Simulated Patients for Competency-Based Undergraduate Medical Education Post COVID-19: A New Normal in India.
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SUBMITTER: Kapoor A
PROVIDER: S-EPMC8464191 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionA community-based training (CBT) program, where teaching and training are carried out in the community outside of the teaching hospital, is a vital part of undergraduate medical education. Worldwide, there is a shift to competency-based training, and CBT is no exception. We attempted to develop a tool that uses a competency-based approach for assessment of CBT.MethodsBased on a review on competencies, we prepared a preliminary list of major domains with items under each domain. We used the Delphi technique to arrive at a consensus on this assessment tool. The Delphi panel consisted of eight purposively selected experts from the field of community medicine. The panel rated each item for its relevance, sensitivity, specificity, and understandability on a scale of 0-4. Median ratings were calculated at the end of each round and shared with the panel. Consensus was predefined as when 70% of the experts gave a rating of 3 or above for an item under relevance, sensitivity, and specificity. If an item failed to achieve consensus after being rated in 2 consecutive rounds, it was excluded. Anonymity of responses was maintained.ResultsThe panel arrived at a consensus at the end of 3 rounds. The final version of the self-assessment tool consisted of 7 domains and 74 items. The domains (number of items) were Public health - epidemiology and research methodology (13), Public health - biostatistics (6), Public health administration at primary health center level (17), Family medicine (24), Cultural competencies (3), Community development and advocacy (2), and Generic competence (9). Each item was given a maximum score of 5 and minimum score of 1.ConclusionThis is the first study worldwide to develop a tool for competency-based evaluation of CBT in undergraduate medical education. The competencies identified in the 74-item questionnaire may provide the base for development of authentic curricula for CBT.
| S-EPMC5395246 | biostudies-literature
Project description:BackgroundWith the advent of competency-based medical education, as well as Canadian efforts to include clinical informatics within undergraduate medical education, competency frameworks in the United States have not emphasized the skills associated with clinical informatics pertinent to the broader practice of medicine.ObjectiveBy examining the competency frameworks with which undergraduate medical education in clinical informatics has been developed in Canada and the United States, we hypothesized that there is a gap: the lack of a unified competency set and frame for clinical informatics education across North America.MethodsWe performed directional competency mapping between Canadian and American graduate clinical informatics competencies and general graduate medical education competencies. Directional competency mapping was performed between Canadian roles and American common program requirements using keyword matching at the subcompetency and enabling competency levels. In addition, for general graduate medical education competencies, the Physician Competency Reference Set developed for the Liaison Committee on Medical Education was used as a direct means of computing the ontological overlap between competency frameworks.ResultsUpon mapping Canadian roles to American competencies via both undergraduate and graduate medical education competency frameworks, the difference in focus between the 2 countries can be thematically described as a difference between the concepts of clinical and management reasoning.ConclusionsWe suggest that the development or deployment of informatics competencies in undergraduate medical education should focus on 3 items: the teaching of diagnostic reasoning, such that the information tasks that comprise both clinical and management reasoning can be discussed; precision medical education, where informatics can provide for more fine-grained evaluation; and assessment methods to support traditional pedagogical efforts (both at the bedside and beyond). Assessment using cases or structured assessments (eg, Objective Structured Clinical Examinations) would help students draw parallels between clinical informatics and fundamental clinical subjects and would better emphasize the cognitive techniques taught through informatics.
| S-EPMC9516378 | biostudies-literature
Project description:The new competency-based medical education undergraduate curriculum (CBMC) was launched for the 2019 admission batch of MBBS students. The programme is designed to create an "Indian Medical Graduate" (IMG) possessing the requisite knowledge, skills, attitudes, values and responsiveness, so that the graduate may function appropriately and effectively as a physician of first contact with the community while being globally relevant. Given that implementation of this curriculum is still in its infancy across the country, we stand to gain from a unified approach to its implementation. Phase I of the curriculum includes anatomy, physiology, and biochemistry along with professional and personal development modules. Biochemistry enjoys an enviable position in the medical curriculum as it explains the molecular basis of diseases. We present an appraisal of the curriculum in Biochemistry by reviewing the components against Harden's six themes which are considered when planning or developing a curriculum. Further, five core components of CBME are selected on the basis of three research papers to characterize underlying assumptions of CBME to suggest ways of logical implementation for achieving the competencies expected of the Indian Medical Graduate. The insight gained shall help students to be equipped with competencies which they shall be able to use in their day- to- day work, which shall ultimately help benefit patient care and the society at large.Supplementary informationThe online version contains supplementary material available at 10.1007/s12291-022-01088-y.
