Background Antibiotics resistance is a major public health threat worldwide. Super bugs, for example, drug resistant tuberculosis or Staphylococcus aureus, are increasingly common in the communities. Hong Kong is one of the areas which have the highest antibiotics resistant strains prevalence rate in the world. Irrational use of antibiotics is an important contributing factor to the emergence of antibiotics resistance. Physician stewardship in the prescription of antibiotics is pivotal in the prevention of antibiotics resistance emergence. Medical students are going to be practicing doctors after graduation from medical school. But few studies had been conducted to investigate their knowledge and attitude towards antibiotics resistance and use, and relations with anticipated antibiotics prescription behaviour. Method 145 medical students at the University of Hong Kong were recruited in this study to complete a self-administered questionnaire. There were in total 14 questions in this questionnaire, covering 2 major themes 1.Self-report of current and past antibiotic use and behaviour; 2.Anticipated prescription behaviour of antibiotics upon graduation and practice in the future. Chi-square test was used to investigate the association between attitude and knowledge of antibiotics with their anticipated prescription behavior upon graduation and practice. Multivariable logistic regression model was used to adjust for potential confounders. Results 67.6 % of the participants hold the correct knowledge of the proper use of antibiotics. Compare with the participants who hold the wrong knowledge, they were to 0.18 times more likely to inappropriately prescribe antibiotics for non-complicated Upper respiratory tract infections (URTI). (OR: 0.18, 95 % CI: (0.08, 0.43); p <0.001). Respectively 33.6 % and 4.9% of all the participants perceived the severity of antibiotics resistance in Hong Kong as “Severe” and “Very severe “. Those who rated “Severe” or above were 0.37 times more likely to inappropriately prescribe antibiotics for non-complicated URTIs compared with the participants who rated “Neutral” or below. (OR: 0.37, 95 % CI: (0.15, 0.91); p = 0.03). Logistic regression model was employed to test the interaction effect. Result showed that clinical training significantly interacted with antibiotics knowledge (p < 0.01)and perceived severity of antibiotics resistance (p = 0.02) in their relations with inappropriate prescription for non-complicated URTIs. Conclusion For the medical students who have received clinical training, those who were more aware of the severity of antibiotics resistance in Hong Kong were less likely to inappropriately prescribe antibiotics for non-complicated URTI. For the medical students who have not received clinical training, correct knowledge of antibiotic use is associated with less inappropriate antibiotics prescription behaviour. These suggest that knowledge and attitude towards antibiotics resistance and use are important factors that may impact on physician stewardship in antibiotics use in the community. / published_or_final_version / Public Health / Master / Master of Public Health

Many non-English-speaking countries and regions are establishing medical programmes using English as the sole medium of instruction, with the aim of producing global leaders who can function without communicative barriers. However, graduates from these programmes still have to use the local, non-English language to communicate with their local patients. The aim of this study is to examine whether these graduates experience any difficulty in communicating with their patients in the local language. We looked at the medical graduates of The University of Hong Kong as a specific example. The results of the study can be used for designing a local language course in these programmes. Graduates from the MBBS program of The University of Hong Kong were invited to take part, using selective, convenience and snowball sampling methods. Nineteen subjects voluntarily took part. Semi-structured interviews were individually conducted, and were based on a framework of questions in the four areas of Chinese language usage: reading, listening, writing, and speaking. All subjects indicated a certain degree of difficulty in using Chinese language in their clinical practice. In reading professional medical documents in Chinese, they had problems in recognizing the hand-written and the simplified Chinese characters. They also had difficulty in understanding the meanings of the words, in particular the Chinese medical terms, their variants, their abbreviations, and in following the complex Chinese academic discourses. In listening, they had difficulties in understanding Mandarin, especially those subjects who graduated more than 14 years ago and had little exposure to Mandarin during their school education. Even if they were able to recognize the spoken words, they may still have difficulties in understanding their meaning, just as they did in reading. In writing, the subjects did not perceive much difficulty, mainly because they could avoid writing professional medical documents in Chinese. In speaking, the subjects had difficulty with Mandarin. But the subjects did not complain of difficulties in speaking to their patients in Cantonese, despite their poor Chinese medical vocabulary, mainly because they developed strategies to avoid using Chinese medical terms, including giving the English terms instead, using a more general term, and or giving a description or explanation instead of the name. These strategies of complete omission, code switching, generalization, circumlocution are commonly used by learners of a second language when they experience lexical difficulties. They may jeopardize doctor-patient communication. Many subjects recognized the importance of having a good level of Chinese medical vocabulary. They also think that the use of Chinese medical terms, under appropriate conditions, allowed patients to have a more accurate and concrete picture of their conditions. The present study has identified Mandarin and Chinese medical vocabulary as the areas in which medical graduates from the HKU medical programme are particularly deficient. With the increasing emphasis on Mandarin in primary and secondary schools, new graduates from the programme can become more competent. But Chinese medical vocabulary remains a problem, and should be considered in the planning of a Chinese language course for the medical students at HKU. The results may also inform medical programmes in other non-English speaking countries and regions which use English as the sole medium of instruction. Training in the local language is important when English is used as the sole medium of instruction. / published_or_final_version / Education / Master / Master of Education

published_or_final_version / abstract / Medicine / Master / Doctor of Medicine

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences