A Cross-Cultural Experience

Posted on Wednesday, December 13, 2017

uOttawa representatives at the Ottawa Shanghai Joint School of Medicine (OSJSM)

By Dr. Ed Seale

The Ottawa Shanghai Joint School of Medicine (OSJSM) was established in October 2014 and the first cohort of medical students are currently progressing through pre-clerkship. In preparation for clinical clerkship, the local Chinese physician preceptors requested training on Canadian bedside clinical teaching. The Chinese teaching model consists of mostly didactic teaching which is in stark contrast to our patient centered model where we discuss issues surrounding cases. 

One of the main goals of OSJSM is the promotion of family medicine as a discipline. Presently, medicine in China is primarily delivered by specialists, in a fragmented way, within both a public and private health care system. The concept of a general practitioner is still in infancy and there is a great divide in the public opinion of GP’s versus specialists. The Chinese government is looking at Canada for primary care reform ideas that we may be able to provide.

At the end of November, three physicians and a fantastic group of administrators at the Faculty of Medicine were asked to develop a 4 day Faculty Development Event to be delivered in 3 months. Drs. Jessica Dy (Ob/Gyn), Ed Seale (Family Medicine) and Chuck Su (Emergency and Family Medicine) were selected due to their varied teaching and clinical roles to provide the Faculty Development in Shanghai in February. Dr. James Chan (General Internal Medicine) was added to the group and provided remote teaching on OSCE development. This added an extra layer of complexity as Dr. Chan did not travel to Shanghai, but rather gave his session remotely from Ottawa. 

To meet the varied needs of our audience (consisting mainly of tertiary care specialists, a small group of GP’s and a practitioner of Traditional Chinese medicine, as well as a dentist) we had to make our sessions interesting and generalizable across many topics.

We gratefully used (and attributed!) multiple sources including Essential Teaching Skills 1, 2 and 3, and portions of lectures by Dr. Alan Ng (Interviewing skills), Dr. Nancy Dudek (Evaluations), Dr. Asif Doja (Hidden Curriculum), and Dr. Laurie McLean (Multisource Feedback). Besides the fantastic team at the Faculty of Medicine, the staff at the DFM went "above and beyond" in helping us get the presentations off the ground. We wish specifically to highlight the assistance of Emma Dickinson, Asiya Rolston and Louise Weir.

It was a whirlwind week of teaching. There were many lessons learned when designing an educational program for a different country. Specifically, it was important to keep in mind the realities of their medical system where the average physician sees 100 patients a day - talk about "teaching on the run!" As well, the Canadian habit of asking questions (not to mention answering them!) in a group setting is not easily replicated in the Chinese environment and could have resulted in a very quick and quiet 4 days if we didn't react to their reality. Developing a work-around of small group work, written questions rather than the raising of hands and lots of videos and laughter contributed to the week being a success. Icebreaker games each morning helped to open up the participants to our style of teaching. For future trips, we will have to remember to properly subtitle our videos so that they can follow along even with difficult content.

Travelling to Shanghai is a long journey but a worthwhile endeavor. Having the opportunity to learn how medicine is practiced and taught in different countries adds to our own knowledge and gives us ideas on how we can make changes in our own home. It was truly a privilege to represent our university overseas, and to be welcomed so warmly by our Shanghai partners.

Xie xie! (Thank you!)

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