| S-EPMC9647740 | biostudies-literature
Project description:PurposeThis study was conducted to determine whether a computer simulation of practical exercises in undergraduate medical pharmacology led to the realization of the intended learning outcomes.MethodsThe study was a descriptive analysis of laboratory classes carried out using computer simulation programs. Five programs were used to teach practical pharmacology to undergraduate medical students at the Mulungushi University School of Medicine and Health Sciences. The study period was January 2018 to December 2019. The computer programs included a pharmacokinetics simulator (CyberPatient), organ bath simulator (OBSim), AutonomiCAL for simulating autonomic pharmacology, and Virtual Cat and Virtual Rat (RatCVS) for simulating cardiovascular pharmacology. Students utilized these programs during their pharmacology laboratory classes, wrote reports, and answered relevant clinical questions.ResultsThe 5 programs provided easy and precise platforms for students to explore concepts and demonstrate knowledge of pharmacokinetics, pharmacodynamics, autonomic and cardiovascular pharmacology, and their clinical applications.ConclusionThe programs were effective learning tools. Students' learning was easily assessed based on their laboratory reports. Although the computer programs met medical students' learning needs, wet laboratory exercises are also needed to meet the needs of students who require practical laboratory skills.
| S-EPMC7364025 | biostudies-literature
Project description:The purpose of this article is to give international readers an overview of the organisation, structure and curriculum, together with important advances and problems, of undergraduate medical education in Germany. Interest in medical education in Germany has been relatively low but has gained momentum with the new "Regulation of the Licensing of Doctors" which came into effect in 2003. Medical education had required substantial reform, particularly with respect to improving the links between theoretical and clinical teaching and the extension of interdisciplinary and topic-related instruction. It takes six years and three months to complete the curriculum and training is divided into three sections: basic science (2 years), clinical science (3 years) and final clinical year. While the reorganisation of graduate medical education required by the new "Regulation of the Licensing of Doctors" has stimulated multiple excellent teaching projects, there is evidence that some of the stipulated changes have not been implemented. Indeed, whether the medical schools have complied with this regulation and its overall success remains to be assessed systematically. Mandatory external accreditation and periodic reaccreditation of medical faculties need to be established in Germany.
| S-EPMC2716556 | biostudies-literature
Project description:Background:Residency training programs in Canada are undergoing a mandated transition to competency-based medical education (CBME). There is limited literature regarding resident perspectives on CBME. As upper year residents act as mentors and assessors for incoming cohorts, and are themselves key stakeholders in this educational transition, it is important to understand how they view CBME. We examined how residents who are not currently enrolled in a competency-based program view that method of training, and what they perceive as potential advantages, disadvantages, and considerations regarding its implementation. Methods:Sixteen residents volunteered to participate in individual semi-structured interviews, with questions focussing on participants' knowledge of CBME and its implementation. We used a grounded theory approach to develop explanations of how residents perceive CBME. Results:Residents anticipated improved assessment and feedback, earlier identification of residents experiencing difficulties in training, and greater flexibility to pursue self-identified educational needs. Disadvantages included logistical issues surrounding CBME implementation, ability of attending physicians to deliver CBME-appropriate feedback, and the possibility of assessment fatigue. Clear, detailed communication and channels for resident feedback were key considerations regarding implementation. Conclusions:Resident views align with educational experts regarding the practical challenges of implementation. Expectations of improved assessment and feedback highlight the need for both residents and attending physicians to be equipped in these domains. Consequently, faculty development and clear communication will be crucial aspects of successful transitioning to CBME.
| S-EPMC7522862 | biostudies-literature
Project description:As nearly all doctors deal with patients requiring palliative care, it is imperative that palliative care education starts early. This study aimed to validate a national, palliative care competency framework for undergraduate medical curricula. We conducted a Delphi study with five groups of stakeholders (palliative care experts, physicians, nurses, curriculum coordinators, and junior doctors), inviting them to rate a competency list. The list was organized around six key competencies. For each competency, participants indicated the level to which students should have mastered the skill at the end of undergraduate training. Stability was reached after two rating rounds (N = 82 round 1, N = 54 round 2). The results showed high levels of agreement within and between stakeholder groups. Participants agreed that theoretical knowledge is not enough: Students must practice palliative care competencies, albeit to varying degrees. Overall, communication and personal development and well-being scored the highest: Junior doctors should be able to perform these in the workplace under close supervision. Advance care planning scored the lowest, indicating performance in a simulated setting. A wide range of stakeholders validated a palliative care competency framework for undergraduate medical curricula. This framework can be used to guide teaching about palliative care.
