Competency based medical education

1. Preparedness
for the “Accreditation and Ranking of Colleges”
by National Medical Commission (NMC)
on 24th and 25th August 2023
Prof. R. K. Dixit
Pharmacology & Therapeutics
King George’s Medical University, Lucknow, 226003
dixitkumarrakesh@gmail.com
7388889327

3. Which is more difficult?
A - To get the Top
B - To stay on the Top

9. • You are a member of NMC team which is to assess an institution of
highest reputation and academic records throughout the globe.
• You want to assess that actually the implementation of recently
introduced CBME curriculum is being implemented appropriately
• Please think questions for which you want answers from the
institution

14. 24th and 25th August are important
to
K. G. M. U. Lucknow

20. What is competency based medical
education (CBME)?
• Competency
• Defined as “the ability to do something successfully and efficiently,”
• It encompasses various components such as knowledge (theory), skills,
values, ethics, and attitudes, communication etc.
IMG ACTS with C2L2P roles to treat professionally

21. • IMG –
• Indian Medical Graduates
• ACTS – by using H3
• Attitude
• Communication
• Theoretical knowledge
• Skills (psychomotor)
• C2L2P –
• Clinician
• Communicator
• Leader and member of the team
• Life long learner
• Professional who works with application of ethics and values
IMG ACTS with C2L2P roles to treat professionally

22. What is competency based medical
education (CBME)?
• CBME
• An approach to ensure that the graduates develop the competencies required to fulfill the patients’ needs in
the society
• Competency based Medical Education provides an effective outcome-based strategy where various domains of
teaching including teaching learning methods and assessment form the framework of competencies
• Promises greater accountability, flexibility, and learner-centeredness
• Assessments frequent and formative in nature
• Feedback inbuilt in the process of training
• Assessed by a measurable standard which is objective and independent of the performance of other
students

31. 2949
2949 + 54 =
3003

37. Alignment

39. Shifting towards
•For learners
•Formative with feedback
•Frequent interactions
•Few (Small group interactions)
•Observations
•Individual

40. ACTS

41. Roles of IMG
(Indian Medical
Graduate)
C2L2P
Professional
Leader and
member of team
Life long learner
Communicator
Clinician

42. CBME started with 2019 MBBS batch

43. Simple truth universally applicable including in medical education
What will be
method for
formation
(Teaching
Learning
Methods)
What will be
assessment
method to be
sure of formation
(Formative and
Summative
assessments)
What do we
want?
Competent
IMG and
Competent
Specialists

45. Remember pyramid

46. T S C A

58. Taking the points one by one

60. Are Faculty staff aligning their teaching methods as per competence,
domain of knowledge (Knowledge, Skill, Attitude & Communication) and
level of competence (Know, know how, Show, Show How & Perform
Independently) mentioned in prescribed competency based curriculum?
O
T

66. Are Faculty staff aligning their teaching methods as per competence, domain of knowledge (Knowledge, Skill, Attitude &
Communication) and level of competence (Know, know how, Show, Show How & Perform Independently) mentioned in prescribed
competency based curriculum?
• DOAP
• Team-based learning in small group
• Simulation based learning (SBL)
• Educational games
• Demonstration
• Wardpostings
• Observational learning
• Project preparation and presentation
• Practical
• Collaborative learning
• Integrated teaching
• Case based learning (CBL)
• Problem based learning (PBL)
• Social media and video lectures (e-learning)
• Flipped classroom
• Assignments
• Tutorial
• Interactive lecture
• Lecture
• Performs
• DOAP
• Team-based learning in small group
• Simulation based learning (SBL)
• Educational games
• Demonstration
• Ward postings
• Observational learning
• Project preparation and presentation
• Peer assisted learning
• Community visit
• Peer assisted learning
• Practical
• Tutorial
• Community visit
• Collaborative learning
• Integrated teaching
• Case based learning (CBL)
• Problem based learning (PBL)
• Social media and video lectures (e-learning)
• Flipped classroom
• Lecture

