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Indian Pediatr 2015;52: 905 |
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Competency-based Medical Education: The Next
Steps
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Kieran Walsh
BMJ Learning, BMA House, Tavistock Square, London
WC1H 9JR
Email: [email protected]
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Modi, et al. should be congratulated
for an excellent account of competency-based medical education, and for
discussing its contextualisation within healthcare professional
education in India [1]. Although their account is high quality, there
are additional features of competency-based medical education that need
to be discussed. There is a need to have teachers and tutors who can
deliver competency-based medical education, and also assessors who can
reliably judge when learners have reached the requisite competence.
These teachers-cum- assessors will need to develop new educational
skills to make these judgements. In the past, assessors might have
judged a trainee by looking at the time they have spent in training, or
their completion of various modules, their passing of certain exams;
however, these achievements will no longer work in the new world of
competency-based medical education [2,3].
First and foremost, when introducing this new concept
of medical education in India, considerable planning will need to be
given to win the hearts and minds of the assessors. Another challenge
will be making the somewhat theoretical concept of
competency-based medical education understandable and practical for all
stakeholders – including both trainees and trainers. In this regard
another model of medical education touched on by the authors will need
to come to the foreground – that of entrustable professional activities
(EPA) [4]. The attractiveness of EPA is that they convert the
high-minded hypotheses of competence back to the grassroot level of
clinical medicine. All clinicians understand what it is to trust a
trainee to carry out a procedure, or to do a consultation with a certain
type of patient, or indeed to go "on-call" without resident supervision.
So an important first step in the journey that medical education in
India must take is that of converting competences into EPA which are
very much context- specific; only that those relevant in the specific
clinical and learning environment of India will work. Doing this work
will be challenging and time-consuming, but the potential reward is
great: a new generation of trainees who have been trained to the highest
possible international standards.
References
1. Modi JN, Gupta P, Singh T.
Competency-based medical education, entrustment and assessment. Indian
Pediatr. 2015;52:413-20.
2. van der Vleuten CP, Schuwirth LW. Assessing
professional competence: From methods to programmes. Med Educ.
2005;39:309-17.
3. Walsh K. Online educational tools to improve the
knowledge of primary care professionals in infectious diseases.
Education for Health 2008;21: 64.
4. ten Cate O. Nuts and bolts of entrustable professional activities.
J Grad Med ‘ Educ. 2013;5:157-8.
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