Table 3 Adaptation to Challenges in EMI Program

A. Insufficient or inappropriate EMI teaching resources

* Using the English textbooks selectively based on their own learning capabilities. Some stick to original English textbooks; some manage to find simplified versions; most of them use both English and Chinese textbooks simultaneously.

* Using the English textbooks selectively based on their understanding of the students’ learning needs, usually with a combination of Chinese textbooks and updated English textbooks.

* Encouraging students to use Chinese textbooks

B. Unsatisfactory teaching efforts

* Previewing before the lectures;

* Learning autonomously after class to make up the content not taught/understood clearly in class;

* Searching learning materials from various sources, such as online medical forum and database (e.g. UpToDate);

* Turning to study groups and peers for help

* Devoting a great deal of time preparing for lessons

* Improving organization of teaching content by setting up clear learning objectives and structuring the content more logically;

* Writing scripts to improve fluency;

* Revising PPTs to improve teaching quality year after year

C. Inadequate classroom interaction

* Asking questions after class (in Chinese);

* Participating in PBL discussions

* Answering questions after class (in Chinese);

* Plan for interactive sections in advance (only practiced by a few teachers);

* Interacting with students during PBL sections (but not all EMI teachers are involved in PBL)

D. Failure to teach medical humanities issues

* Learning and discuss MH issues in PBL discussions;

* Learning MH from other courses;

* Participating in pre-internship and volunteer activities

* Including case analysis in class instruction when MH issues might be mentioned (but not very often)

* Involving students in MH discussions in PBL