Strength weakness opportunities challenge analysis of implementing competencybased medical education curriculum: Perspectives from anatomy specialty

JKIMSU, Vol. 13, No. 1, January-March 2024 ISSN 2231-4261 ORIGINAL ARTICLE Strength weakness opportunities challenge analysis of implementing competencybased medical education curriculum: Perspectives from anatomy specialty 1 2 3 T. S. Gugapriya , Dhivya M. S. , Ilavenil K , N. Vinay Kumar 4* 1 Department of Anatomy, All India Institute of Medical Sciences, Nagpur-441108 (Maharashtra) India, 2 Department of Anatomy, Arunai Medical College and Hospital, Tiruvannamalai-606603 (Tamil Nadu) India, 3Department of Anatomy, Karpagam Medical College, Coimbatore-641032, (Tamil Nadu) India, 4 Department of Anatomy, Government Medical College, Palakkad-678001 (Kerala), India Abstract Background: Delivery of quality healthcare to meet societal needs begins with robust medical education training of health professionals. Implementation of Competency-based Medical Education (CBME) was one such step by the Medical Council of India (MCI) in sculpting an Indian Medical Graduate (IMG). India implemented the CBME from its 2019-2020 batch of medical undergraduates. Aim and objectives: This study was to understand and analyze the Strengths, Weaknesses, Opportunities, and Challenges (SWOC) involved in implementing CBME in the middle of the academic year in the Anatomy specialty. Material and Methods: A convenience sample of 95 anatomy faculty members was invited to participate in the study by email from the harvested list of emails from institutional websites. A Google form of a self-structured pre-validated questionnaire was used as the study tool. The perceptions regarding the CBME curriculum and its implementation were obtained. The SWOC of CBME implementation in the anatomy specialty were deduced by mixed method analysis. Results: By voluntary response sampling method, 42 faculty members responded. Initiating the faculty development programs and revising the curriculum were perceived as strengths. A weakness was a need for more understanding of the tools and materials, such as guidebooks and competencies framework. The responders thought that the CBME had provided opportunities for their professional development. Still, the deficiency of the workforce, the poor documentation, and the lack of inter-departmental coordination were voiced as the main challenges that needed to be addressed to implement CBME effectively. Conclusion: The faculty considered implementing the CBME as an avenue for learning and growth. An ethos of collaboration, resource augmentation, and support is required to ensure productive CBME implementation. There is a need for improved quality of training material. Inclusive capacity building and training of all faculty is essential to achieving the intended objectives of CBME implementation. Keywords: Competency, Medical Education, Medical graduate, Anatomy, Curriculum Introduction Competency-Based Medical Education (CBME) is an outcome-based approach designed, implemented, evaluated, and assessed based on the framework of competencies [1]. The CBME curriculum, which includes new components of pedagogy like aligned and integrated lectures, Early Clinical Exposure (ECE), Self-Directed Learning (SDL), and a month-long foundation course, was introduced for the 2019-2020 batch of first-year medical undergraduates. Reflection was introduced as a primary tool in continuous formative assessment [1]. Ó Journal of Krishna Institute of Medical Sciences University 25 JKIMSU, Vol. 13, No. 1, January-March 2024 To implement this change in curriculum, the Medical Council of India (MCI) rolled out capacity building in phases [2]. The faculty training encompasses sensitization and training of faculty across the country, sensitization of students, structuring of curriculum, and formulation of defined entrusted professional and programmatic activities. Upgrading of infrastructure and different learning resources is mandatory [3-4]. For accomplishing the mentioned prerequisites, the training programs such as Curriculum Implementation Support Program (CISP), Revised Basic Course Workshop in Medical Education (RBCW), Attitude, Ethics, and Communication (AETCOM) programs were implemented under the Medical Educational Unit (MEU) of every institution for a successful CBME implementation [5]. The newer tools like the CBME manual and logbook guided the implementation of the curriculum [6]. MEU of each medical college has formed a continuous first-line support system for implementing CBME. Each MEU has trained all teaching faculty in their respective institution in a timebound, outcome-based method. Explicit knowledge regarding each component of CBME, such as vertical and horizontal integration, different pedagogical methods, and assessment formats, will help to successfully implement the curricular program [7]. The study aims to understand and analyze the Strengths, Weaknesses, Opportunities, and Challenges (SWOC) involved in implementing CBME in the context of anatomy specialty in the mid-year of implementation. T. S. Gugapriya et al. Material and Methods Study setting The study is an interim observation study following the implementation of the CBME curriculum. The study obtained clearance from Institutional Ethics Committee (IEC/Pharmac/53/20 dated 13/03/ 2020) before the commencement of the study. Data collection and sampling Emails of 95 anatomy faculty members were retrieved from institutional websites from 50 medical institutions in south India without any further sampling. These 95 anatomy faculty members formed the convenience sample for this study and received the study tool questionnaire via Google Forms, which needed a response within a week. The investigators sent a reminder email seven days after the first email. The written informed consent was incorporated along with the Google form to be filled out by the participants. Study tool A focus group discussion among the study investigators resulted in four major areas that needed exploration for this SWOC study. The emergent areas for investigation were as follows: 1. functionality of MEU and usefulness of its training program, 2. understanding tools of CBME implementation, 3. implementation of advocated pedagogical methods, and 4. measures for the implementation outcomes. The study tool was developed based on the details shown in Table 1. A final structured questionnaire consisting of 43 items was developed, as given in Table 2, following the content validation process conducted by three Medical Education Training (MET) faculty members independent of the study group. Ó Journal of Krishna Institute of Medical Sciences University 26 JKIMSU, Vol. 13, No. 1, January-March 2024 T. S. Gugapriya et al. Table 1: Details obtained from respondents by the study tool questionnaire The study tool sections Details probed Demographic data l l l l Functionality of MEU & usefulness of its training program- 8 items l l l l l l l Understanding tools of CBME implementation l l l l Implementing advocated pedagogic (...truncated)