Medical curriculum worldwide is experiencing a paradigm shift towards Competency-Based Medical Education (CBME), an outcome-based structure that needs the integration of information, skills, values, and attitudes into observable and measurable competencies. In our country there have been decisive steps in that direction as well [1, 2]. The need for betterment in medical education is based upon landmark recommendations of the Accreditation Council of Graduate Medical Education of America which mandates the acquisition of six domains of competencies namely, patient care, knowledge, practice-based learning, communication skills, professionalism, and systems-based practice [3–6].
CBME emphasizes a shift from teacher-centered to learner-centered educative methods and a systematic interdisciplinary integrated learning rather than piecemeal information in each department. Another noteworthy alteration is problem-based learning which triggers the scholar to arm himself with knowledge crucial to encounter and solve real-life problems within the hospital or community. Entrustable Professional Activities (EPA) are observable and measurable outcomes in CBME which bridges the gap between the idea and practice of technical skills thereby integrating multiple competencies in a holistic nature [7, 8]. CBME is conducive to the Dreyfus model which emphasizes the medical graduate to travel past five milestones- a novice, advanced beginner, competent, proficient, and expert as a graded transition[9]. (Figure.1 )
The goal of CBME is to produce an Indian Medical Graduate (IMG) who is envisaged as a doctor fulfilling the roles of clinician, leader, communicator, professional and lifelong learner[10, 18] (Table 1). The new regulations on Graduate Medical Education (Amendment), 2019 is more learner-centric, patient-oriented, gender-sensitive, and environment-appropriate leading to an outcome-driven curriculum, in conformity with global trends. To initiate the process of transformation from traditional curriculum into CBME, the teaching faculty of medical institutions need to be sensitized and molded into the modern day medical education facilitators. The National Faculty Development Program (FDP) initiative of the Medical Council of India (MCI) is a step forward in the direction, which aimed to enable and empower faculty of every medical institution across the country by a structured and perpetuating process (Fig. 2).
There has been a steep rise in the number of medical colleges in India from 297 in 2009 (146 within the Government sector and 151 within the private sector) to a total of 554 medical colleges in 2019 (285 within the Government sector and 269 within the private sector) [10–12]. In the last 10 years FDP of MCI had trained 44,932 faculties in Basic Course in Medical Education Technology through 1697 workshops conducted by regional centers and nodal centers. The Curriculum Implementation Support Program (CISP-Phase 1) had been implemented through 557 programs which trained 15,509 faculty in a record time of 7 months [13].
Though FDP’s have been in vogue since 2009 till date very little research has gone into assessing the faculty’s knowledge and mental preparedness to embrace CBME. Neither has it been evaluated whether the training process has percolated to the grass roots. In this research we aimed to study the existent level of awareness, attitude and perceived barriers towards implementation of CBME among teaching faculty of medical institutes countrywide.
Table 1
Represents the roles of IMG and new components of GMER 2019
Roles of Indian Medical Graduate with description | New components of Graduate Medical Regulations (GMER) 2019 |
• Clinician - preventive, promotive, curative, palliative and holistic care with compassion • Communicator - patients, families, colleagues and community • Leader -Leader and member of the health care team - collect analyze, synthesize and communicate health data • Lifelong learner - continuous improvement • Professional - ethical, responsive and accountable. | ¬ Foundation course ¬ Early clinical exposure ¬ AETCOM ¬ Self-Directed Learning ¬ Elective posting ¬ Basic research ¬ Problem based learning ¬ Integrated and aligned learning ¬ Reflection and meta-cognition |