Abstract
The traditional lecture-based medical education is difficult to apply in undergraduate ophthalmology because of the limited I-week attachment period and the very different nature of the subject compared with other core specialties (e.g. internal medicine). Exposure to suitable and relevant cases are not ensured. Currently, 16 standard case scenarios are taught semi-passively in a "case tutorial" class (the teacher will go through the cases and questions are usually answered by a few active medical students). There is a need to engage all the students to participate actively in the case discussion.
Our proposal will combine the concept of flipped classroom and hands-on practice by 1) pre-class gamified e-learning materials; 2) in-class problem-based learning (PBL, digitalised clinical cases with relevant clinical photos and animations, guided by the teacher); and 3) after-class social community work. Base on the e-learning materials, students can revisit and apply the knowledge through several case scenarios during the PBL session. The students and the teacher will work as a team to go through these cases and solve the clinical problems. Key points will be emphasised by the teacher. In-depth discussion and revision of the relevant clinical skills will also be possible. Interested students can join the after-class community service (cooperating with the Medical Outreachers Hong Kong [MOHK]), to serve the society and to practice ophthalmologic examination skill under supervision. This combination can achieve 1) fun learning, repetition and application of the core knowledge; 2) enhancement of student-teacher interaction; 3) motivating self-learning and enhancing learner's autonomy; and 4) application of knowledge and skill to serve the society. The effectiveness of the project will be measured by student scores in post-course assessment, Likert scale questionnaires, and qualitative-translational impact assessment. The teaching concept and learning model will be disseminated through conferences, workshops, publications, and media. We aim to promote this concept and model to other university departments and local educational institutions of all levels.
Brief write-up
Project objectives
To design, apply, and evaluate the effectiveness of a new system of teaching ophthalmology to undergraduate medication students (a flipped classroom problem-based learning [FC-PBL] system) that consisted of (1) pre-classroom eLearning (including teaching videos and gamified cases); (2) classroom PBL case discussion; and (3) outside classroom community service with a randomized controlled trial study design.
Activities, process and outcomes
Created a teaching website that consists of pre-classroom materials (14 teaching videos and 9 gamified e-learning cases). A total of 216 final year medical students were randomised to be taught with the new system (FC-PBL group) or the traditional system (control group) (108 students in each group). Students in the FC-PBL group showed a significantly higher satisfaction with their tutor-student communication, teaching materials, instructional methods, course outcomes, course workload, and the tutors in the FC-PBL group obtained higher Course and Teaching Evaluation (CTE) scores (all with P≤0.003). The FC-PBL showed non-inferior MCQs scores compared with the control group. The pre-classroom materials will be available on our departmental website and will be readily available for all CUHK medical students soon.
Deliverables and evaluation
We created the learning website and it will be available on our department website in June 2022 (
https://master.d3fl8hc1jesi7p.amplifyapp.com/). Students and tutors find the teaching materials and new teaching system helpful and enjoyable. Apart from fulfilling the study objective and KPIs, the teaching materials proved helpful during the cancellation of clinical attachment and face-to-face teaching during the COVID-19 pandemic.
Dissemination, diffusion, impact and sharing of good practices
One presentation in the CUHK Teaching and Learning Innovation Expo 2021 and one in a department retreat (19.5.2021). We are preparing two manuscripts for submission. We plan to share our practice in media once one of the submissions is accepted in index journal.
Impact on teaching and learning
(1) the teaching materials are reusable;
(2) the system enhances the students’ and teachers’ experience;
(3) the project team is now adding patient’s experience in the PBL cases and this will be something that the students could not learn from textbooks; and
(4) the project inspired the development of other teaching projects, including enhancement of the new teaching system (UGC VTL: 3212131), development of an online surgical workshop (TDLEG: 4170744), and a teaching programme for postgraduate students (TDLEG: 4170879).
