Title:

Exploring the Online Learning Interactions Among Medical Students During a Self-Initiated Enrichment Year.

Period:

January 8-12, 2020

Dr Julie Chen, Dr Pauline Luk, Mr Francis Tsoi, Ms Joyce Tsang

Background:

Increasingly, medical schools are recognizing the potential of a holistic, experiential curriculum to nurture the professional development of their students. Beginning in 2018-19, the entire third year class of medical students at the LKS Faculty of Medicine embark on a mandatory, credit-bearing enrichment year of their own choosing. This novel initiative allows all students an opportunity for substantive engagement in a personal area of interest related to research, service or humanitarian work, pursuit of a higher degree, or university exchange anywhere in the world. An online virtual community of learning was developed to provide learning and social support to students and to help them link their diverse experiences with the common goal of being a doctor. This study aims to examine the nature, pattern and content of online interactions among medical students within the community of learning to identify features that support learning and personal growth.

Methods:

This was a mixed method, quantitative-qualitative study involving the most active teams in the virtual community of learning housed on the proprietary platform “Workplace”. Each team was comprised of 6-8 medical students and a faculty mentor. They worked on 3 compulsory discussion-based learning modules from September 2018-April 2019. Platform data analytics were used to determine the frequency, timing, duration, content of the interactions while social network analysis was used to establish the pattern of interactions. These quantitative data were triangulated with the written and oral feedback as well as comments compiled from focus group interviews with the faculty mentors and medical students.

Results:

Five teams were identified as the most active. The nature of their interactions were predominantly text-based and centred on social support, professional knowledge exchange, and information dissemination. Image-based messages attracted more attention and stimulated more constructive discussion. The pattern of interactions were visually represented in a social network analysis. It showed that the active teams could have single-centered interaction or multi-centred interaction with each representing different team dynamics. This was associated with effectiveness of collaboration and completion of tasks. The qualitative feedback and interviews also indicated that proactivity by even one team member, participation by the team mentor, responsiveness and social/non-academic discussions fostered a positive team dynamic and a positive online learning experience, regardless of whether the team interaction was primarily single-centred or multi-centred.

Conclusions:

Online interactions that are less structured, relate to personal interests and use multimedia appear to generate the most meaningful content and do not necessarily need to have a leader to be effective. A structured online network that adopts these features can better support learners who are geographically separated and engaged in different learning experiences.

Title:

Re-imagining Medical Education: An Enrichment Year in the Core MBBS Curriculum

Period:

10 December, 2019

Professor Chak-sing Lau (Leader), Dr. Julie Y. Chen, Professor Gilberto K.K. Leung, Dr. George L. Tipoe and Dr. Gordon T.C. Wong

https://tl.hku.hk/2019/12/2019-teaching-excellence-awards

Title:

Burden of chronic kidney and cardiovascular diseases on life expectancy and health service utilization - A cohort study of Hong Kong Chinese hypertensive patients.

Period:

6 - 8 December, 2019

EYF Wan, Esther YT Yu & Weng-Yee Chin et al.

Background:

The relative effects of combinations of CKD, heart disease, and stroke on risk of mortality, direct medical costs, and life expectancy are unknown.

Methods:

In a retrospective cohort study of 506,849 Chinese adults in Hong Kong with hypertension, we used Cox regressions to examine associations between all-cause mortality and combinations of moderate CKD (eGFR of 30-59 ml/min per 1.73 m2), severe CKD (eGFR of 15-29 ml/min per 1.73 m2), heart disease (coronary heart disease or heart failure), and stroke, and modeling to estimate annual public direct medical costs and life expectancy.

Results:

Over a median follow-up of 5.8 years (2.73 million person-years), 55,666 deaths occurred. Having an increasing number of comorbidities was associated with incremental increases in mortality risk and medical costs and reductions in life expectancy. Compared with patients who had neither CKD nor cardiovascular disease, patients with one, two, or three conditions (heart disease, stroke, and moderate CKD) had relative risk of mortality increased by about 70%, 160%, and 290%, respectively; direct medical costs increased by about 70%, 160%, and 280%, respectively; and life expectancy at age 60 years decreased by about 5, 10, and 15 years, respectively. Burdens were higher with severe CKD.

