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1.
J Dent Educ ; 84(1): 97-104, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31977092

RESUMEN

Assessment in competency-based dental education continues to be a recognized area for growth and development within dental programs around the world. At the joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, the workshop on assessment was designed to continue the discussion started in 2017 at the ADEA-ADEE Shaping the Future of Dental Education II.1 The focus of the 2019 conference involved examining the potential of entrustable professional activities (EPAs) and current thinking about workplace-based assessment (WBA) within competency-based education in the 21st century. Approximately 30 years ago, George Miller wrote about the assessment of competence in medical education and challenged faculty to reach for higher levels of assessment than knowledge or skill.2 Acknowledging that no one assessment method can result in a valid assessment of competence, Miller proposed a four-level framework for assessment. The lowest level involves measuring what students know ("knows"), followed by assessment of the skill with which knowledge is applied in relevant tasks or problems ("knows how"). Next is an assessment of task performance in standardized settings ("shows how"), and finally, the highest level assesses the student's performance in the unstandardized clinical workplace ("does"). The 2019 assessment workshop focused on advances in the assessment of learners in the unstandardized workplace-the highest level of Miller's assessment pyramid ("does"). Research has shown that dental education has struggled to implement assessment strategies that meet this level.3 The workshop brought together individuals from around the world, with an interest in assessment in dental education, to consider how assessment in the "does" level, specifically EPAs and WBA, factors into competence assessment in dentistry/dental education.


Asunto(s)
Educación Basada en Competencias , Educación en Odontología , Competencia Clínica , Europa (Continente) , Predicción , Humanos , Lugar de Trabajo
2.
Int J Radiat Oncol Biol Phys ; 106(1): 32-36, 2020 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-31647968

RESUMEN

PURPOSE: Radiation treatment planning (RTP) is a unique skill that requires interdisciplinary collaboration among radiation oncologists (ROs), dosimetrists, and medical physicists (MP) to train and assess residents. With the adoption of competency-based medical education (CBME) in Canada, it is essential residency program curricula focuses on developing competencies in RTP to facilitate entrustment. Our study investigates how radiation oncology team members' perspectives on RTP education align with requirements of the CBME approach, and its implications for improving residency training. METHODS AND MATERIALS: This qualitative research study took place in the Department of Oncology at a midsize academic institution. Through convenience sampling, focus groups were conducted with radiation oncologists (n = 11), dosimetrists (n = 7), medical physicists (n = 7), and residents (n = 7). Thematic design was adopted to analyze the transcripts through open coding resulting in 3 overarching themes. RESULTS: The results identified existing strengths and weaknesses of the residency program and future opportunities to redesign the curriculum and assessment process within a CBME model. Three overarching themes emerged from the analysis: (1) the strengths of RTP in the CBME environment; (2) challenges of RTP in CBME; and (3) opportunities for change. Stakeholders were optimistic CBME will help enrich resident learning with the increased frequency and quality of competency-based assessments. Participants suggested building a library of cases and developing computer-based learning resources to provide a safe environment to develop skills in contouring, dosimetry, and plan evaluation, in accordance with CBME training. CONCLUSIONS: This study identified future opportunities to redesign the RTP curriculum and assessment process within a CBME model. The need for innovative teaching and learning strategies, including case libraries, computer-based learning, and quality assessments, were highlighted in designing an innovative RTP planning curriculum.


Asunto(s)
Competencia Clínica , Educación Basada en Competencias , Internado y Residencia , Oncología por Radiación/educación , Planificación de la Radioterapia Asistida por Computador , Canadá , Competencia Clínica/normas , Educación Basada en Competencias/normas , Grupos Focales , Predicción , Humanos , Internado y Residencia/normas , Cultura Organizacional , Investigación Cualitativa , Oncólogos de Radiación , Oncología por Radiación/normas , Enseñanza/organización & administración , Carga de Trabajo
3.
Pan Afr Med J ; 33: 208, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31692729

RESUMEN

The Mozambican Field Epidemiology and Laboratory Training Program (Moz-FELTP) is a two-year, competency-based post-graduate training and service program designed to build sustainable public health capacity in applied epidemiology. Despite the efforts, Moz-FELTP residents have historically difficulty to publishing their work for a variety of reasons that includes language barriers, lack of writing skills and motivation, limited budgetary support and lack of effective mentorship. This outline the need for different approaches to continuous improving the publication, such scientific writing mentorship for non-English FELTP residents.


