Perceptions of AETCOM module amongst medical students: a questionnaire-based study

Background: The Attitude, Ethics and Communication (AETCOM) module is a cornerstone of competency-based medical education (CBME), implemented in the medical curriculum. It aims to instill effective patient communication skills in students. The present study evaluates students' perspectives on the implementation of the AETCOM module. Methods: This cross-sectional questionnaire-based study was conducted through Google form filling in 2nd phase MBBS students. Questions about knowledge attitudes and perspectives about the implementation of the AETCOM module in their MBBS curriculum were assessed.  Results: 172 students filled out the Google forms with a response rate of 86%. 169 (98.25%) students felt that it was essential to learn this module. 170 (98.83%) opined that ethics in medical practice is very important and learning it will help them in their future practice of medicine. 34% students reported of getting burdened in exams. Students preferred case-based scenarios and role plays most effective methods of learning. 53.5% of participants felt both summative assessment (SA) and formative assessment (FA) are essential for the complete evaluation of AETCOM competencies. Conclusions: The participants reported inclusion of AETCOM is important because it helped them improve their communication skills and good relationships build with doctors. 34% of participants reported being stressed during exams due to the burden of the already existing heavy curriculum. These findings draw the attention of all stakeholders for a revision in the implementation of the module to ease learning. Students think that even though time-consuming, conducting both FA and SA is justifiable

Perspectives of MBBS Students on The AETCOM Module After the Second Year of The Competency Based Medical Education Curriculum

Knowledge of proper Attitude, Ethics and Communication Skills with the patients plays a vital role in success of medical professionals. So, AETCOM module has been formulated to train the medical students from first MBBS itself as a part of their foundation course. The purpose of this study is to evaluate the change in the students' behaviour towards attitude, ethics and communication at the end of their second professional course. METHODS This cross-sectional observational study was carried out over the course of a month with second-year MBBS students who enrolled in Tagore Medical College in the academic year 2019–20. 100 students were included in this study. The teaching schedule of AETCOM Module had four sessions three hours each. At the end of the module feedback on their perception was obtained by pre validated questionnaire and was analysed. RESULTS: A majority of the students (96.1%) opined that the AETCOM Module will definitely improve their communication skills with the patients. They also felt that such training should be integrated in regular teaching curriculum and done continuously in all the semesters. All the 100 students were given the same questionnaire. Most (30) of the first-year students joined the foundation course late because of the delay in the counselling; whereas, at any given time, 20 students were absent for these teaching sessions. AETCOM Module was satisfactory for 84% of students. For 12% it was just satisfactory, the other extreme, 4% students were highly satisfied. Students’ views on AETCOM were- asset for gaining confidence of the patients (72%), useful for themselves and for future practice (10%), excellent method for improvement of diagnosis (8%), wanted multiple exposures continuously throughout the UG course (6%) and can avoid medicolegal issues (4%). CONCLUSIONS: The AETCOM Module will be good for the second year MBBS students on the whole for communicating better with the patients in their medical course. Strengths of this study include feedback from the students for further improvement in the long-term outcome

Perspectives of junior doctors on violence against medical professionals: a cross-sectional study in a tertiary care centre in Thrissur District

Background: Violence is defined by the World Health Organization in the World Report on Violence and Health as “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either result in or has a high likelihood of resulting in injury, death, psychological harm, mal-development or deprivation”. The Indian Medical Association (IMA) has reported that 75% of doctors have faced physical or verbal violence during their lifetime, so it is important to study the perspective of junior doctors. This study aims to study the perspectives of junior doctors on violence against medical professionals and to find the proportion of doctors who had faced violence during their practice in a Tertiary Care Centre in the Thrissur district.Methods: Cross-sectional study was conducted among 95 junior doctors at Government Medical College, Thrissur. Institute Ethical Committee clearance and written informed consent were obtained from all the study participants. A semi-structured questionnaire containing questions on socio-demographic variables and 19 questions related to violence against doctors was used.Results: Mean age of the study participants was 27.06±4.04 years, of which, 70.5% were females. 98.9% were concerned with the rising incidence of violence against doctors. 41.1% (95%CI- 31.1, 51.6) have faced some type of abuse during their practice. 56.8% believed that both the patient and doctors are to blame for such incidents. 41.1% have not received training on how to communicate with patients.Conclusions: The majority of the doctors were concerned about the rising incidence of violence and have faced some type of violence. It is of concern that almost half of the doctors have not received any training on how to communicate with the patients

