Training graduating medical students to develop the non-technical domains necessary for holistic competence in practical procedural skills, using patient-focused simulation and practice

Principal Supervisor

Professor Shekhar M. Kumta, Teaching and Learning Resources Centre, Office of Educational Services, Faculty of Medicine


3 years

Approved Budget

HK 1,000,000

  • Project Objectives
  • Description of process, outcomes or deliverable
  • Evaluation
  • Dissemination, diffusion and impact

Project Objectives

The main aim of this project was to foster the development of professional behaviors that reflect compassion empathy and sensitivity, particularly during the practice of procedures on patients. We expected to achieve this through authentic simulation of practice environments in which students practice procedures initially on surrogate patients, student volunteers and peers and are given constructive and formative feedback on their behavioral performance – so called Patient Focused Simulation.

Description of process, outcomes or deliverable

380 Students in their clinical years (3-5) were asked to perform 6-8 practical procedures on simulated patients (SP's). 14 simulated patients have been trained to fit the roles described in the training scripts – SP’s also provide feedback to the student/trainer. Importantly we have trained experienced nurses to act as examiners and observers. These inter-professional assessors provide the most authentic feedbacks to learners as their assessment and reflection is based on their many years of experiencing the professional behaviors they expect of “doctors” in their wards or within their practice environment.


Students as well as the SP's found the project was meaningful and that it made them reflect on their professional and technical behaviours. The project was also evaluated through data on OSCE exam performance and Internship performance. OSCE Student performances have continued to improve year on year indicating that students are well aware of the importance of their professional practice behaviors.

Data for intern performance (1st Quarter July-September) for the first batch of students starting their internship in 2012 showed a 29% decrease in adverse events and complaints related to practical procedures performed by CUHK interns (n=44) in the NT East Cluster of hospitals.

Dissemination, diffusion and impact

  • The project has been presented and discussed at the Annual Retreat of the Medical Faculty in 2010 and 2011.
  • The project was presented at Asia-Pacific Medical Education Conference held in Singapore in January 2011 where it received a poster award.
  • This project was presented and discussed during a Workshop held during the East-West Alliance Meeting in Shantao University (May 2012).

  • Diffusion:
  • PFS techniques are being considered as obligatory components of pre-internship training across all of the Hospital Authority’s cluster hospitals where interns are posted.

  • Sustainability:
  • This project has enabled us to put in place a scheme that fosters the development of good professional behaviors in our students. This has been well accepted by students as well as teachers and therefore is eminently sustainable. Indeed its adoption as an essential component of pre-internship training is vital to the reduction of intern-related complaints in practice.