Asunto(s)
Epidemiología/educación , Lenguaje , Edición/estadística & datos numéricos , Investigación/educación , Educación Basada en Competencias , Humanos , Laboratorios , Mentores , Mozambique , Publicaciones Periódicas como Asunto/estadística & datos numéricos , Salud Pública
4.
Scand J Trauma Resusc Emerg Med ; 27(1): 91, 2019 Oct 17.
Artículo en Inglés | MEDLINE | ID: mdl-31623634

RESUMEN

BACKGROUND: The Basic-Trauma Management (BTM) course has been taught to third-year medical students in small groups for many years without substantial changes. With the introduction of a new curriculum for Swiss medical students, it was necessary to revise the BTM content and re-align it. Our aim was to identify core competencies for the revised BTM course. METHODS: We applied a three-round step-wise Delphi consensus. First, we asked open-ended questions on what were the most important competencies to be taught for BTM; the second round used Likert scales to ensure agreement on the competencies; and the final round reached out for consensus on these BTM competencies. Stakeholders were selected based on their long-standing experience in teaching BTM and in managing trauma patients. RESULTS: Consensus was found on 29 competencies out of an initial 130 proposals. "Human Factors", which had not been taught previously, scored relatively high, at 22%. The sole specific trauma skill agreed upon was the use of tourniquets. CONCLUSIONS: This is an example of curricular revision of a clinical skills course after the introduction of a regulatory framework for undergraduate medical education. The revised course curriculum tailors the concepts and skills in trauma that fulfill stakeholder needs, and are in agreement with the new Swiss learning outcomes.


Asunto(s)
Educación Basada en Competencias , Curriculum , Educación de Pregrado en Medicina , Traumatología/educación , Competencia Clínica , Técnica Delfos , Humanos , Estudiantes de Medicina , Suiza , Enseñanza
5.
Harefuah ; 158(10): 643-647, 2019 Oct.
Artículo en Hebreo | MEDLINE | ID: mdl-31576709

RESUMEN

INTRODUCTION: During the last decades the dominant paradigm, in which the duration of a rotation/course, the required content to be learnt (the material covered) and a test (usually a multiple choice one) evaluating the knowledge of the content, were paramount, is being replaced by a new paradigm: outcome/competency based medical education (CBME, OBME). In this paper the reasons for adopting this change in the developed world are presented, its nature and basic assumptions enumerated and national examples of its adoption from Scotland, Canada, UK and USA described. We will present in some detail the changes this approach entails, the new definitions it adopts, the learning outcomes it aspires to and how to evaluate them. Finally, we will present a draft outcomes proposal adapted to the Israeli reality. Since the Medicine Deans Forum and the Scientific Council of the Israeli Medical Association have adopted the new paradigm for the training of Israeli physicians, it is an opportune moment to expose the readership of Harefuah (i.e. Israel's physicians and medical students) to this relatively new paradigm.


Asunto(s)
Educación Médica , Médicos , Estudiantes de Medicina , Educación Basada en Competencias , Humanos , Israel
6.
Harefuah ; 158(10): 674-679, 2019 10.
Artículo en Hebreo | MEDLINE | ID: mdl-31576716

