|Year : 2019 | Volume
| Issue : 1 | Page : 5-6
Implementation of competency-based medical education for postgraduate courses in India
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth, Kancheepuram, India
|Date of Submission||15-Feb-2019|
|Date of Acceptance||05-Nov-2019|
|Date of Web Publication||10-Jul-2019|
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Thiruporur-Guduvancherry Main Road, Sembakkam, Kancheepuram - 603 108, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Shrivastava SR, Shrivastava PS. Implementation of competency-based medical education for postgraduate courses in India. Int J Adv Med Health Res 2019;6:5-6
|How to cite this URL:|
Shrivastava SR, Shrivastava PS. Implementation of competency-based medical education for postgraduate courses in India. Int J Adv Med Health Res [serial online] 2019 [cited 2019 Dec 16];6:5-6. Available from: http://www.ijamhrjournal.org/text.asp?2019/6/1/5/262490
| Introduction|| |
Competency-based medical education (CBME) has been acknowledged as the need of the hour owing to the multiple benefits associated with it over traditional curriculum. CBME is a learner-driven process, with teachers serving the role of facilitator, and it allows a learner to acquire the desired skills at their own pace. Competency refers to the habitual and judicious use of various attributes required to improve the health of an individual patient and the community. In general, competency is always more than one domain (viz., comprises knowledge, skills, and attitudes in varying combinations), whereas entrustable professional activities (EPAs) comprise more than one competencies.,
| Competency-Based Medical Education in India|| |
In fact, with the declaration of the introduction of competency-based undergraduate curriculum from the 2019 academic year in India, it has become a mandate for all the medical colleges to fall in line. However, based on the experiences of the earlier departments/institutions wherein CBME has been implemented, the process has not been really smooth as it is a resource-intensive program and requires careful planning from the administrators, medical education unit, and the curriculum committee members of a medical college for the successful implementation of the same., The CBME program in postgraduation courses carries immense potential as it helps a student to become proficient/expert in the subject-specific EPAs through the promotion of a student from one milestone to another during the entire course duration.,
| Implementing Competency-Based Medical Education in Postgraduate Courses in India|| |
To ensure a smooth implementation of the CBME program for postgraduate (PG) program is relatively easier owing to the lesser number of students and logistic requirements. The first step in the process of planning is to form a team comprising of the dean, curriculum committee members, members of the medical education unit, and head of the departments., The next step will be to formulate an action plan to streamline the process of transition, and this could be done by the adoption of systems approach. The inputs include objectives of the PG curriculum, curriculum content, organization of content and learning experience, learner (PG student), availability of resources (viz., number of faculty available, financial support, and infrastructure), expertise available (number of trained people who can aid in the transition of the assessment), existing assessment method, plan proposed for assessment, evaluation process, and feedback mechanism.
The process primarily has to include sensitization sessions targeting faculty and students, development of an action plan specifying timelines, and assisting departments in the smooth transition., Obviously, the output which we are looking for is a competent health-care professional possessing the five major roles specified by the regulatory body. However, the cycle is not complete unless we obtain feedbacks from the learners, faculty, and other stakeholders (including patients and parents) about the process and the mode of assessment.
It is quite clear that the success of the implementation of CBME for PG courses depends on the sensitization sessions planned for the faculty members and the learners and clearing their doubts and providing them necessary clarifications with or without involvement of the external experts.,,, During the sensitization programs, the emphasis should be given on what is CBME and how it differs from the conventional approach of teaching–learning, principles and pillars of CBME, the need for the transition, the advantages linked with CBME and how it negates the limitations of conventional teaching, and finally, the expectations from the faculty/learners (viz., roles and responsibilities) to enable a smooth transition.,,
In continuation, the PG departments should be sensitized about the entrustable professional activities, how to frame them, and the process about the formulation of the rubrics of milestones to assess their professional growth., In fact, the department colleagues should sit together and frame specific EPAs, which the PG students must possess after their graduation and on what basis they will be assessed. This has to be followed by the development of a timeline for organizing assessments (viz., formative and summative assessments) after discussing with the students.
Finally, we have to take a call regarding the various tools which will be used for the assessment depending on the EPA and the domain of learning for which assessment has to be planned., These assessment tools could be e-portfolio, reflective writing, workplace-based assessment (WPBA) tools, subject-specific WPBA tools (like objective structured assessment of technical skills or objective structured assessment of ultrasound skills), or even simulation-based assessment tools (in settings with lack of clinical material). Despite all these preparations and planning, it is bound to happen that some challenges will come into the picture, and they have to be properly dealt with [Table 1].,,,,, However, it is important to remember that despite all these reforms in teaching–learning, summative examinations would still be under the control of the regulatory body, and therefore, all efforts should be targeted toward accomplishing competency during the formative process.
|Table 1: Anticipated challenges in the implementation of competency-based medical education and the recommended solutions|
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| Conclusion|| |
In conclusion, the process of implementation of CBME for PG medical education is a challenging task, and thus, it will require a team effort and a system-based approach from all the involved stakeholders.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest
| References|| |
Powell DE, Carraccio C. Toward competency-based medical education. N
Engl J Med 2018;378:3-5.
Frank JR, Snell L, Englander R, Holmboe ES; ICBME Collaborators. Implementing competency-based medical education: Moving forward. Med Teach 2017;39:568-73.
Schultz K, Griffiths J. Implementing competency-based medical education in a postgraduate family medicine residency training program: A stepwise approach, facilitating factors, and processes or steps that would have been helpful. Acad Med 2016;91:685-9.
Shrivastava SR, Shrivastava PS. How to successfully implement competency-based medical education in India. Educ Health Prof 2018;1:61-3. [Full text]
Humphrey-Murto S, Wood TJ, Ross S, Tavares W, Kvern B, Sidhu R, et al.
Assessment pearls for competency-based medical education. J Grad Med Educ 2017;9:688-91.