The International Charter for Human Values in Healthcare: An interprofessional global collaboration to enhance values and communication in healthcare

Objectives: The human dimensions of healthcare—core values and skilled communication necessary for every healthcare interaction—are fundamental to compassionate, ethical, and safe relationship-centered care. The objectives of this paper are to: describe the development of the International Charter for Human Values in Healthcare which delineates core values, articulate the role of skilled communication in enacting these values, and provide examples showing translation of the Charter’s values into action. Methods: We describe development of the Charter using combined qualitative research methods and the international, interprofessional collaboration of institutions and individuals worldwide. Results: We identified five fundamental categories of human values for every healthcare interaction—Compassion, Respect for Persons, Commitment to Integrity and Ethical Practice, Commitment to Excellence, and Justice in Healthcare—and delineated subvalues within each category. We have disseminated the Charter internationally and incorporated it into education/training. Diverse healthcare partners have joined in this work. Conclusion: We chronicle the development and dissemination of the International Charter for Human Values in Healthcare, the role of skilled communication in demonstrating values, and provide examples of educational and clinical programs integrating these values. Practice implications: The Charter identifies and promotes core values clinicians and educators can demonstrate through skilled communication and use to advance humanistic educational programs and practice

An exploratory study of the teaching and learning of secondary science through English in Hong Kong: classroom interactions and perceptions of teachers and students

Previous studies have shown that teachers and students using English as the medium of instruction (EMI) in science classrooms encounter many language challenges with teaching and learning processes. Problems include the limited English communication skills of science teachers, the lack of EMI training for science teachers, the studentsâ different language abilities and science teachersâ beliefs that they are not responsible for addressing studentsâ language needs in science. Teachersâ lack of language awareness has led to poor teaching practices and limited interactions in the classrooms. This lack of language awareness, in turn, suggests that there are limited opportunities for students to learn English as a second language in the science classroom. This study extends the research on EMI classroom interactions in Hong Kong (Lo and Macaro, 2012) to the previously unexamined context of senior secondary science classrooms. A total of 19 teachers and 545 students from grades 10 and 11 EMI science class were recruited in Hong Kong from âearlyâfull EMIâ schools (full EMI instruction from grades 7 to 12) and âlateâpartial EMIâ schools (Chinese medium from grades 7 to 9 and partial EMI instruction from grades 10 to 12). The project used multiple sources of qualitative data (i.e. semi-structured interviews and 33 videotaped classroom observations) to explore the similarities and differences in classroom interactions during the first and second years of the senior science curriculum (grades 10 and 11) in the two types of EMI schools. This project also investigated these science teachersâ and studentsâ perceptions of EMI teaching and learning processes, their preference of instructional language and their beliefs about teaching and learning in the EMI environment. Interviews also probed teachersâ language awareness, teachersâ and studentsâ belief about EMI, studentsâ self-concepts in science (studentsâ perceptions or beliefs about their ability to do well in science, see Wilkins, 2004)) and their perceptions of language challenges and coping strategies in EMI classrooms. The results from the observational data show similar interactional patterns in both earlyâfull and lateâpartial EMI science classrooms when measured as percentages of interaction time, distribution of time between teacher and student talk and frequency of pedagogical functions. However, the nature of the interactions is different. In lateâpartial EMI schools, overall, there are more (but shorter) student initiations and responses, more use of higher-order questions from the teachers but less direct feedback to students. Both teachers and students tend to use their L1 more. In both types of schools, there was less interaction time and a lower maximum length of student turns and more L1 use in grade 11 than in grade 10. The discourse analysis of the four biology lesson transcripts also shows that both earlyâfull and lateâpartial EMI students predominantly produced incomplete sentences consisting of short, technical nouns or noun phrases referring to scientific items. Science teachers rarely made any attempts to correct their studentsâ language mistakes, nor did they encourage students to produce a complete sentence. This lack of teacher feedback on studentsâ L2 language production perhaps reflects the fact that EMI science teachers rarely provide comprehensible input to facilitate studentsâ L2 language learning. These findings suggest the important role of the teacherâs modified input in teacherâstudent interaction in developing studentsâ content knowledge and language skills. The adoption of EMI appears to lead to the development of studentsâ comprehension of content knowledge more than development of their language production skills. As a result of their language shortfalls, the studentsâ L2 productive skills remain under-developed despite English instruction. This lack of language support by teachers appears to indicate a gap between the aims of the EMI policy and its implementation. The interview and questionnaire data show that the science teachers from both the earlyâfull and lateâpartial EMI schools held many of the same views about their EMI teaching experiences, but they differed in their attitudes towards the value of English language skills and their language awareness. The earlyâfull EMI teachers believed English language skills were important and these earlyâfull teachers have a higher language awareness than the lateâpartial EMI science teachers. Students from both types of schools also held similar views about their EMI learning, indicating that they welcome the adoption of EMI instruction. However, while the lateâpartial EMI students see EMI as an opportunity to improve their English, those in the earlyâfull EMI schools believe that EMI discouraged them from learning. By providing an evidence-based, pedagogically focused analysis of teacher and student classroom interactions and their perceptions, this research sheds light on ways to improve the quality of instructional practices in different EMI classrooms in Hong Kong and in similar contexts around the world