RESUMEN

INTRODUCTION: Competency Based Medical Education (CBME) is an educational approach that occupies a central place in medical education. Medical education is accountable for the graduates' professional level, ensuring they are skilled and competent in all key areas of their profession. Adopting CBME underscores the importance of simulation-based training. Experiential training provides, among other things: standardization of training, controlled exposure to extreme events and soft skills, such as patient-caregiver communication and teamwork training. Unlike the traditional apprentice approach, accountability reinforces the choice of a preliminary encounter with simulated patients prior to real-life care, as a complimentary tool for improving patient safety. Incorporating a practical exam is self-evident in CBME because of the need to ensure that the examinees are competent to provide unsupervised safe and quality care. Implementation of a national CBME program, likewise, incorporating simulation into national training programs, requires involvement and supervision on health system regulators. In this paper, we describe simulation-based national training programs that to date integrate competency-based training in the various medical sectors. As national programs, they are implemented under the guidance and in cooperation with the regulators. On the one hand, CBME is a new approach and its implementation will require time and the cooperation of many stakeholders. On the other hand, simulation is an existing, well-established training and assessment tool that can be used as an anchor around which you can start building the competency-based training programs.


Asunto(s)
Educación Basada en Competencias , Educación Médica , Humanos
7.
Prensa méd. argent ; 105(9 especial): 532-537, oct 2019.
Artículo en Inglés | LILACS, BINACIS | ID: biblio-1046454

RESUMEN

The article deals with the organizational- methodological and content aspects of practice-oriented tasks aimed at the formation of professional competencies of future professionals who study the theory and practice of the inclusive education of children with disabilities. Practice-oriented tasks aimed at the formation of knowledge about the essence of the basic concepts used in the process of the professional activity of specialists in an inclusive educational space are presented. In addition, practice-oriented tasks aimed at the formation of the abilities to analyze and summarize educational activities in organizations engaged in educational activities and to support children with disabilities and their families are given.


Asunto(s)
Educación Compensatoria , Personas con Discapacidad/educación , Educación Basada en Competencias , Educación Profesional/métodos , Políticas Públicas Antidiscriminatorias
9.
Rev Saude Publica ; 53: 74, 2019 Sep 09.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31508779

RESUMEN

In their pedagogical projects, health management courses focus on multidisciplinarity, interdisciplinarity, comprehensiveness and transversality, whose main merit is to question health issues from different theoretical perspectives. Analyzing these issues under many perspectives does not necessarily mean the development of transversal competences. The development and application of these competences suppose going beyond integrating curricular contents and theory/practice. They depend on how the knowledge will be articulated to changes at organizational, sectorial and institutional levels and on the coevolution between these competences and changes. It is understood that health services manager role is effectively transversal when he/she: (i) acts at organizational boundaries, fostering interaction between organizations and other actors in the system; (ii) provides (and receives) feedback to (and from) these actors; and (iii) these feedbacks help decision makers to undertake organizational changes to respond to the environment and shape it.


Asunto(s)
Educación Basada en Competencias/métodos , Administradores de Instituciones de Salud/educación , Brasil , Administradores de Instituciones de Salud/organización & administración , Humanos , Competencia Profesional
10.
Oral Maxillofac Surg Clin North Am ; 31(4): 621-626, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31416664

RESUMEN

Simulation involves the re-creation of real-life situations, processes, or structures for the purpose of improving safety, effectiveness, and efficiency of health care services: simulation provides a controlled and safe environment for training and assessment. In an age in which regulatory burdens, fiscal challenges, and renewed focus on patient safety increasingly constrain surgical residency programs, innovation in teaching is vital for the future of oral and maxillofacial surgery (OMS) training. Of the simulation technologies in modern day health care education, many have found their way into OMS training. This article reviews these technologies, and some examples of their uses in OMS.