67. Are Faculty staff aligning their teaching methods as per competence, domain of knowledge (Knowledge, Skill, Attitude &
Communication) and level of competence (Know, know how, Show, Show How & Perform Independently) mentioned in prescribed
competency based curriculum?
• Performs
• DOAP
• Team-based learning in small group
• Simulation based learning (SBL)
• Educational games
• Demonstration
• Ward postings
• Observational learning
• Project preparation and presentation
• Peer assisted learning
• Community visit
• Practical
• Collaborative learning
• Integrated teaching
• Case based learning (CBL)
• Problem based learning (PBL)
• Social media and video lectures (e-learning)
• Flipped classroom
• Assignments
• Tutorial
• Interactive lecture
• Lecture
O
T

70. • Every method has advantages and disadvantages
• Every method does not suffice all requirements
• How to select the most appropriate teaching learning methods
• Topic
• Competency
• Division in competency (which Domain is more focused? KSAC
• Level of competencies expected
• Knows
• Knows how
• Shows
• Shows how
• Performs
• Facilities available
• Staff
• Technologies
• Time

75. Are Faculty staff developing Lesson Plans with
specifications of Competence, derived objectives,
type of teaching methods and assessment methods
will be used? (The lesson plans are supposed to be
uploaded)
• A lesson plan is the instructor's road map of what students need to learn and how it will be done effectively during
the class time. Then, you can design appropriate learning activities and develop strategies to obtain feedback on
student learning
• Specific competency
• Objective
• Teaching method
• Assessment method

76. Are Faculty staff developing Lesson Plans with specifications of Competence, derived objectives, type of teaching
methods and assessment methods will be used? (The lesson plans are supposed to be uploaded)
• Instructor's road map of need to learn and how it will be done
• Design appropriate learning activities and develop strategies to obtain
feedback
• Specific competency
• Objective
• Teaching method
• Assessment method

77. •Each learning activity in the lesson must be
(1) Aligned to the lesson’s learning objectives
(2) Meaningfully engage students in active, constructive, authentic,
and collaborative ways
(3) Useful where the student is able to take what they have learnt
from engaging with the activity and use it in another context, or for
another purpose

80. • Title of the lesson
• Time required to complete the lesson
• Objectives
• List of required materials
• The set (or lead-in, or bridge-in) pictures or models, asking leading questions, or reviewing previous lessons
• An instructional component that describes the sequence of events that make up the lesson
• Independent practice that allows students to extend skills or knowledge on their own
• A summary, where the teacher wraps up the discussion and answers questions
• An evaluation component, a set of questions to answer or a set of instructions to follow
• An analysis component the teacher uses to reflect on the lesson itself—what worked and what not

81. •Required
•Relevant
•Related
•Real
•Resemblance
•Repetition

83. Are Faculty staff using teaching methods like
Small Group Discussion, Lectures and
demonstrations for knowledge domain and
Know and Know how level of competence?
• Selection of appropriate teaching learning method depending on the
• Place
• Timing
• Competency (Dominance of KSAC)
• Level
• Learner

85. Are Faculty staff using teaching methods like Small Group Discussion, Lectures and demonstrations for
knowledge domain and Know and Know how level of competence?
• Selection of appropriate teaching learning method depending on the
• Place
• Timing
•Competency (Dominance of KSAC)
• Level
•Learner
Please Teach Competent Level Learners

87. Are Faculty staff using DOAP sessions in Laboratory,
Demonstrations, Bed side clinic, Small Group Discussions
and Lecture for Knowledge & Skill Domains of
Competences and Show How level of concerned
Competence?
• DOAP (Demonstration -Observation - Assistance - Performance): A practical session that allows the student to observe a
demonstration, assist the performer, perform in a simulated environment, perform under supervision or perform independently
• Bed side clinic
• Small group discussion

