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 Table of Contents  
PERSPECTIVE
Year : 2019  |  Volume : 6  |  Issue : 1  |  Page : 3-4

Handling the transition: What is needed for effectively embracing competency-based undergraduate medical education?


Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

Date of Submission31-Jan-2019
Date of Acceptance17-Apr-2019
Date of Web Publication10-Jul-2019

Correspondence Address:
V Dinesh Kumar
Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJAMR.IJAMR_16_19

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How to cite this article:
Kumar V D, Rajasekhar S. Handling the transition: What is needed for effectively embracing competency-based undergraduate medical education?. Int J Adv Med Health Res 2019;6:3-4

How to cite this URL:
Kumar V D, Rajasekhar S. Handling the transition: What is needed for effectively embracing competency-based undergraduate medical education?. Int J Adv Med Health Res [serial online] 2019 [cited 2019 Dec 16];6:3-4. Available from: http://www.ijamhrjournal.org/text.asp?2019/6/1/3/262489



We are standing at the verge of implementation of curricular reform grounded on the competency-based principles,[1] and these reforms are hailed as evolution which would potentially align the teaching–learning practicum to the outcome abilities of a graduate. However, it is imperative to understand that this transition, from traditional content, focused medical education to competency-based outcome-oriented one, might induce newer challenges for faculty who are involved in the implementation. This perspective tries to address four pertinent challenges based on which we, the medical community, should devise certain sensitization programs to facilitate the transition process.

First, a significant proportion of faculty needs to get accustomed with the principles of competency-based assessment particularly in terms of observation styles and maintenance of an optimal learning environment.[2] It includes providing students with frequent and structured feedback till they acquire necessary competencies.[3] The principles of competency based medical education (CBME),[4] which focus on making a criterion-based evaluation, allows room for improvement of specific competencies in which students are incompetent. This principle is diagonally opposite to the existing patterns of examinations in many universities where students are conferred with a pass or fail, based on the “ad hoc” decision made by the examiners in the stipulated time. The mismatch between expectation and reality could likely result in a logistical chaos during the initial years of implementation. Second, competency-based teaching, in an ideal sense, is grounded on reductionism which tends to break down the subject into small nested units.[5] Indeed, one of the major criticism for CBME was regarding its propensity to reduce the charm of teaching to a series of checkboxes to be ticked at.[6]

Third, taking lessons from the international examples, we perceive the need for robust faculty development programs in a relatively shorter time. As the adoption of a new modality of assessment becomes inevitable, the process may precipitate some early adopters among the faculty, who are zealous and willing to embrace any innovative change.[7] Each institute should identify those early adopters who can in turn train others so that the implementation of competency-based assessment can be achieved in a fairly short time. This might help in communicating the broader perspective regarding the paradigm shift to each of the stakeholders and help in achieving the intended goals.

Fourth, to sustain the momentum of curricular reform, medical colleges should incorporate and effectively implement the principles of organizational development.[8] Once a radical reform is initiated, there is a need to meticulously collect information using productive techniques such as structured brainstorming and Delphi panel and recognize the factors hindering the change. Concurrently, various components of the intended reform should be checked for the validity multiple times so that the necessary modifications can be incorporated to prevent any unforeseen difficulties during its actual implementation. Unless an effective two-way communication process develops among administrators and executors, any educational change will not yield the intended outcome and cannot be sustained with the desired momentum.

In conclusion, there is a need to acknowledge the need for introducing educational reforms that are intended to fill the existing lacunae in our medical education system and prepare our future medical graduates in a better way. In an optimistic sense, this would offer an opportunity to enroll a significant number of stakeholders in the organizational development. Rather than waiting for the Medical Council of India mandated training programs, the medical institutions should strive to update themselves regarding the general principles and theories of education to build and implement customized faculty development modules. As said by Mahatma Gandhi, “Let us be the change we desire to see.” Designing and implementation of the medical educational reforms should be a dynamic activity than a one-time change.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Medical Council of India. Competency Based Undergraduate Curriculum for the Indian Medical Graduate. Vol. 1. Medical Council of India; 2018. p. 1263. Available from: https://www.old.mciindia.org/UGCurriculum/UGCurriculumVolI.pdf. [Last accessed on 2019 Jan 20].  Back to cited text no. 1
    
2.
Sheu L, Kogan JR, Hauer KE. How supervisor experience influences trust, supervision, and trainee learning: A Qualitative study. Acad Med 2017;92:1320-7.  Back to cited text no. 2
    
3.
Bing-You RG, Trowbridge RL. Why medical educators may be failing at feedback. JAMA 2009;302:1330-1.  Back to cited text no. 3
    
4.
Albanese MA, Mejicano G, Mullan P, Kokotailo P, Gruppen L. Defining characteristics of educational competencies. Med Educ 2008;42:248-55.  Back to cited text no. 4
    
5.
Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, et al. Competency-based medical education: Theory to practice. Med Teach 2010;32:638-45.  Back to cited text no. 5
    
6.
Talbot M. Monkey see, monkey do: A critique of the competency model in graduate medical education. Med Educ 2004;38:587-92.  Back to cited text no. 6
    
7.
Weinberger SE, Pereira AG, Iobst WF, Mechaber AJ, Bronze MS; Alliance for Academic Internal Medicine Education Redesign Task Force II. Competency-based education and training in internal medicine. Ann Intern Med 2010;153:751-6.  Back to cited text no. 7
    
8.
Campion MA, Fink AA, Ruggeberg BJ, Carr L, Phillips GM, Odman RB. Doing competencies well: Best practices in competency modelling. Pers Psychol 2011;64:225-62.  Back to cited text no. 8
    




 

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