An exploratory study of the teaching and learning of secondary science through English in Hong Kong: classroom interactions and perceptions of teachers and students

Previous studies have shown that teachers and students using English as the medium of instruction (EMI) in science classrooms encounter many language challenges with teaching and learning processes. Problems include the limited English communication skills of science teachers, the lack of EMI training for science teachers, the students’ different language abilities and science teachers’ beliefs that they are not responsible for addressing students’ language needs in science. Teachers’ lack of language awareness has led to poor teaching practices and limited interactions in the classrooms. This lack of language awareness, in turn, suggests that there are limited opportunities for students to learn English as a second language in the science classroom. This study extends the research on EMI classroom interactions in Hong Kong (Lo and Macaro, 2012) to the previously unexamined context of senior secondary science classrooms. A total of 19 teachers and 545 students from grades 10 and 11 EMI science class were recruited in Hong Kong from ‘early–full EMI’ schools (full EMI instruction from grades 7 to 12) and ‘late–partial EMI’ schools (Chinese medium from grades 7 to 9 and partial EMI instruction from grades 10 to 12). The project used multiple sources of qualitative data (i.e. semi-structured interviews and 33 videotaped classroom observations) to explore the similarities and differences in classroom interactions during the first and second years of the senior science curriculum (grades 10 and 11) in the two types of EMI schools. This project also investigated these science teachers’ and students’ perceptions of EMI teaching and learning processes, their preference of instructional language and their beliefs about teaching and learning in the EMI environment. Interviews also probed teachers’ language awareness, teachers’ and students’ belief about EMI, students’ self-concepts in science (students’ perceptions or beliefs about their ability to do well in science, see Wilkins, 2004)) and their perceptions of language challenges and coping strategies in EMI classrooms. The results from the observational data show similar interactional patterns in both early–full and late–partial EMI science classrooms when measured as percentages of interaction time, distribution of time between teacher and student talk and frequency of pedagogical functions. However, the nature of the interactions is different. In late–partial EMI schools, overall, there are more (but shorter) student initiations and responses, more use of higher-order questions from the teachers but less direct feedback to students. Both teachers and students tend to use their L1 more. In both types of schools, there was less interaction time and a lower maximum length of student turns and more L1 use in grade 11 than in grade 10. The discourse analysis of the four biology lesson transcripts also shows that both early–full and late–partial EMI students predominantly produced incomplete sentences consisting of short, technical nouns or noun phrases referring to scientific items. Science teachers rarely made any attempts to correct their students’ language mistakes, nor did they encourage students to produce a complete sentence. This lack of teacher feedback on students’ L2 language production perhaps reflects the fact that EMI science teachers rarely provide comprehensible input to facilitate students’ L2 language learning. These findings suggest the important role of the teacher’s modified input in teacher–student interaction in developing students’ content knowledge and language skills. The adoption of EMI appears to lead to the development of students’ comprehension of content knowledge more than development of their language production skills. As a result of their language shortfalls, the students’ L2 productive skills remain under-developed despite English instruction. This lack of language support by teachers appears to indicate a gap between the aims of the EMI policy and its implementation. The interview and questionnaire data show that the science teachers from both the early–full and late–partial EMI schools held many of the same views about their EMI teaching experiences, but they differed in their attitudes towards the value of English language skills and their language awareness. The early–full EMI teachers believed English language skills were important and these early–full teachers have a higher language awareness than the late–partial EMI science teachers. Students from both types of schools also held similar views about their EMI learning, indicating that they welcome the adoption of EMI instruction. However, while the late–partial EMI students see EMI as an opportunity to improve their English, those in the early–full EMI schools believe that EMI discouraged them from learning. By providing an evidence-based, pedagogically focused analysis of teacher and student classroom interactions and their perceptions, this research sheds light on ways to improve the quality of instructional practices in different EMI classrooms in Hong Kong and in similar contexts around the world