Learner’s perspectives on competency-based medical education in pharmacology at a tertiary care teaching hospital in South India

Background: Competency based medical education (CBME) was implemented recently in India. The study was conducted to evaluate the perspectives of undergraduate medical students towards CBME curriculum in pharmacology at a tertiary care medical college in South India.Methods: After the completion of the curriculum, feedback was taken in a semi-structured, validated questionnaire. It was based on Kirkpatrik’s level 1 model of evaluation. Majority of the questions were framed on a 5-point Likert's scale (1 being poor to 5 being excellent). Qualitative data was collected by open ended question on additional comments.Results: The response rate was 72.8%. Majority of the participants rated the theory classes, practical classes, small group discussions, self-directed learning, integration, and assessments as good and excellent. More than 80% participants rated role play as an innovative and worthwhile concept towards mastering prescription communication. They felt that role play ignites team work, and provides confidence. Close to 90% of the participants rated the overview on emergency use authorization, orientation on drug regulators, perspectives on hydroxychloroquine prophylaxis as effective and excellent. More than 85% participants felt that AETCOM provided them insight on ethical issues, patient communication, and perspective of doctors as caregivers. 9.8% (16) participants provided comments to open ended question for feedback.Conclusions: The study provided an insight of medical undergraduates towards CBME curriculum. Further studies can be designed to look into the effectiveness of teaching learning methods based on the performance of the students, perspective of faculties with focus faculty development, and role of various stakeholders

Perspectives of Teachers at Medical Colleges Across India regarding the Competency based Medical Education Curriculum – A Qualitative, Manual, Theoretical Thematic Content Analysis

Background: Competency-based medical education (CBME) curriculum has been implemented in India since 2019 with a goal to create an “Indian Medical Graduate” (IMG) possessing requisite knowledge, skills, attitudes, values, and responsiveness. Objectives: To explore teachers’ perceptions across India at medical colleges on the newly implemented competency-based medical education curriculum. Methods: This was a qualitative cross?sectional study conducted among teachers working at medical colleges across India, between February and April 2022 (n = 192). The data collection was done using Google forms online survey platform on teachers’ perception regarding CBME, its specific components, and perceived bottlenecks. We analyzed this qualitative data using manual, theoretical thematic content analysis following the steps endorsed in Braun and Clarke’s six-phase framework. Results: The majority of the teachers (64.1%) have positively responded to the CBME curriculum’s implementation. However, it came with a caution that the curriculum should continuously evolve and adapt to regional demands. The foundation course, early clinical exposure, and the family adoption program were the specific components of CBME curriculum over which the teachers raised concerns. The need for additional teachers in each department (department-specific teacher or faculty per hundred students ratio to be worked out) and the need for enabling faculty preparedness through adequate training was highlighted. Concerns were also raised regarding implementing CBME with teachers without a medical background (especially in preclinical departments). Conclusion: It is the need of the hour for the curriculum to incorporate a systematic feedback mechanism built into the system, though which such critical appraisals can be meaning collated and acted upon, to ultimately evolve, thereby creating an “Indian Medical Graduate” for the needs of todays’ society

Perception for educational environment among medical students, Nainital: A Mixed method Cross-sectional study