Asunto(s)
Competencia Clínica , Tecnología Educacional/tendencias , Cirugía General/educación , Internado y Residencia , Otolaringología/educación , Entrenamiento Simulado , Educación Basada en Competencias , Evaluación Educacional , Humanos , Internado y Residencia/métodos , Internado y Residencia/tendencias , Procedimientos Quirúrgicos Reconstructivos/educación , Entrenamiento Simulado/tendencias
11.
J Vet Med Educ ; 46(3): 340-352, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31460844

RESUMEN

BACKGROUND: Entrustable Professional Activities (EPAs) combine feedback and evaluation with a permission to act under a specified level of supervision and the possibility to schedule learners for clinical service. This literature review aims to identify workplace-based assessment tools that indicate progression toward unsupervised practice, suitable for entrustment decisions and feedback to learners. METHODS: A systematic search was performed in the PubMed, Embase, ERIC, and PsycINFO databases. Based on title/abstract and full text, articles were selected using predetermined inclusion and exclusion criteria. Information on workplace-based assessment tools was extracted using data coding sheets. The methodological quality of studies was assessed using the medical education research study quality instrument (MERSQI). RESULTS: The search yielded 6,371 articles (180 were evaluated in full text). In total, 80 articles were included, identifying 67 assessment tools. Only a few studies explicitly mentioned assessment tools used as a resource for entrustment decisions. Validity evidence was frequently reported, and the MERSQI score was 10.0 on average. CONCLUSIONS: Many workplace-based assessment tools were identified that potentially support learners with feedback on their development and support supervisors with providing feedback. As expected, only few articles referred to entrustment decisions. Nevertheless, the existing tools or the principals could be used for entrustment decisions, supervision level, or autonomy.


Asunto(s)
Toma de Decisiones , Educación en Veterinaria , Lugar de Trabajo , Animales , Competencia Clínica , Educación Basada en Competencias , Curriculum , Retroalimentación , Humanos
12.
J Grad Med Educ ; 11(4 Suppl): 158-164, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31428274

RESUMEN

Background: Postgraduate medical education (PGME) has become increasingly individualized, and entrustable professional activities (EPAs) have been adopted to operationalize this. At the same time, the process and content to determine residents' progress using high-stakes summative entrustment decisions by clinical competency committees (CCCs) is not yet well established. Objective: We evaluated the experiences with a structured process for assessment of EPAs to attain uniform summative entrustment decisions for a national sample of pediatric residents. Methods: An EPA-based national PGME program for pediatric residents was introduced in the Netherlands, including a process of uniform summative entrustment decisions, termed the Evaluation and Assessment of Residents by Supervisors (EARS) procedure. To evaluate the program, we assessed survey data and information from invitational conferences. Results: Beginning in January 2017, 125 pediatric residents in all 8 Dutch residency regions started training in the EARS program. The program enabled robust summative entrustment decisions. Preliminary data suggested that faculty, despite increased preparation time, appreciated the comprehensive appraisal of resident qualifications. The EPA-based program was well accepted by residents. Fifty-one percent (57 of 112) had at least 2 EARS procedures per year, and for 75% (84 of 112) the level of supervision was often or always adjusted to their level of training. Conclusions: A national EPA-based program provided a structured process for summative entrustment decisions by CCCs and enabled individualized stepwise progression of residents toward unsupervised practice. Broader application of these concepts may require adaptations to accommodate different health care systems and specialties.


Asunto(s)
Competencia Clínica/estadística & datos numéricos , Internado y Residencia , Pediatría/educación , Evaluación de Programas y Proyectos de Salud , Educación Basada en Competencias/normas , Toma de Decisiones , Educación de Postgrado en Medicina , Docentes Médicos , Humanos , Países Bajos , Encuestas y Cuestionarios
13.
J Grad Med Educ ; 11(4): 422-429, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31440337

