Dr. Ryan Fernandes, Medical Director, Dr. Polaris explains how Competency-Based Medical Education helps with non- cognitive variables like professionalism, communication skills etc and results in better observable outcomes
“I hear and I forget, I see, and I remember, I do, and I understand” is a well-known Chinese quote by Confucius, which underscores the importance of practical knowledge in any field of study. No pilot ever takes off in a plane full of passengers on his first attempt no matter how many hours of lecture he has listened to. Instead, he spends countless hours on a flight simulator, simulating every aspect of a flight so that when the time comes for his first actual flight, he is well prepared. A formula one racer doesn’t drive on a track without first descending into a race simulator where he judges every straight, masters every corner and anticipates every braking zone. Why then should a medical student not have a similar experience so that he/she can be more confident while dealing with a patient? In this article, we will explore the value of Competency-Based Medical Education (CBME) in the Undergraduate (UG) Medical Curriculum and the role of online coaching in teaching CBME.
The current state of medical education
According to NMC, the objective of the Indian graduate medical training programme is “to create a medical graduate with enough knowledge, skills, values such that he or she can function effectively, as physician of first contact in the community while staying relevant”. Medical education has essentially remained the same since 1997. However, with changing times and technology, it was essential that medical education needed an overhaul since it was leading to a situation where a lot of focus was given to the accumulation of knowledge in a classroom without a focus on practical applications in a real-world scenario. One of the most significant challenges facing medical education is the need to produce competent and qualified medical professionals who can meet the demands of a rapidly changing healthcare landscape which is why the NMC took it upon themselves to bring this change in the form of CBME in 2018.
Value of CBME in the current state of medical education
CBME attempts to provide an environment where a student not only acquires knowledge but also applies it practically and provides means for these skills to be assessed by the faculty. This approach ensures that medical students are prepared to meet the demands of treating patients adequately and confidently the moment they finish the course.
Gone are the days when 150 to 200 students sat in a classroom and listened to a lecture. CBME focuses on small group teaching where the students are divided into smaller batches so that they get individualised attention. Also, a lot of focus is now given to “integration” wherein different topics, in different subjects, across different years are studied together rather than as a lone subject as it was done previously. That way students can grasp the concepts better by relating one subject to another just like how different aspects of our body are related to one another.
CBME focuses a lot on simulation-based teaching. Medical simulation attempts to bridge the gap between theory and practical aspects of medicine in a way that a student can rehearse in a simulated environment, just like a pilot or racing driver. The beauty of this is that a learner can practice a skill repeatedly till he/she gets the “process” right such that when the time comes to do the same on a patient the learner does not have to think about the steps and rather just perform the procedure concentrating on perfection rather than wondering what is the next step.
Online coaching can be a powerful supplementary tool that can complement CBME in the UG medical curriculum. Online coaching allows medical students to access high-quality educational resources from anywhere, at any time. NMC, in its guidelines, encourages students to access reliable online resources and encourages colleges to provide the same to the students so that they can understand the subject better.
For educators, CBME offers a more efficient and effective way to teach medical students. CBME provides a framework for designing and implementing a curriculum that is based on the specific competencies that medical students need to develop. The onus now is not on any one faculty but leads to a multidisciplinary approach to teaching as well.
Conclusion
CBME is an innovative approach to medical education that emphasizes the development of specific competencies in medical students. However, a qualitative and robust faculty development program in CBME to align the competencies with the assessment methods will be a sustainable approach toward the successful implementation of CBME in India. Furthermore, by adopting CBME and incorporating online coaching into the UG medical curriculum, we can ensure that medical students receive the training and education they need to become competent and qualified medical professionals.
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