Questioning the Sustainability of English-Medium Instruction Policy in Science Classrooms: Teachers’ and Students’ Experiences at a Hong Kong Secondary School

Teaching science through English as a medium of instruction (EMI) is a growing phenomenon around the world. In Hong Kong, this was realised on a large scale in 2010, with the implementation of a “fine-tuning” compulsory language policy. This allowed Chinese-medium schools to adopt EMI fully. Yet, despite such rapid and widespread adoption, an adequate understanding of key stakeholders’ experiences in relation to their perceptions of what constitutes effective EMI science education remains scarce. Thus, we question the sustainability of EMI programs that are driven by top-down policy. In this case study, we explore the perspectives and experiences of six EMI science teachers and thirteen of their students as their secondary school transitions from partial to full EMI. From in-depth interviews (complemented by classroom observations), findings reveal that the transition to full EMI has presented challenges that appear to hinder students’ development of scientific knowledge and the language of science in English. This directly counters the primary goal of the fine-tuning policy. Nevertheless, findings also illuminate a number of coping strategies teachers and students use to deal with their changing curricula. Overall, we offer insights into this under-researched context of transitioning EMI programs and provide recommendations for future research and practice

Using Ethnographic Discourse Analysis to Understand Doctor-Patient Interactions in Clinical Settings

Using ethnographic discourse analysis in an Emergency Department in Hong Kong, this study explored the features of doctor-patient interactions in a hospital setting. By audio-recording 10 patient journeys, from triage to disposition, we analyzed the complexity of turn-taking patterns in spoken interactions between patients and doctors, as well as the subsequent complexities in this communication process. In particular, we traced the flow of communication surrounding the patients’ medical conditions at different stages of their journeys (e.g., taking patient history, making diagnosis and translating medical information in a bilingual environment). Communication in this Emergency Department, as in all Emergency Departments in Hong Kong, involves repeated translation from spoken Cantonese interactions to the written English patient notes and vice versa. For this study, the ethnographic discourse analysi

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

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

The photometric observation of the quasi-simultaneous mutual eclipse and occultation between Europa and Ganymede on 22 August 2021

Mutual events (MEs) are eclipses and occultations among planetary natural satellites. Most of the time, eclipses and occultations occur separately. However, the same satellite pair will exhibit an eclipse and an occultation quasi-simultaneously under particular orbital configurations. This kind of rare event is termed as a quasi-simultaneous mutual event (QSME). During the 2021 campaign of mutual events of jovian satellites, we observed a QSME between Europa and Ganymede. The present study aims to describe and study the event in detail. We observed the QSME with a CCD camera attached to a 300-mm telescope at the Hong Kong Space Museum Sai Kung iObservatory. We obtained the combined flux of Europa and Ganymede from aperture photometry. A geometric model was developed to explain the light curve observed. Our results are compared with theoretical predictions (O-C). We found that our simple geometric model can explain the QSME fairly accurately, and the QSME light curve is a superposition of the light curves of an eclipse and an occultation. Notably, the observed flux drops are within 2.6% of the theoretical predictions. The size of the event central time O-Cs ranges from -14.4 to 43.2 s. Both O-Cs of flux drop and timing are comparable to other studies adopting more complicated models. Given the event rarity, model simplicity and accuracy, we encourage more observations and analysis on QSMEs to improve Solar System ephemerides.Comment: 23 pages, 5 appendixes, 16 figures, 7 table

Speak-up culture in an intensive care unit in Hong Kong: a cross-sectional survey exploring the communication openness perceptions of Chinese doctors and nurses

Objectives Despite growing recognition of the importance of speaking up to protect patient safety in critical care, little research has been performed in this area in an intensive care unit (ICU) context. This study explored the communication openness perceptions of Chinese doctors and nurses and identified their perceptions of issues in ICU communication, their reasons for speaking up and the possible factors and strategies involved in promoting the practice of speaking up. Design A mixed-methods design with quantitative and sequential qualitative components was used. Setting and participants Eighty ICU staff members from a large public hospital in Hong Kong completed a questionnaire regarding their perceptions of communication openness. Ten clinicians whose survey responses indicated support for open communication were then interviewed about their speak-up practices. Results The participating ICU staff members had similar perceptions of their openness to communication. However, the doctors responded more positively than the nurses to many aspects of communication openness. The two groups also had different perceptions of speaking up. The interviewed ICU staff members who indicated a high level of communication openness reported that their primary reasons for speaking up were to seek and clarify information, which was achieved by asking questions. Other factors perceived to influence the motivation to speak up included seniority, relationships and familiarity with patient cases. Conclusions Creating an atmosphere of safety and equality in which team members feel confident in expressing their personal views without fear of reprisal or embarrassment is necessary to encourage ICU staff members, regardless of their position, to speak up. Because harmony and saving face is valued in Chinese culture, training nurses and doctors to speak up by focusing on human factors and values rather than simply addressing conflict management is desirable in this context.This work was supported by funding from the Hospital Authority’s Kowloon Central Cluster Research Grant (grant number: KCC/RC/G/1516-B03)

Physiological responses during ascent to high altitude and the incidence of acute mountain sickness.