Conclusions:

This study demonstrated extremely high mortality risk and medical cost increases for severe CKD, exceeding the combined effects from heart disease and stroke. Mortality risks and costs for moderate CKD, heart disease, and stroke were similar individually and roughly multiplicative for any combination. These findings suggest that to reduce mortality and health care costs in patients with hypertension, CKD prevention and intervention merits priority equal to that of cardiovascular disease.

DOI: 10.1681/ASN.2018101037

Title:

Five-Year Effectiveness of the Multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM) on Diabetes-Related Complications and Health Service Uses—A Population-Based and Propensity-Matched Cohort Study.

Period:

1 June, 2019

Eric YF Wan, Colman SC Fung & Esther YT Yu et al.

Background:

To evaluate the 5-year effectiveness of a multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM) in primary care patients with type 2 diabetes.

Research Design and Methods:

A 5-year prospective cohort study was conducted with 121,584 Chinese primary care patients with type 2 DM who were recruited between August 2009 and June 2011. Missing data were dealt with multiple imputations. After excluding patients with prior diabetes mellitus (DM)-related complications and one-to-one propensity score matching on all patient characteristics, 26,718 RAMP-DM participants and 26,718 matched usual care patients were followed up for a median time of 4.5 years. The effect of RAMP-DM on nine DM-related complications and all-cause mortality were evaluated using Cox regressions. The first incidence for each event was used for all models. Health service use was analyzed using negative binomial regressions. Subgroup analyses on different patient characteristics were performed.

Results:

The cumulative incidence of all events (DM-related complications and all-cause mortality) was 23.2% in the RAMP-DM group and 43.6% in the usual care group. RAMP-DM led to significantly greater reductions in cardiovascular disease (CVD) risk by 56.6% (95% CI 54.5, 58.6), microvascular complications by 11.9% (95% CI 7.0, 16.6), mortality by 66.1% (95% CI 64.3, 67.9), specialist attendance by 35.0% (95% CI 33.6, 36.4), emergency attendance by 41.2% (95% CI 39.8, 42.5), and hospitalizations by 58.5% (95% CI 57.2, 59.7). Patients with low baseline CVD risks benefitted the most from RAMP-DM, which decreased CVD and mortality risk by 60.4% (95% CI 51.8, 67.5) and 83.6% (95% CI 79.3, 87.0), respectively.

Conclusions:

This naturalistic study highlighted the importance of early optimal DM control and risk factor management by risk stratification and multidisciplinary, protocol-driven, chronic disease model care to delay disease progression and prevent complications.

https://doi.org/10.2337/dc17-0426

Yu Y.T.E., Yeung C.H.N., Tang H.M., Wan Y.F.E. and Lam C.L.K.

Best Poster Presentation Award 1st Prize for "Impact of lifestyle on Allostatic Load of the Hong Kong Population"

7th Asia Pacific Primary Care Research Conference

2019

Yu Y.T.E., Wan Y.F.E., Tang H.M., Chan K.C., Liu S.N.K., Fong D.Y.T., Wong C.K.H., Kwok L.P., Chan K.H., Chao D.V.K., Tsui W.W.S., Liang J., Hui M.T., Luk W., Wong M. and Lam C.L.K.

The HKCFP Best Research Award 2018 for "5-year effectiveness of the multi-disciplinary Risk Assessment and Management Programme for primary care patients with hypertension (RAMP-HT) on HT-related complications and health service utilization - A population-based matched cohort study"

The Hong Kong College of Family Physicians

2019

Title:

Cultivating compassion: building resilience in medical students

Period:

18-19 December, 2018

Julie Chen, Harry Wu, Venus Wong, Nicolette Ray, Abigail Wright, Barry Kerzin and Samson Wong

Context:

Stress and distress among health care professions students is not uncommon. While systemic change is needed, efforts can be also be directed towards helping students build resilience to better thrive in the current environment. The idea of compassion, which may be understood as ‘a sensitivity to suffering in ourselves and others with a desire to alleviate and prevent it’, has been a promising framework for intervention. We share our experience in implementing a programme within the medical school curriculum to help students recognize distress and to build resilience through self-awareness and self-compassion.

