Teaching Development Grant

Abstract
Brief write-up

Abstract

Starting in 2015, a new bioethics education program for undergraduate medical students began development orchestrated by the Faculty of Medicine. Bioethics teaching has traditionally been developed within Euro-American contexts. As such, the historical lack of relevance to the cultural and socioeconomic realities of Hong Kong hindered the applicability of the learning material and the extent of student engagement in the curriculum. What is more, hands-on learning in applying ethical principles in the clinical setting proved inadequate as ethical issues are rarely touched on at the bedside modules designed for medical students. As a result, students graduated from medical school with insufficient understanding and experience in handling bioethics issues.
There exists an opportunity to enhance experiential learning, engage students and increase the applicability of the teaching material as a part of the new bioethics curriculum currently under development. To meet these needs, we will develop new teaching approaches in bioethics comprised multidimensional teaching methods including development of documentary videos comprehensively illustrating local bioethics cases in clinical settings, guided small group discussion-based seminars and reflective essays to explore students' attitudes towards ethical issues. This new teaching approach can facilitate experiential learning, ethical reasoning and critical thinking skills, as well as real connections with the bioethical issues present at the local level.
The new approach of bioethics teaching will allow our medical students to become physicians equipped with the globally recognized skills of appreciation of diversity and cultural influences that impact patients' interaction with medical care, as well as communication and collaboration at both the patient and societal levels.
The outcome of the new developments in bioethics education project will be evaluated both quantitatively and qualitatively based on student essays, group-based activities, and simulated case studies that require definitive action on the part of the student.

Brief write-up

Project objectives

A new teaching approach – narrative medicine using illustrating genuine local cases of bioethical issues in Hong Kong is created. In the regular teaching, documentary videos depicting the real patients’ clinical situations are used to supplement the clinical ethics curriculum, followed by in-class small group interactive discussions and students’ submission of reflective essays to explore their attitudes towards these ethical issues. This new approach to clinical teaching facilitates much needed experiential learning in ethical reasoning for final year medical students.

Activities, process and outcomes

We initially planned to produce 4 micro-modules in the format of documentary videos on the following topics: (1) Organ donation; (2) End-of-life care; (3) Confidentiality; and (4) Medical Error. We failed to find an appropriate real patient who experienced the effect of medical error during the project period. As a result, two end-of-life cases were produced, with one focusing on the ethical issue related to the communication with the patient and the other focusing on the communication with the patient’s family.

Deliverables and evaluation

No.	Expected key activities/ deliverables/ outcomes	Evaluation
1	Four Micro-modules of bioethics education	The 4 micro-modules have been produced, however, the content of the material was only used in real time online teaching. The micro-modules can be further enhanced to suit the need for online self-learning purposes.
2.	Incorporation of the four micro-modules into the pre-clinical and clinical bioethics curriculum.	The bioethics curriculum in the pre-clinical years have been shifted to the CUHK Blackboard eLearning platform in the academic year of 2020-21. Some of the content of the 4 micro-modules can be used to illustrate important ethical concepts in the pre-clinical curriculum. The 4 micro-modules can give excellent guidance on ethical reasoning to medical students and prepare them to participate in the newly developed teaching activities of ethical debates for clinical year medical students.
3.	Evaluation of the new teaching approach in bioethics education	As face-to-face teaching is not allowed due to the COVID-19 pandemic, the quantitative and qualitative evaluation of the newly developed teaching material was delayed to the 2^nd and 3^rd quarters of 2022.
4.	Dissemination of the new teaching approach in bioethics education	The process and outcome of the project were presented at the four regional and international conferences: · Asia Pacific Medical Education Conference 2021 · Asia Pacific Bioethics Education Network (APBEN) Conference 2021 · Teaching and Learning Innovation EXPO 2021. · Asia Pacific Bioethics Education Network (APBEN) Conference 2022s

Dissemination, diffusion, impact and sharing of good practices

Conference	Organizer	Format	Title of presentation
Asia Pacific Medical Education Conference 2021	Centre for Medical Education NUS Yong Loo Lin School of Medicine, Singapore	Oral Presentation	Experiential learning in bioethics: Using Documentary Video Depicting Clinical Encounters with real patients
Asia Pacific Bioethics Education Network 3^rd Annual Conference 2021	Asia Pacific Bioethics Education Network, Deakin University, Australia	Oral Presentation	Experiential learning in bioethics: Using patient interview video
Teaching and Learning Innovation Expo 2021	The Chinese University of Hong Kong, Hong Kong SAR, China	Oral Presentation	Using Patient Case Video Vignettes to Explore Goad of Medicine and Value of life
Asia Pacific Bioethics Education Network 4^th Annual Conference	Asia Pacific Bioethics Education Network, The Chinese University of Hong Kong, Hong Kong SAR, China	Conference Workshop	Ethical Issues arising from Culture in a clinical context

Impact on teaching and learning

Students who have tried out the newly developed teaching materials gave positive responses to the outcome of the project. They have requested additional case vignettes for teaching and learning. Qualitative and quantitative analysis of students’ experience and satisfaction are postponed due to the COVID-19 pandemic. Similar to other clinical teachings, the element of experiential learning in bioethics teaching can engage students and enhance their interest and understanding of ethical issues in clinical practices.