MBChB Year 5 Clinical Module
The 9-Week Paediatric Module
During the 9-week clinical module in paediatrics, students participate in a range of activities in Hospital Settings (ward work and outpatient clinics at the Prince of Wales Hospital, Hong Kong Children’s Hospital and regional hospitals) and Primary care settings (private paediatrician clinics, Maternal and Child Health Centres, Developmental Paediatrics Clinic, Child Assessment Centres, Hong Chi Pinehill School, Heep Hong or Watchdog Early Education Centre). Lectures will be combined with bedside and tutorial teaching. The final paediatric assessment combines results from continuous assessment, clinical skills assessment, multiple choice examination and OSCE examination.
Students are allocated to one of eight groups that rotate through the Prince of Wales Hospital and two outside hospitals: Alice Ho Miu Ling Nethersole Hospital (AHNH) + United Christian Hospital (UCH) OR Kwong Wah Hospital (KWH) + Princess Margaret Hospital (PMH).
Paediatric Mentorship Programme
Students in their allocated 8 groups (a-g) will be randomly assigned to a mentor. In addition to providing continuity in learning support to a small group of students, the mentorship programme focuses on teaching bioethics, communication skills, and medical record taking. The bioethics component of this teaching is a General Education requirement of the Faculty with 3 hours of contact time per Year 5 module. Paediatric mentors will meet their students 4-5 times during the module providing approximately 6 hours of contact time (3 hours of bioethics teaching and 2-3 hours of communications skills teaching and general mentorship).
Students must get a pass in this bioethics session in order to pass the programme Clinical Ethics I (MEDU 4300). There are both common and unique bioethical considerations that paediatricians face while treating children for health conditions. For children, unlike for adult patients, healthcare decisions are often made by someone other than the person to be treated i.e. by the parents/main carers. Issues of patient confidentiality, consent for treatment, end-of-life management and child protection require the treating doctor to be aware of the specific needs and desires of the child and to be able to respect and adequately address situations when the child’s and parents’ views and needs diverge. The mentorship programme provides students with opportunities for small group discussions around these issues. Students in groups of 2 to 3 will select and present a bioethics topic. Students may select any topic related to their interest and could be related to some clinical experience. Students should seek confirmation from their mentor that the chosen topic is appropriate.
Paediatric practice presents various additional challenges to effective communication not only between healthcare professionals and their patients, who may range from young children to adolescents, but also with the patient’s parents and main carers. In order to help students further develop their communication skills, mentors will provide an opportunity for each student to practise communicating information about common paediatric conditions using the MRCPCH approach. The SPIKES approach may be used but is more suitable for breaking bad news which will be covered in Year 6.
1. Introduce yourself and what you plan to do
2. Ask what they know already
3. Ask what they do wish to know
4. Tell them what you are going to tell them/ what you are going to discuss
5. Tell them/ discuss the issue
6. Check understanding
7. Opportunity to ask questions
8. Closure/ safety netting
S – set up (set up the venue, set the scene, introduce yourself)
P – perception (what does the patient/family know/understand/worry about?)
I – invitation (does the patient/family expect detailed information? Do they want an overview?)
K – knowledge (deliver your messages and content and check their understanding)
E – emotion/empathy (observe for emotional response, may ask how the patient feels)
S – summary (overview of the counselling session, may give a plan for further management/counselling)