Interventions:

‘Culture and Caring’ is one of the five themes in the compulsory Medical Humanities programme of the HKU MBBS curriculum. It aims to build resilience through a series of workshops led by a multidisciplinary team of teachers by exploring the mind-body connection in the generation of emotions, the difficult emotions that can be experienced when encountering patient decline or death, meeting grieving family members, or facing the personal adversity that inevitably arises as part of the medical training process. Through reading, story sharing, mindfulness practice and expressive art, students learn compassion-based techniques and strategies which can be applied in their own contexts.

Observations:

All students in every cohort since 2012 have participated in these workshops, with each cohort comprised of 210-235 medical students. Their words through semi-structured written reflections, and through informal small group presentations of their body-mapping artwork, have indicated that students can articulate, appreciate and use approaches learned in the workshops to deal with difficult emotions in a self-compassionate way. Their evaluations of the workshop have indicated that they are effective and relevant to their development as a doctor.

Conclusions:

Multimodal, longitudinal compassion training helps provide strategies to handle difficult emotions in day to day life as well as in the clinical setting and is valued by students.

Wan Y.F.E., Fung S.C.C., Jiao F., Chin W.Y., Fong D.Y.T., Yu Y.T.E., Chan A.K.C., Chan K.H., Kwok R.L.P. and Lam C.L.K.

Distinguished Research Making Family Medicine Shine Award and Best Contribution to Family Medicine Award, for paper: “E.Y.F. Wan, C.S.C. Fung, F.F. Jiao, E.Y.T. Yu*, W.Y.Chin, D.Y.T. Fong, C.K.H. Wong, A.K.C. Chan, K.H.Y. Chan, R.L.P. Kwok, C.L.K. Lam. 5-year effectiveness of the Multi-disciplinary Risk Assessment and Management Programme for primary care patients with Type 2 Diabetes Mellitus (RAMP-DM) on DM-related complications and health service utilizations – A Population-based and Propensity-matched Cohort Study"

Diabetes Care. 2018; 41:49-59

WONCA World Conference

Seoul, Korea

2018

Liu R., Lam C.L.K., Li Z., Chen Q., Jia Y. and Wong W.C.W.

2017年度优秀论文三等奖 for paper “劉瑞紅, 林露娟, 李卓, 陳慶奇, 賈亦真, 黃志威. 綜合醫院全科門診患者自強能力及關因素調查分析. (Patient enablement and its related factors in family medicine clinic of a general hospital.)

中國全科醫師雜志 ( Clin J Gen Practice) 2017; 16 (9): 681-86, 中华医学会《中华全科医师杂志》. Seoul, Korea

2018.

Title:

To evaluate the 5-year effectiveness of a multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM) in primary care patients with type 2 diabetes.

Period:

17 - 20 Oct, 2018

E.Y.F. Wan, C.S.C. Fung, & E.Y.T. Yu et al.

Background:

To evaluate the 5-year effectiveness of a multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM) in primary care patients with type 2 diabetes.

Research Design and Methods:

A 5-year prospective cohort study was conducted with 121,584 Chinese primary care patients with type 2 DM who were recruited between August 2009 and June 2011. Missing data were dealt with multiple imputations. After excluding patients with prior diabetes mellitus (DM)-related complications and one-to-one propensity score matching on all patient characteristics, 26,718 RAMP-DM participants and 26,718 matched usual care patients were followed up for a median time of 4.5 years. The effect of RAMP-DM on nine DM-related complications and all-cause mortality were evaluated using Cox regressions. The first incidence for each event was used for all models. Health service use was analyzed using negative binomial regressions. Subgroup analyses on different patient characteristics were performed.

