COVID-19 created a huge challenge for disciplines that require students to have contact with patients. Teachers found creative solutions that met curriculum demands and opened new avenues for engagement. CLINICAL TRIALS Dental Students Get Back in Touch with Patients The dilemma of balancing safety with professional training has been a major concern for dentistry, which was deemed to have the highest COVID-19 occupational risk by the US Department of Labour. “About 80 per cent of our teaching is clinical and cannot be taught online,” said Professor Thomas Flemmig, Dean of Dentistry and Kingboard Professor in Advanced Dentistry. “But in dentistry we have procedures, such as drilling, that create this blast of aerosols.” When in-person teaching was halted across the University in early 2020, the Faculty of Dentistry immediately went to work finding a feasible way to get students back into the clinic. Following much consultation with staff and students, a set of safety measures was arrived at to allow students to start treating patients in person from May 2020. This included mandatory SARS-CoV-2 testing for all students and staff, enhanced infection control through increased spacing in clinics and additional personal protective equipment, and input from the Faculty of Engineering on the best extra-oral suction devices for reducing aerosols (the chosen device reduces them by about 90%). An additional daily clinic was added, as were summer sessions, to increase capacity given the reduced number of patients per clinic. As a result, students have been able to acquire and demonstrate the required competencies to graduate, albeit with a few extra months of study. “Our graduates need to be competent clinicians who can perform invasive, irreversible procedures – drill and fill – on live patients,” Professor Flemmig said. “The measures we have introduced have allowed us to have stable patient care and clinical teaching, even during waves of the pandemic.” Tech Solutions for the Medical Faculty The medical and nursing programmes used technology to ensure their students continued to be exposed to real patient scenarios during COVID-19 restrictions. The School of Nursing, for instance, drew on its earlier experience with technologies such as a simulation laboratory, immersive virtual reality, high-fidelity simulation and robotics, and increased their use in clinical teaching and learning. Students were provided with high- and midfidelity simulated activities in a ward-like laboratory, and virtual simulation involving virtual patients with pre-set vital signs and scenarios. Technology was also used for clinical assessment of 188 final-year nursing students who, in place of face-to-face sessions, performed virtual care, engaged in self-reflection and considered how to apply their new learning in practice. A study by the School found that students using these technologies developed similar clinical competencies and reported greater satisfaction and self-confidence compared with traditional simulation. The School’s success in using all these technologies won the University’s 2020 Teaching Innovation Award, which was bestowed in March 2021. “Simulation education can never completely mirror the value of clinical practicum in hospital wards, but it meant we could provide a safe platform for students to learn professional skills and procedures,” said Dr Veronica Lam Suk-fun of the School. The MBBS programme also deployed technology and supervised teleconsultations, and is now developing telemedicine to be a permanent feature of the Family Medicine rotation. “The principles central to physicianpatient relationships still apply to telemedicine: students are held to the same standards, responsibilities, ethical considerations and the like, whether they see patients via teleconsultation or in person,” said Dr Anderson Tsang Chun-on, who has spearheaded the telemedicine initiative. Speech Therapy through Zoom Teleclinics have helped get speech and hearing sciences students over the COVID-19 hump and uncovered unexpected benefits. Their adoption predated the pandemic, when trials of teleclinics began in summer 2019 to see if they could be used to reach patients in remote areas. This was quickly scaled up in 2020 to enable students to consult with patients over Zoom. Some patients were found to prefer this approach, particularly those with mobility issues due to Parkinson’s Disease and stroke, while others required adaptations. For young children, parents were trained to help support treatment delivered through Zoom, while for elderly patients with dementia, a clinical supervisor sat next to and supported patients in the nursing home while students conducted the online therapy sessions. “This form of teleclinic meant students could get exposure to different institutional settings and other healthcare professionals, which was similar to the clinical experience they had before COVID-19,” said Associate Professor Dr Karen MK Chan, who leads the teleclinic team. The teleclinic arrangements were originally intended to be temporary but the outcome has been so positive that preparations are now underway to make them a regular part of the speech therapy curriculum and develop more materials specifically for teleclinic use. Dr Chan and her team will also explore the possibility of administering teleclinics outside Hong Kong. Dental students are required to wear personal protective equipment (PPE) and face shields in the Simulation Laboratory even if they are not treating real patients. Nursing students taking part in simulated activities in a laboratory setting that resembles an actual ward. Students watching a teleclinic session of an on-site clinical educator with a patient in an old age home. Teaching and Learning HKU ANNUAL REPORT 2021 12 | 13
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