88. Are Faculty staff using DOAP sessions in Laboratory, Demonstrations, Bed
side clinic, Small Group Discussions and Lecture for Knowledge & Skill
Domains of Competences and Show How level of concerned Competence?
• DOAP (Demonstration -Observation - Assistance -
Performance): A practical session that allows the student to
observe a demonstration, assist the performer, perform in a
simulated environment, perform under supervision or perform
independently
• Bed side clinic
• Small group discussion

90. Are Faculty staff using DOAP Sessions /Skill Laboratory based simulated
sessions, case discussions, demonstrations in clinical setting prominently for
Skill Domain and Perform level for concerned competence?
• Skill Laboratory
• Simulated sessions
• Case discussion
• Demonstrations

92. Are Faculty particularly in AETCOM, using Skill Lab sessions & case
discussion for Attitude & Communication domains & Show How
level for concerned competences?
•Attitude Ethics Communication
•Teaching learning methods

96. AETCOM Modules
• Module 1.1: What does it mean to be a doctor?
• Module 1.2: What does it mean to be a patient?
• Module 1.3: The doctor-patient relationship
• Module 1.4: The foundations of communication – 1
• Module 1.5: The cadaver as our first teacher
• Module 2.1: The foundations of communication – 2
• Module 2.2 The foundations of bioethics
• Module 2.3: Health care as a right
• Module 2.4: Working in a health care team
• Module 2.5: Bioethics continued – Case studies on
patient autonomy and decision making
• Module 2.6: Bioethics continued: Case studies on
autonomy and decision making
• Module 2.7: Bioethics continued: Case studies on
autonomy and decision making
• Module 2.8: What does it mean to be family member
of a sick patient?
• Module 3.1: The foundations of communication - 3
• Module 3.2: Case studies in bioethics - Disclosure of
medical errors
• Module 3.3: The foundations of communication - 4
• Module 3.4: Case studies in bioethics – Confidentiality
• Module 3.5: Case studies in bioethics - Fiduciary duty
• Module 4.1: The foundations of communication – 5
• Module 4.2: Case studies in medico-legal and ethical
situations
• Module 4.3: Case studies in medico-legal and ethical
situations
• Module 4.4: Case studies in ethics empathy and the
doctor-patient relationship
• Module 4.5: Case studies in ethics: the doctor-industry
relationship
• Module 4.6: Case studies in ethics and the doctor -
industry relationship
• Module 4.7: Case studies in ethics and patient
autonomy
• Module 4.8: Dealing with death
• Module 4.9: Medical Negligence

105. Have Faculty staff identified which type competences will be developed in
Skill Lab based simulated setting or in actual clinical setting?
• Domains that will enable the physician to be competent
• Patient care
• Medical knowledge
• Practice-based learning
• Interpersonal relationship
• Communication skills
• Professionalism
• System-based practice

107. Are students aware about which type competences they are required to acquire and
demonstrate in Skill Lab based simulated setting or actual clinical setting?
Are Faculty staff predominantly using DOAP based clinical training in lab based
simulated environment?

109. Are Faculty staff organizing grand rounds, interactive discussions
and clinical demonstrations?
• Grand rounds help doctors and other healthcare professionals keep
up to date in important evolving areas which may be outside of their
core practice. Most departments at major teaching hospitals will have
their own specialized, often weekly, grand rounds. Attending grand
rounds is also an important supplement to medical school and on-
the-job resident training. Grand rounds can also be distinguished
from rounds which is the (typically) daily visit by the attending
physician and team to all that physician's patients on the ward.
Rounding with an attending physician is an important part of medical
on-the-job training and education, but its primary focus is immediate
care for the patients on the ward. Grand rounds tends to present the
bigger picture, including experience with patients over many years,
and the newest research and treatments in an area. Grand rounds
tend to be open to the entire medical professional community,
whereas rounds are specific to individual attending physicians and
their teams

112. Are Students provided with opportunity as team member to attend ward round with
attending physician/Faculty staff in the wards of Clinical departments in Teaching
Hospital?