RESUMEN

Background: Determining procedural competence requires psychometrically sound assessment tools. A variety of instruments are available to determine procedural performance for central venous catheter (CVC) insertion, but it is not clear which ones should be used in the context of competency-based medical education. Objective: We compared several commonly used instruments to determine which should be preferentially used to assess competence in CVC insertion. Methods: Junior residents completing their first intensive care unit rotation between July 31, 2006, and March 9, 2007, were video-recorded performing CVC insertion on task trainer mannequins. Between June 1, 2016, and September 30, 2016, 3 experienced raters judged procedural competence on the historical video recordings of resident performance using 4 separate tools, including an itemized checklist, Objective Structured Assessment of Technical Skills (OSATS), a critical error assessment tool, and the Ottawa Surgical Competency Operating Room Evaluation (O-SCORE). Generalizability theory (G-theory) was used to compare the performance characteristics among the tools. A decision study predicted the optimal testing environment using the tools. Results: At the time of the original recording, 127 residents rotated through intensive care units at the University of Calgary, Alberta, Canada. Seventy-seven of them (61%) met inclusion criteria, and 55 of those residents (71%) agreed to participate. Results from the generalizability study (G-study) demonstrated that scores from O-SCORE and OSATS were the most dependable. Dependability could be maintained for O-SCORE and OSATS with 2 raters. Conclusions: Our results suggest that global rating scales, such as the OSATS or the O-SCORE tools, should be preferentially utilized for assessment of competence in CVC insertion.


Asunto(s)
Cateterismo Venoso Central/instrumentación , Catéteres Venosos Centrales/normas , Educación Basada en Competencias/normas , Evaluación Educacional , Internado y Residencia , Maniquíes , Reproducibilidad de los Resultados , Alberta , Lista de Verificación , Cuidados Críticos , Educación de Postgrado en Medicina , Femenino , Humanos , Masculino
14.
J Grad Med Educ ; 11(4): 430-438, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31440338

RESUMEN

Background: Workplace-based assessment (WBA) is critical to graduating competent physicians. Developing assessment tools that combine the needs of faculty, trainees, and governing bodies is challenging but imperative. Entrustable professional activities (EPAs) are emerging as a clinically oriented framework for trainee assessment. Objective: We sought to develop an EPA-based WBA tool for pediatric critical care medicine (PCCM) fellows. The goals of the tool were to promote learning through benchmarking and tracking entrustment. Methods: A single PCCM EPA was iteratively subdivided into observable practice activities (OPAs) based on national and local data. Using a mixed-methods approach following van der Vleuten's conceptual model for assessment tool utility and Messick's unified validity framework, we sought validity evidence for acceptability, content, internal structure, relation to other variables, response process, and consequences. Results: Evidence was gathered after 1 year of use. Items for assessment were based on correlation between the number of times each item was assessed and the frequency professional activity occurred. Phi-coefficient reliability was 0.65. Narrative comments demonstrated all factors influencing trust, identified by current literature, were cited when determining level of entrustment granted. Mean entrustment levels increased significantly between fellow training years (P = .001). Compliance for once- and twice-weekly tool completion was 50% and 100%, respectively. Average time spent completing the assessment was less than 5 minutes. Conclusions: Using an EPA-OPA framework, we demonstrated utility and validity evidence supporting the tool's outcomes. In addition, narrative comments about entrustment decisions provide important insights for the training program to improve individual fellow advancement toward autonomy.


Asunto(s)
Benchmarking/normas , Competencia Clínica/normas , Cuidados Críticos/normas , Evaluación del Rendimiento de Empleados/normas , Pediatría/educación , Educación Basada en Competencias/normas , Educación de Postgrado en Medicina , Femenino , Humanos , Internado y Residencia , Masculino , Reproducibilidad de los Resultados , Lugar de Trabajo
15.
J Grad Med Educ ; 11(4): 439-446, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31440339

RESUMEN

Background: Changes to assessment efforts following the shift to milestones-based assessment in the ACGME Next Accreditation System have not been fully characterized. Objective: This study describes themes in initial milestones-based assessment practices with the goal of informing continued implementation and optimization of milestones-based assessment. Methods: Semistructured interviews were conducted with 15 residency program leaders in 6 specialties at 8 academic medical centers between August and December 2016. We explored what was retained, what was added, and what was changed from pre-milestones assessment efforts. We also examined the perceived impact of the shift to milestones-based assessment on the programs. Thematic analysis began after the first 5 interviews and ended once thematic sufficiency was reached. Two additional authors reviewed the codes, offered critical input, and informed the formation and naming of the final themes. Results: Three themes were identified: (1) program leaders faced challenges to effective implementation; (2) program leaders focused on adaptability and making milestones work in what felt like a less than ideal situation for them; and (3) despite challenges, program leaders see value and utility in their efforts to move to milestones-based assessment. We describe a number of strategies that worked for programs during the transition, with perceived benefits acknowledged. Conclusions: While adaptation to milestones has occurred and benefits are noted, negative impacts and challenges (eg, perceived lack of implementation guidance and faculty development resources) persist. There are important lessons learned (eg, utilizing implementation experiences formatively to improve curricula and assessment) in the transition to milestones-based assessment.


