Stages of Concern of Medical Faculty toward Adoption of Competency-based Medical Education in India: A Multicentric Survey.

Context: Currently, a major curricular reform in the form of competency-based medical education (CBME) curriculum is being rolled out across all medical colleges in India. However, it is important to find out and address the concerns of faculty regarding various aspects of this new curriculum. Aim: To analyze the concerns of the faculty members of medical colleges in India in response to the changes emerging from the adoption and implementation of the new curriculum through the concerns-based adoption model by applying the stages of concern (SoC) questionnaire. Methodology: A multicentric, cross-sectional quantitative study involving faculty members currently working in medical colleges and with more than 2 years of teaching experience was conducted using SoC questionnaire (SoCQ). The questionnaire was delivered as Google Form. Results: Of the 744 faculty participants, 41.1% (306) of faculty belonged to the 31-40 years age group followed by the 41-50 years age group (267, 35.9%). Respondents rated their level of concern differently among the seven SoC - percentile scores were highest in Stage 0- awareness (94) and least in Stage 4- consequences (59). An appreciably higher percentile scores were seen at the consequences stage (63 vs. 54), collaboration stage (80 vs. 68), and refocusing stage (77 vs. 69) in those faculty members who were trained in curriculum implementation support program (CISP) compared to the untrained group. However; the SoCQ profiles of CISP trained and untrained faculty were very much similar. SoCQ profiles of holders of advanced training in medical education and non-holders were also the same. Conclusion: Almost after 2 years of well-planned introduction of the CBME curriculum in India, the generalized faculty profile is still suggestive of interested but non-user type for the adoption of CBME. However; compared to untrained faculty, CISP trained faculty is more concerned about the impact of CBME on students, collaborating with colleagues for its proper implementation and exploring more benefits from the implementation of CBME, indicating that more hand-holding is required for faculty development beyond CISP.

Changing Assessment Scenarios: Lessons for Changing Practice.

Assessment is a process that includes ascertainment of improvement in the performance of students over time, motivation of students to study, evaluation of teaching methods, and ranking of student capabilities. It is an important component of the educational process influencing student learning. Although we have embarked on a new curricular model, assessment has remained largely ignored despite being the hallmark of competency-based education. During the earlier stages, the assessment was considered akin to "measurement," believing that competence is "generic, fixed and transferable across content," could be measured quantitatively and can be expressed as a single score. The objective assessment was the norm and subjective tools were considered unreliable and biased. It was soon realized that "competence is specific and nontransferable," mandating the use of multiple assessment tools across multiple content areas using multiple assessors. A paradigm change through "programmatic assessment" only occurred with the understanding that competence is "dynamic, incremental and contextual." Here, information about the students' competence and progress is gathered continually over time, analysed and supplemented with purposefully collected additional information when needed, using carefully selected combination of tools and assessor expertise, leading to an authentic, observation-driven, institutional assessment system. In the conduct of any performance assessment, the assessor remains an important part of the process, therefore making assessor training indispensable. In this paper, we look at the changing paradigms of our understanding of clinical competence, corresponding global changes in assessment and then try to make out a case for adopting the prevailing trends in the assessment of clinical competence.

Online Teaching in Medical Training: Establishing Good Online Teaching Practices from Cumulative Experience.

Online teaching has the potential to transcend geographical boundaries, is flexible, learner centered and can help students develop self-directed learning skills. The recently introduced competency-based curriculum has also advocated e-learning as an indispensable tool for self-directed learning. For effective online learning, good online teaching practices should be adopted. These include alignment of online teaching and learning with delivery of curriculum and objectives, synchronous, and asynchronous interaction between teacher and student, encouraging the development of higher-order thinking skills, active learning, and self-directed learning in students. In addition, good online teaching practices should have an inbuilt component of feedback and provide for effective time management, respect for diverse talents and ways of learning with continuous monitoring and mentoring of the learners. Online assessments, both formative and summative should also aim to ensure student involvement in the process. Capacity building of faculty through faculty development programs for the development of specific competencies such as social competency, pedagogical competency, managerial competency, and technical competency in the times of COVID-19 is now recognized as the need of the hour. Although online teaching and learning in medical education is new, it has the potential to become mainstream in future.

Introduction of Medical Humanities in MBBS 1st Year.

CONTEXT: Most vital areas of patient management such as empathy, professionalism, and ethics are lacking in fresh undergraduates. These areas are considered to be part of hidden curriculum, and as these are not formally taught, we lack competent medical graduates. Introduction of medical humanities (MH) early in the medical curriculum can help to inculcate required soft skills. AIMS: This study aims to develop, administer, and evaluate MH module in 1st year MBBS students. SETTINGS AND DESIGN: Module of MH was introduced among 150 1st year MBBS medical students. SUBJECTS AND METHODS: After taking permission from ethical committee of the institute, a core committee for development of MH module was formed. A standardized validated module for MH comprising of three sessions was formed and was introduced in 1st year MBBS 150 students. Evaluation was done in the form of student and faculty feedback questionnaire, consisting of open- and closed-ended questions. STATISTICAL ANALYSIS USED: Analysis was done using descriptive statistics using mean and standard deviation. RESULTS: According to participants' feedback and perception, mean overall rating of MH module was 4.69, indicating that it was received well by the students. Out of 3 sessions conducted, students gave maximum grades to session 2: cinemeducation. Results of faculty feedback questionnaire indicated that MH is needed and should be introduced in every batch of 1st year MBBS and should be continued longitudinally. CONCLUSIONS: Awareness, knowledge, and attitude of students improved as a result of MH module. Our results indicate that such modules should be implemented in undergraduate medical curriculum.

Implementation of cardiopulmonary resuscitation workshop in first MBBS.

CONTEXT: Students should be exposed to early clinical scenario so that they start developing competency-based learning right from their MBBS 1(st) year. Medical Council of India has recognized this need and has suggested early clinical exposure of MBBS 1(st) year students in their document Vision 2015. Medical education in India needs change for achieving desired competencies. It has been concluded that Indian medical undergraduates have inadequate knowledge in cardiopulmonary resuscitation (CPR). AIMS: To implement CPR workshop in MBBS 1(st) year, and to study the impact of CPR workshop among MBBS 1(st) year students. DESIGN: Interventional study. MATERIALS AND METHODS: CPR workshop was conducted with the help of Faculty of Anesthesia and Physiology among MBBS 1(st) year students. Teaching learning methods employed were lecture, demonstration, and hand-on practice on mannequin in small groups. The evaluation was done by pre- and post-standardized, validated questionnaire; direct observation procedural skill, and feedback questionnaire. RESULTS: There was a significant improvement in knowledge of students as shown from results of pre- and post-questionnaire. About 84.24% students found the presentation excellent, 71.23% students found the demonstration excellent in terms of visibility and clarity, 63.7% students found the instructions excellent. All students were successful in acquiring skills of CPR as shown by results of directly observed procedural skills. CONCLUSIONS: Results of this study suggest that the workshop provided students with sound basic knowledge and adequate practical skills in CPR. CPR workshop should be carried out every year among undergraduate students. CPR workshop should be introduced in MBBS 1(st) year curriculum.