The International Centre for Communication in Healthcare: Creating Safer and More Compassionate Healthcare Systems around the World

Background: The role of communication in healthcare receives increasing attention, yet little research exists that brings together perspectives from interprofessional healthcare researchers and practitioners with linguists and communication specialists. The International Centre for Communication in Healthcare[1] is a response to increasing recognition of the central role of communication and relationships in the delivery of safe, effective and compassionate healthcare.Objective: To develop a worldwide, multidisciplinary collaborative of internationally recognized healthcare professionals and communication experts working together to translate research into education and practice to improve patient safety, communication and relationships in healthcare.Methods: The International Collaborative for Communication in Healthcare (a precursor to the Centre) began in 2010, and was founded at Hong Kong Polytechnic University (PolyU) in March 2011. We initiated research collaborations and presented colloquia, workshops and papers at international conferences.Results: The Centre, co-convened by PolyU and University of Technology, Sydney, was formally launched at PolyU in June 2013 with over 50 members from over 10 countries. The Centre is developing a strategic research agenda for communication in healthcare to improve the quality and safety of patient care, and to mobilize knowledge and expertise gained from research to guide teaching and implementation of communication skills and compassionate care in healthcare education and practice.  In an early initiative in 2011, we created the International Charter for Human Values in Healthcare[2], a collaborative effort involving people, organizations and institutions around the world working together to restore core human values to healthcare. The values of the International Charter inform the Centre’s research, education and practice initiatives.Conclusions: Effective communication is increasingly recognized as integral to safe, effective, and compassionate healthcare. The International Centre for Communication in Healthcare brings together interdisciplinary researchers, educators and practitioners from diverse disciplines to explore and improve communication and relationships in healthcare settings around the world.References1. The International Centre for Communication in Healthcare.  Hong Kong Polytechnic University and University of Technology, Sydney. http://icchweb.org2. The International Charter for Human Values in Healthcare. December 2, 2012. http://charterforhealthcarevalues.or

Restoring Core Values: An International Charter for Human Values in Healthcare

Background: The human dimensions of healthcare are fundamental to the practice of compassionate, safe, and ethical relationship-centered care. Attending to the human dimensions improves patient and clinician satisfaction, outcomes and quality of care; however, these dimensions have not received the emphasis necessary to make them central to every healthcare encounter. We established an international collaborative effort to identify and promote the human dimensions of care.Objectives: a) To describe work to date on the International Charter for Human Values in Healthcare; b) To discuss translation of the Charter’s universal values into education, research, and practice.Methods: An international working group of expert educators, clinicians, linguists, and researchers identified initial values that should be present in every healthcare interaction. The working group and four additional groups -- National Academies of Practice (NAP) USA, International Conference on Communication in Healthcare, Interprofessional Patient-Centered Care Conference, American Academy on Communication in Healthcare Forum -- identified values for all healthcare interactions and prioritized top values. The NAP group also prioritized top values for interprofessional interactions. Additional data was gathered via a Delphi process and 2 focus groups of Harvard Macy Institute scholars and faculty.Results: Through iterative content analyses and consensus, we identified 5 categories of core human values that should be present in every healthcare interaction: Capacity for Compassion, Respect for Persons, Commitment to Integrity and Ethical Practice, Commitment to Excellence, and Justice in Healthcare. Through further consensus and Delphi methodology, we identified values within each category.Conclusions: The International Charter for Human Values in Healthcare [1] is a cooperative effort to restore core human values to healthcare around the world. Major healthcare and education partners have joined this international effort. We are working to develop methods to translate the Charter’s universal values into education (teaching, assessment, curricula), research and practice.ReferenceThe International Charter for Human Values in Healthcare. http://charterforhealthcarevalues.or