Acute mountain sickness (AMS) occurs when there is failure of acclimatisation to high altitude. The aim of this study was to describe the relationship between physiological variables and the incidence of AMS during ascent to 5300 m. A total of 332 lowland-dwelling volunteers followed an identical ascent profile on staggered treks. Self-reported symptoms of AMS were recorded daily using the Lake Louise score (mild 3-4; moderate-severe ≥5), alongside measurements of physiological variables (heart rate, respiratory rate (RR), peripheral oxygen saturation (SpO2 ) and blood pressure) before and after a standardised Xtreme Everest Step-Test (XEST). The overall occurrence of AMS among participants was 73.5% (23.2% mild, 50.3% moderate-severe). There was no difference in gender, age, previous AMS, weight or body mass index between participants who developed AMS and those who did not. Participants who had not previously ascended >5000 m were more likely to get moderate-to-severe AMS. Participants who suffered moderate-to-severe AMS had a lower resting SpO2 at 3500 m (88.5 vs. 89.6%, p = 0.02), while participants who suffered mild or moderate-to-severe AMS had a lower end-exercise SpO2 at 3500 m (82.2 vs. 83.8%, p = 0.027; 81.5 vs. 83.8%, p 5000 m (OR 2.740, p-value 0.003) predicted the development of moderate-to-severe AMS. The Xtreme Everest Step-Test offers a simple, reproducible field test to help predict AMS, albeit with relatively limited predictive precision

Factors associated with nurses’ perceptions, their communication skills and the quality of clinical handover in the Hong Kong context

Abstract Background Clinical handover is a pivotal, high-risk communicative event because it involves the transfer of responsibility and accountability for patients and their care. Nurses’ perceptions and their communication skills inevitably impact on their ability of clinical handover. Limited studies have explored nurses’ handover practice in the Hong Kong context. This study aimed to identify factors associated with and specific impact paths between the quality, communication skills and nurses’ perceptions on clinical handover. Methods A questionnaire survey was conducted immediately after the nurses’ training in effective handover communication. A convenience sample of 206 bilingual nursing staff from a local hospital in Hong Kong participated in this paper-and-pencil survey adopted from the Nurses Handover Perceptions Questionnaire survey. Results The path analysis revealed that except the opportunity to ask questions and high perceptions of the ISBAR communication protocol, other factors were significantly correlated with improved quality of handover. In addition, nurses who had updated information were likely to ask more questions and obtain a better understanding of the patient care plan during handover. Conclusions The quality of nursing handover depended on the degree of nurses’ grasp of the patient care plan. The ISBAR communication protocol was considered helping nurses to improve their communication skills with other colleagues and indirectly enhance patient’s safety. However, although ISBAR facilitated nurses to structure clearer handover communication, it was not the most important predictive factor for determining handover quality

Questioning the Sustainability of English-Medium Instruction Policy in Science Classrooms: Teachers’ and Students’ Experiences at a Hong Kong Secondary School

Teaching science through English as a medium of instruction (EMI) is a growing phenomenon around the world. In Hong Kong, this was realised on a large scale in 2010, with the implementation of a “fine-tuning” compulsory language policy. This allowed Chinese-medium schools to adopt EMI fully. Yet, despite such rapid and widespread adoption, an adequate understanding of key stakeholders’ experiences in relation to their perceptions of what constitutes effective EMI science education remains scarce. Thus, we question the sustainability of EMI programs that are driven by top-down policy. In this case study, we explore the perspectives and experiences of six EMI science teachers and thirteen of their students as their secondary school transitions from partial to full EMI. From in-depth interviews (complemented by classroom observations), findings reveal that the transition to full EMI has presented challenges that appear to hinder students’ development of scientific knowledge and the language of science in English. This directly counters the primary goal of the fine-tuning policy. Nevertheless, findings also illuminate a number of coping strategies teachers and students use to deal with their changing curricula. Overall, we offer insights into this under-researched context of transitioning EMI programs and provide recommendations for future research 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