Asunto(s)
Competencia Clínica/normas , Educación Basada en Competencias/organización & administración , Internado y Residencia/organización & administración , Evaluación de Programas y Proyectos de Salud/normas , Curriculum , Educación de Postgrado en Medicina/organización & administración , Docentes Médicos , Humanos , Entrevistas como Asunto , Desarrollo de Personal
17.
Plast Reconstr Surg ; 144(3): 496e-507e, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31461050

RESUMEN

BACKGROUND: Simulation has gained notable recognition for its role as an effective training and assessment modality in the present era of competency-based medical education. Despite the well-documented efficacy of both live and cadaveric animal models, several ethical, financial, and accessibility issues persist with their use. Lower fidelity nonbiological simulators have gained recognition for their ability to circumvent these challenges. This systematic review reports on all prosthetic and virtual reality simulators in use for microsurgery training, with an emphasis on each model's complexity, characteristics, advantages, disadvantages, and validation measures taken. METHODS: A systematic search was performed using the National Library of Medicine (PubMed), MEDLINE, and Embase databases. Search terms were those pertaining to prosthetic and virtual reality models with relevance to microsurgical training in plastic surgery. Three independent reviewers evaluated all articles retrieved based on strict inclusion and exclusion criteria. RESULTS: Fifty-seven articles met the inclusion criteria for review, reporting on 20 basic prosthetic models, 20 intermediate models, 13 advanced models, and six virtual reality simulators. CONCLUSIONS: A comprehensive summary has been compiled of all nonbiological simulators in use for microsurgery training in plastic surgery, demonstrating efficacy for the acquisition and retention of microsurgical skills. Metrics-based validation efforts, however, were often lacking in the literature. As plastic surgery programs continue to innovate, ensure accountability, and safely meet today's training standards, prosthetic simulators are set to play a larger role in the development of a standardized, ethical, accessible, and objectively measurable microsurgery training curriculum for the modern-day plastic and reconstructive surgery resident.


Asunto(s)
Educación Basada en Competencias/métodos , Microcirugia/educación , Procedimientos Quirúrgicos Reconstructivos/educación , Entrenamiento Simulado/métodos , Cirugía Plástica/educación , Competencia Clínica , Curriculum , Humanos , Internado y Residencia/métodos , Modelos Anatómicos , Prótesis e Implantes , Cirujanos/educación , Realidad Virtual
18.
Nurs Older People ; 31(3): 22-27, 2019 May 23.
Artículo en Inglés | MEDLINE | ID: mdl-31468787

RESUMEN

Although there is a long history of advanced nursing practice in the UK, without registration it is difficult to ensure that all staff who regard themselves as advanced practitioners have the necessary clinical acumen. This article explores how a capability-based training programme was developed for one advanced nurse practitioner (ANP) in the care of older people in a community healthcare NHS trust. It also considers whether the programme could be replicated for other clinicians wishing to train for a specific advanced practice role. The programme was developed as part of a service improvement project and used work-based practice to identify the clinician's learning needs. Various learning tools were used and the trainee ANP recorded their development in a portfolio of work including reflections and clinical summaries. The main direction for learning was through the use of a written programme guide that set out benchmarks to be achieved during the two-year programme. The trainee ANP met the requirements of the programme and was appointed to a senior ANP post at the end of the two years. There is merit in using a standardised capability-based training programme when developing advanced practitioners. Standardisation allows an organisation to ensure that advanced practitioners can provide an appropriate level of clinical practice to older patients with complex needs.