Results:

The cumulative incidence of all events (DM-related complications and all-cause mortality) was 23.2% in the RAMP-DM group and 43.6% in the usual care group. RAMP-DM led to significantly greater reductions in cardiovascular disease (CVD) risk by 56.6% (95% CI 54.5, 58.6), microvascular complications by 11.9% (95% CI 7.0, 16.6), mortality by 66.1% (95% CI 64.3, 67.9), specialist attendance by 35.0% (95% CI 33.6, 36.4), emergency attendance by 41.2% (95% CI 39.8, 42.5), and hospitalizations by 58.5% (95% CI 57.2, 59.7). Patients with low baseline CVD risks benefitted the most from RAMP-DM, which decreased CVD and mortality risk by 60.4% (95% CI 51.8, 67.5) and 83.6% (95% CI 79.3, 87.0), respectively.

Conclusions:

This naturalistic study highlighted the importance of early optimal DM control and risk factor management by risk stratification and multidisciplinary, protocol-driven, chronic disease model care to delay disease progression and prevent complications.

https://doi.org/10.2337/dc17-0426

Chan L.K., Chen J.Y. and Chung W.S.E.

Hong Kong Publishing Biennial Awards 2017

"Publishing Award” in the category of "Life and Science”, for the book “Dissecting the Meaning of Life – An Anthology of Essays on Body Donation” (大體大得——遺體捐贈感思文集)

Hong Kong Publishing Professionals’s Society

WONCA World Conference

2017

Chin W.Y., Wan Y.F., Dowrick C., Arroll B. and Lam C.L.K.

Best Poster Award

WONCA

2017

Dao M.C., FU S.N., Chan C.W., Wong C.K.H., Wong Y.S., Luk W. and Yiu Y.K.,

RACGP Foundation Best Poster Award, GP18 Conference,

Royal Australian College of General Practitioners.

2018.

Chin W.Y., Wan Y.F., Chan K.H., Chen J.Y., Chan L.K. and Lau W.C.S.

Merit Award

Asian Medical Education Association (AMEA)

2017

Lam C.L.K.

The Medal of Honour

Government of the HKSAR

2018.

Chen J.Y., Chin W.Y., Chan L.K., Tiwari A.F.Y., Wong J.Y.H., Worsley A.J., Feng Y., Sham M.H., Tsang J.P.Y. and Lau W.C.S.

Free Paper Presentation - Poster Audience Award

Asian Medical Education Association

2017

Chan L.K., Chen J.Y. and Chung W.S.E.

Hong Kong Publishing Biennial Awards 2017

"Publishing Award” in the category of "Life and Science”, for the book “Dissecting the Meaning of Life – An Anthology of Essays on Body Donation” (大體大得——遺體捐贈感思文集)

Hong Kong Publishing Professionals’s Society

WONCA World Conference

2017

Chin W.Y., Wong C.K.H., Ng C.W., Choi P.H., Tran V.T., Ravaud P. and Lam C.L.K.

Best Research Paper Award

Hong Kong College of Family Physicians (HKCFP) 40th Anniversary Conference

2017

Chin W.Y., Wan Y.F., Dowrick C., Arroll B. and Lam C.L.K.

HKCFP Award for Best Research 2016

Hong Kong College of Family Physicians (HKCFP)

2017

Henning M.A., Krägeloh C.U., Booth R., Hill E.M., Chen J.Y. and Webster C.

E-Poster Presentation Merit Award

14th Asia Pacific Medical Education Conference

2017

Lam C.L.K., Law W.L., Poon T.C.J., Wong C.K.H., McGhee S. and Fong D.Y.T.

Excellent Research Award

Health Research Symposium 2017

Health and Medical Research Fund, Food & Health Bureau, the Government of HKSAR

2017

Wong C.K.H. and Lang H.H.B.

Best Poster Award Finalist (Top 10% research poster presentations)

International Society for Pharmacoeconomics and Outcomes Research (ISPOR) 20th Annual European Congress

2017

Wong W.C.W.

Excellence Leadership in Population Health & Health Promotion

Australian Council on Healthcare Standards assessment at HKU-Shenzhen Hospital

2017

Yu Y.T.E., Guo Y., Wong C.K.H., Ho S.Y., Sit W.S.R., Wang H.L.J. and Lam C.L.K.

The Best Poster: "Association between moderate-to-vigorous physical activity and cardiovascular disease risk in Chinese primary care patients with impaired fasting glucose"

22nd WONCA Europe Conference 2017

2017