Pain and Joy in Implementation of Curriculum Reform: The University of Hong Kong Medical Faculty Experience

Abstract

The University of Hong Kong (HKU) Li Ka Shing faculty of medi­ cine (established 1886), introduced curriculum reform in 1997, and implemented problem­based learning (PBL) as a part of hybrid curriculum. The reform made significant modi fi cations to time­tabling including reorganization of basic sciences program into system­based blocks structured around PBL tutorials, lectures, practicals, demonstrations and relevant anatomy dis­ sections. Assessment was also integrated at the faculty rather than departmental-based for the first three medical years. During the reform, apprehension and concern in relation to outcomes and quality of graduates were raised, particularly on students’ basic science foundation and whether students would be able to cope with demands related to PBL. To address these concerns, a study was undertaken to evaluate new graduates’ performance from two aspects: (1) knowledge­based perfor­ mance before their internship, and (2) on­the­job perfor mance during their internship, under the old and new curriculum. To evaluate intern’s knowledge­based performance, a written test consisting of multiple choice questions and short answer questions, based on combination of basic sciences knowledge and clinical scenarios was given to two cohorts of old (2000–2001) and new (2002–2003) graduates. To evaluate graduate’s on­the­job performance, scores from internship perfor mance over the past 9 years were retrieved from the faculty. Results from the first 2 years of new curriculum graduates and the last two cohorts of old curriculum graduates demonstrated that they had similar basic sciences knowledge­ based performance. On the other hand, new curriculum gra­ duates did significantly better in their on-the-job internship performance. Areas of strength within our graduates were attitude to staff, sense of responsibility and attitude to patients.