Background- Environmental measurement has drawn some attention in the context of health professional education, with special focus on its effects on students outcomes. We sought to clarify the impact of CBME modules on the learning environment. An understanding of the educational program environment can help improve quality assurance. Aim and Objectives- To gain insight into medical students’ perception for Traditional and CBME curriculum for their educational environment in GMC Haldwani using DREEM Tool. To identify the strengths of current curriculum and suggestions for further improvement. Methodology- It is a mixed method Cross-sectional study conducted at Government Medical College Haldwani from November 2023-January 2024. In this study, the Dundee Ready Education Environment Measure (DREEM) tool was used for undergraduate medical students of traditional batch 2018 and CBME batch 2020. Scores obtained were expressed as mean ± Standard Deviation (SD). For qualitative part of the study, in depth interview of the 30 students of CBME Batch was conducted. Results- In quantitative part of the study ,we compared the DREEM scores of both the batches. The mean DREEM scores in this study were 120/200 for batch 2018 and 126/200 for batch 2020. Total scores were slightly high in CBME batch which means students of CBME batch were quite more satisfied with their learning environment. In qualitative part of the study we conducted in depth interviews with 30 randomly selected students from the CBME batch to understand the strengths of their curriculum and further ideas for improvement. Questions in the interview were asked under the domains of the DREEM tool. In qualitative part, reduction in duration of lectures and more research oriented teaching was suggested by the students. More student-centered activities like hospital visits and discussions of clinical scenarios were recommended. In social self perception, hostel rules to be relaxed more along with adding more of extra curricular activities were suggested. Conclusion- Both group of students had a positive perception of their learning environment, based on their scores. Through qualitative part of this study many strengths were perceived by the students of CBME curriculum along with the suggestions for further improvement

Electives in Medical Curriculum- An Insight of Medical Students

Background: Electives include courses that are interest based, where the students are free to choose the course content. NMC has introduced electives in medical curriculum and it has been implemented for the first time in various medical colleges. Aims and Objectives: The objective of this study is to assess the perception of MBBS students regarding Electives program. Methodology: This cross-sectional study was conducted among the first batch of MBBS students that completed the electives program after taking their consent and approval from ethical committee. Electives Experience scale (EES) and Electives Rating Scale (ERS) were developed, tested, and used for this study. Median, inter quartile range, Cronbach’s alpha and Mann Whitney tests were used for analysis. Results: Most of the students learnt theory, practical, AETCOM (ethics & communication), clinical skills and research in both blocks of posting but research was more focussed in block 1 and practical knowledge and clinical skills in block 2. For the Likert scales (EES-1, EES-2, ERS-1, ERS-2 & ERS), Cronbach’s alpha was found to be quite robust for all the scales. Median and inter quartile range were calculated for EES and ERS scores. Mann Whitney test showed significant gender difference for EES-2. If the student had got elective of his/her choice in block 1, the mean ranks of EES & ERS were significantly higher but if the student had got the elective of his/her choice in block 2, significantly higher scores were seen in overall ERS, ERS-2 and EES-2 only. Conclusion: Electives is a welcome addition to the medical curriculum. However, proactive approach from the student is a must to utilize this opportunity to the fullest

Impact of Curriculum Implementation Support Programme in changing the Knowledge, Attitude and Perceptions of Medical faculties towards Competency Based Medical Education in a Private Medical College

Background: CBME is a skill-based curriculum focusing on the desired competencies stated to be achieved by merits. To sensitize and train the faculty about CBME, the Curriculum Implementation Support Program (CISP) workshops have been held at various colleges across India. Aim& Objective: To find out the changes in the knowledge, perceptions and attitudes among medical teachers regarding CBME following CISP training. Methods and Material: The study carried out was cross-sectional and the data was collected before and after conduction of the CISP training programme. All the medical teachers who were enrolled in the CISP training were included in the study. The outcome result for knowledge-based questions was recorded as multiple choice options and that for attitudes and perceptions was recorded with a 5-point Likert scale ranging from strongly agree to strongly disagree. Statistical analysis used: Descriptive statistics were calculated using numbers and simple proportions. Results: There was a significant improvement in the knowledge and perceptions of medical teachers following CISP training showing its impact. The perceived challenges as felt by the faculties also reduced substantially. Conclusions: Capacity building programmes must be conducted at regular intervals for faculties for successful implementation of all the components of CBME

Crew appliance study

Viable crew appliance concepts were identified by means of a thorough literature search. Studies were made of the food management, personal hygiene, housekeeping, and off-duty habitability functions to determine which concepts best satisfy the Space Shuttle Orbiter and Modular Space Station mission requirements. Models of selected appliance concepts not currently included in the generalized environmental-thermal control and life support systems computer program were developed and validated. Development plans of selected concepts were generated for future reference. A shuttle freezer conceptual design was developed and a test support activity was provided for regenerative environmental control life support subsystems