Asunto(s)
Enfermería de Práctica Avanzada/educación , Educación Basada en Competencias/organización & administración , Educación en Enfermería/organización & administración , Enfermería Geriátrica/educación , Anciano , Humanos , Desarrollo de Programa , Medicina Estatal , Reino Unido
19.
Indian J Pharmacol ; 51(3): 212-213, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31391688

RESUMEN

BACKGROUND: The healthcare needs of the general population are on the rise and to meet these demands, the healthcare professionals, especially doctors have to acquire a large number of skills. In the Indian settings, as of now, conventional system of education is being followed in medical colleges and this is despite the fact that it has many flaws associated with it. AIMS AND OBJECTIVES: The objective of the article is to explore the utility and the need of Competency Based Medical Education (CBME) in Indian settings. MATERIALS AND METHODS: It is a brief review of pertaining to the transition of delivery of medical education in India and is well-supported by the studies from different nations. RESULTS: CBME is a thoughtful approach to develop physicians in their future practice and encourages better accountability and flexibility. However, if so many things are good with CBME, then the question arises why it has not been implemented yet across all the medical colleges in India? This is because of the various challenges which have been identified in the planning and implementation phase of the program. CONCLUSION: In conclusion, CBME remains the ultimate solution for the problems persisting in the conventional system of medical education. However, a systemic plan and better involvement of the stakeholders in the preparedness phase will significantly enhance the chances of the success of the program.


Asunto(s)
Educación Basada en Competencias , Educación Médica , Humanos , India
20.
Public Health ; 175: 43-53, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31382084

RESUMEN

OBJECTIVES: The objective of this study is to evaluate the uptake of competency-based behaviour change counselling training within a primary healthcare setting. Specific questions concerning provider readiness for training, perceived importance of training in the context of service demands and perceptions of competence after training were addressed. STUDY DESIGN: A process-focused study which adopted a complex systems approach to implementation. Each step was evaluated before the next step was developed. The design was guided by the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. METHODS: Four specific primary care services were identified and behaviour change counselling training tailored to each service was provided, based on a model of training built around competencies in establishing change-based relationships, assessing and promoting readiness to change, using evidence-based behaviour modification skills when ready and addressing psychosocial determinants of behaviour within scope of practice. Before training, a manager's readiness to facilitate training and identification of peer leaders to support ongoing practice of skills were completed. RESULTS: Two programs negotiated 8 h of formal training, one program received 10 h and one program received 12 h. All programs engaged in peer support activities. Despite willingness to support training, 90% of managers were ambivalent about training activities, relative to one half of healthcare providers (HCPs). Few HCPs and no managers self-identified as ready without ambivalence. Furthermore, HCPs were reluctant to be evaluated by an expert and preferred self-evaluation methods. In contrast, HCPs uniformly endorsed the relevance, value and professional commitment to all component skills of the behaviour change counselling model. At the end of the training, over 75% of staff reported receiving formal training (reach). Almost 80% of staff reported using change-based relationship skills daily, with less frequent use of skills associated with addressing psychosocial issues. The degree of corrective feedback was generally low, however. An index of competency based on formal training, frequent use and receiving corrective feedback indicated that most HCPs did not meet these criteria. CONCLUSION: Training in behaviour change counselling competencies was successfully implemented in this project. The vast majority of HCPs received training, despite ambivalence. Furthermore, HCPs strongly valued these skills and used them frequently. However, they were reluctant to accept corrective feedback. Future research is needed to evaluate innovative strategies to overcome obstacles to receiving corrective feedback in the use of behaviour change counselling skills.


Asunto(s)
Terapia Conductista/organización & administración , Enfermedad Crónica/terapia , Consejo/organización & administración , Personal de Salud/educación , Atención Primaria de Salud/organización & administración , Actitud del Personal de Salud , Terapia Conductista/educación , Educación Basada en Competencias/estadística & datos numéricos , Consejo/educación , Personal de Salud/psicología , Humanos
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