114. Are students provided with opportunities for providing care and applying
clinical procedures on patients under supervision or independently as per
requirements of concerned Programs UG & PG?

116. Are Faculty and students organizing Journal Clubs, clinical pathological
meetings & conferences etc. as per requirements of UG/PG programs for
clinical teaching/training purpose?

118. Have Faculty staff identified type of assessment tools and techniques which are being used them
for formative assessment purpose in theory classes/lectures.
•Understood
•How much
•Right track
•What to give as assignment

119. Have Faculty staff identified type of assessment tools and techniques which are being used them
for formative assessment purpose in theory classes/lectures.
• One Minute reflection
• Concept Map
• Misconception Check
• Quiz
• Choral Response
• Debriefing
• Summary Frames
• Think-Pair- Share/ Turn to Your Partner
• Think-Write-Pair Share
• Muddiest (or Clearest) Point
• Directed Paraphrasing
• Say Something
• K-W-L & KWL+ (Know, want to
know, what they learnt)
• Choral Reading
• One Question and One Comment

121. Have Faculty staff identified and aligned assessment tools &
techniques with type competences, domains of knowledge (K, S, A & C) and level
of Competence (K, KH, S, SH & P) related to clinical and non-clinical subjects?

123. Have Faculty staff identified type of formative assessment tools & techniques which are being
used during: * Practical/Hands on activities in Laboratory * Clinical teaching/learning in
lab based simulated setting or actual clinical setting * Clinical Posting?
•One minute preceptor
•DOPS
•Multi source feedback
•Mini Clinical Evaluation EXercise (mini-CEX)
•Objective Structured Assessment of Technical Skills (OSATS)

125. Are Faculty staff maintaining evidences(electronic/physical) of formative
assessment of students during Practical/Clinical teaching/clinical postings/ hands on
training in clinical setting as per requirements of program?
•Giving feedback with clear instruction followed by
signature, date and time
•Electronic surveys
•Electronic portfolio
•Records to dean

127. Is College conducting required number of Internal Assessment as
required by Medical Regulator?
•How many
•Methods
•What inference and utilization
•Weightage of internal to final

129. Has College maintained student wise assessment/evaluation sheets
for internal assessments in past 1 year?
Present the evidences

131. Log Books & Portfolio based Tracking learning
progress of students vis-à-vis laid down clinical Skills/Competences
1. Are all students maintaining Log Books as per requirement of Program?
2. Do Faculty have determined list of competence to be included in the Log Book of
students aligning with prescribed guideline on Log Book based assessment by Medical
Regulator?
3. Are students provided with activity for demonstrating competences included in Log
Book?
4. Do Faculty staff based on criteria rate the activity based demonstrated competence by
students and mention their observations like rating, and type of modification
required if not meeting expectation?

132. Log Books & Portfolio based Tracking learning
progress of students vis-à-vis laid down clinical Skills/Competences
1. Do Faculty staff ask students for repeating the activity or sometimes organize
remedialsessions if demonstrated competence through activity had not met
desired expectation?
2. Do Faculty after giving feedback and students after receiving feedback put signature
with date in the Log book?
3. Are students mention competences in Log Book which are to be performed in Skill
Laboratory/Simulated Lab?

136. Words are singularly the most powerful
force available to humanity

137. Enjoy every bit of your life to the fullest
English translation of
•दुख हमेशा साथ रहता है मगर ख़ुशी आती जाती रहती है
•My wife is with me but her sister comes
and goes

138. • 24th and 25th August 2023 NMC team is going to interact with faculty
• Be prepared regarding the basic terminologies and methods used for
the teaching learning and assessment of competencies
• Evidences -in the form of log book with feedback by faculty
• Just tell the answer in minimum words and clearly without any
conflict
• If one is hesitant other faculty of same department should support
• We are committed to excellence and will prove

139. Comments / Queries on- dixitkumarrakesh@gmail.com
7388889327