience for our undergraduate medical students. First, for each examination technique, we included written information regarding: (a) technique; (b) physical signs demonstrated; (c) common mistakes by medical students, and (d) clinical relevance. Second, we recorded a video of a clinical teacher demonstrating the techniques on a surrogate patient. We uploaded both written material and videos on the e-learning platform of our medical school. Third, after going through the online materials, the students were split into small groups of 30 students for a single 60-minute tutorial with a clinical teacher on the Zoom cloud-based video conference platform. During the tutorial, the teacher went through each key ophthalmic clinical skill and highlighted important points, pitfalls and clinical knowledge. The last 10 minutes were reserved for questions from students. Using the private message function, students were able to send live questions as they maintained anonymity. Assessment was conducted at the end of the block in the form of objective structured clinical examination (OSCE) stations. | ...

Video triggers are preferred by both students and facilitators over paper cases in PBL.

BackgroundTo provide patient-centred holistic care, doctors must possess good interpersonal and empathic skills. Medical schools traditionally adopt a skills-based approach to such training but creative engagement with the arts has also been effective. A novel arts-based approach may help medical students develop empathic understanding of patients and thus contribute to medical students’ transformative process into compassionate doctors. This study aimed to evaluate the impact of an arts-making workshop on medical student empathy.MethodsThis was a mixed-method quantitative-qualitative study. In the 2011–12 academic year, all 161 third year medical students at the University of Hong Kong were randomly allocated into either an arts-making workshop or a problem-solving workshop during the Family Medicine clerkship according to a centrally-set timetable. Students in the arts-making workshop wrote a poem, created artwork and completed a reflective essay while students in the conventional workshop problem-solved clinical cases and wrote a case commentary. All students who agreed to participate in the study completed a measure of empathy for medical students, the Jefferson Scale of Empathy (JSE) (student version), at the start and end of the clerkship. Quantitative data analysis: Paired t-test and repeated measures ANOVA was used to compare the change within and between groups respectively. Qualitative data analysis: Two researchers independently chose representational narratives based on criteria adapted from art therapy. The final 20 works were agreed upon by consensus and thematically analysed using a grounded theory approach.ResultsThe level of empathy declined in both groups over time, but with no statistically significant differences between groups. For JSE items relating to emotional influence on medical decision making, participants in the arts-making workshop changed more than those in the problem-solving workshop. From the qualitative data, students perceived benefits in arts-making, and gained understanding in relation to self, patients, pain and suffering, and the role of the doctor.ConclusionsThough quantitative findings showed little difference in empathy between groups, arts-making workshop participants gained empathic understanding in four different thematic areas. This workshop also seemed to promote greater self-awareness which may help medical students recognize the potential for emotions to sway judgment. Future art workshops should focus on emotional awareness and regulation.

SBP variability, irrespective of the mean SBP level, is a potential predictor for the development of CVD and all-cause mortality in patients with diabetes. In addition to monitoring BP targets for their patients with diabetes, clinicians should also remain vigilant about the visit-to-visit fluctuation of BP.

HD was associated with a greater negative impact of ESRD on daily lives than was PD, which may be a consideration when deciding on the dialysis modality for first-line renal replacement therapy. To improve HRQOL among patients on maintenance dialysis, more attention should be paid to those with demographic risk factors, preventing CVD, and meeting clinical dialysis outcome targets such as hemoglobin and albumin levels.

AimThe aim of this study was to evaluate the validity, reliability and sensitivity of the disease-specific items of the Kidney Disease Quality of Life-36 (KDQOL-36) in Chinese patients undergoing maintenance dialysis.MethodsThe content validity was assessed by content validity index (CVI) in ten subjects. 356 subjects were recruited for pilot psychometric testing. The internal construct validity was assessed by corrected item-subscale total correlation. Confirmatory factor analysis (CFA) was used to confirm the factor structure. The convergent validity was assessed by Pearson’s correlation test between the disease specific subscale scores and SF-12 version 2 Health Survey (SF-12 v2) scores. The reliability was assessed by the internal consistency (Cronbach’s Alpha coefficient) and 2-week test–retest reliability (intraclass correlation coefficient (ICC)). The sensitivity was determined by performing known group comparisons by independent t-test.ResultsThe CVI on clarity and relevance was ≥ 0.9 for all items. Corrected item- total correlation scores were ≥0.4 for all, except an item related to problems with access site. CFA confirmed the 3-factor structure of the disease-specific component of the KDQOL-36. The correlation coefficients between the disease-specific domain scores and the SF-12 v2 physical and mental component summary scores ranged from 0.328 to 0.492. The reliability was good (Cronbach’s alpha coefficients ranged from 0.810 to 0.931, ICC ranged from 0.792 to 0.924). Only the effect subscale was sensitive in detecting differences in HRQOL between haemodialysis and peritoneal dialysis patients, with effect size = 0.68.ConclusionThe disease-specific items of the KDQOL-36 are a valid, reliable and sensitive measure to assess the health-related quality of life of Chinese patients on maintenance dialysis.

Background: Peer physical examination (PPE) is commonly used in clinical skills teaching to allow students to practice physical examination techniques on each other. Previous studies have demonstrated medical students' generally positive attitudes towards PPE, but the correlation between student attitude and actual practice of PPE has yet to be examined. Aim: To determine if a positive student attitude towards PPE leads to subsequent action. Methods: The target population were MBBS I students (2006-2007 cohort) admitted to the Li Ka Shing Faculty of Medicine, The University of Hong Kong. Student attitude towards PPE and subsequent practice of PPE were assessed through self-completed written questionnaires before and after the compulsory Clinical Skills Programme (CSP). Results: A total of 100/128 (78%) students completed both questionnaires, of which 83 (65%) could be linked to demographic data. All study participants were ethnically Chinese. A high level of willingness to conduct PPE persisted before and after the CSP for both male and female students. However, more than half of the students did not subsequently examine various non-intimate body regions of a fellow student during the CSP. Female students were more likely to exhibit attitude-behaviour inconsistency. Conclusion: The existing positive attitudes towards PPE need to be harnessed so that more students are encouraged to follow through and actually practise PPE, thus realizing the educational benefits of this activity. This may be done by ensuring that PPE is conducted in a safe setting while being conscientious of gender differences. Scheduled time and the use of a logbook may be useful to facilitate students practising PPE.