| S-EPMC7177526 | biostudies-literature
Project description:BACKGROUND: Cultural competency is an important skill that prepares physicians to care for patients from diverse backgrounds. OBJECTIVE: We reviewed Accreditation Council for Graduate Medical Education (ACGME) program requirements and relevant documents from the ACGME website to evaluate competency requirements across specialties. METHODS: The program requirements for each specialty and its subspecialties were reviewed from December 2011 through February 2012. The review focused on the 3 competency domains relevant to culturally competent care: professionalism, interpersonal and communication skills, and patient care. Specialty and subspecialty requirements were assigned a score between 0 and 3 (from least specific to most specific). Given the lack of a standardized cultural competence rating system, the scoring was based on explicit mention of specific keywords. RESULTS: A majority of program requirements fell into the low- or no-specificity score (1 or 0). This included 21 core specialties (leading to primary board certification) program requirements (78%) and 101 subspecialty program requirements (79%). For all specialties, cultural competency elements did not gravitate toward any particular competency domain. Four of 5 primary care program requirements (pediatrics, obstetrics-gynecology, family medicine, and psychiatry) acquired the high-specificity score of 3, in comparison to only 1 of 22 specialty care program requirements (physical medicine and rehabilitation). CONCLUSIONS: The degree of specificity, as judged by use of keywords in 3 competency domains, in ACGME requirements regarding cultural competency is highly variable across specialties and subspecialties. Greater specificity in requirements is expected to benefit the acquisition of cultural competency in residents, but this has not been empirically tested.
| S-EPMC3693685 | biostudies-other
Project description:BackgroundEfforts to support flagging mentoring programs facing shortages of experienced clinical mentors have had an unexpected and welcome effect. Supplementing traditional mentoring programs with peer-mentoring have not only addressed gaps in practice, structure, support and mentee oversight but have offered mentees charged with peer-mentoring duties the opportunity to take on mentoring roles under senior supervision. This study evaluates the experiences of peer-mentors within a local research mentoring program to better understand and advance this endeavor.MethodsSemi-structured interviews and post-interview surveys based on recent reviews on mentoring were employed. Adapting the Systematic Evidence Based Approach, data was analysed using thematic and content analysis. Results were combined using the Jigsaw Perspective to ensure that key elements of the different mentoring stages were identified.ResultsThe interviews and surveys revealed the following domains: Motivation, Initiation, Practicing, and Mentoring Environment.ConclusionThese findings provide novel insight into a structured framework that may help guide the experiences, training, assessment, and oversight of peer-mentors beyond the auspices of our local program. These general observations will equip host organizations with the direction they need to take in designing and executing peer-mentoring training and assessment programs of their own. Whilst the stages of peer-mentoring need further evaluation and an effective means of assessment and support pivotal, we believe our findings suggest that peer-mentoring may not only help to address the shortfall in mentors but is an invaluable learning experience that prepares and instils key values, beliefs and principles in young would-be mentors.
| S-EPMC9477267 | biostudies-literature
Project description:BackgroundCoaching is emerging as a novel approach to guide medical students toward becoming competent, reflective physicians and master adaptive learners. However, no instruments currently exist to measure academic coaching at the undergraduate medical education level.ObjectiveTo describe the development and psychometric assessments of two instruments designed to assess academic coaching of medical students toward creating a robust measurement model of this educational paradigm.DesignObservational psychometric.ParticipantsAll medical students in the 2014 and 2015 cohorts and all their coaches were invited to complete the instruments being tested, which led to 662 medical student responses from 292 medical students and 468 coaching responses from 22 coaches being included in analyses. Medical student response rates were 75.7% from 2014 and 75.5% from 2015. Overall, the coaches' response rate was 71%.Main measuresTwo 31-item instruments were initially developed, one for medical students to assess their coach and one for faculty coaches to assess their students, both of which evaluated coaching based on definitions we formulated using existing literature. Each was administered to two cohorts of medical students and coaches in 2015 and 2016. An exploratory factor analysis using principal component analysis as the extraction method and Varimax with Kaiser normalization as the rotation method was conducted.Key resultsEighteen items reflecting four domains were retained with eigenvalues higher than 1.0 for medical students' assessment of coaching, which measured promoting self-monitoring, relationship building, promoting reflective behavior, and establishing foundational ground rules. Sixteen items reflecting two domains were retained for the faculty assessment of coaching with eigenvalues higher than 1.0: the Practice of Coaching and Relationship Formation.ConclusionsWe successfully developed and psychometrically validated surveys designed to measure key aspects of the coaching relationship, coaching processes, and reflective outcomes. The new validated instruments offer a robust measurement model for academic coaching.
| S-EPMC6502930 | biostudies-literature