Curricular reforms: A mixed method study to identify perceptions of students and faculty regarding implementation of Foundation course in 1st year MBBS in an Indian medical school.

Document Type : Original Article

Authors

1 Department of Pharmacology, Government Medical College, Ratlam, Madhyapradesh, India

2 Department of Pharmacology, Pramukhswami Medical College, Anand, Gujarat, India

3 Principal Investigator, Women Scientist Scheme-B under Department of Science & Technology, Department of Pharmacology, Government Medical College, Ratlam, Madhyapradesh, India

Abstract

Background: The year 2019 witnessed   major curricular reforms in terms of launching Foundation Course (FC) by National Medical Commission (NMC) as a part of CBME (Competency Based Medical Education). Feedback from various stakeholders in medical education can register its merits and demerits. This study aimed to explore perceptions of   students and faculties of 1st year MBBS, regarding implementation of FC.
Methods: A mixed-method study was employed immediately as post implementation of FC using a structured questionnaire and a focus group interview to report perception of students and faculties. Study was conducted in Government medical college & Hospital, Ratlam, Madhypradesh India in September month of 2019.
Results: Majority of students i.e. 92.13 % felt, that FC orientation module helped them acclimatize to new environment and helped them engage with peers and   faculties. 91.01%   were sensitized to importance of professionalism and ethics in medicine.92.68% reported an enhancement in their communication skills, 83.70% mentioned its help in   stress management, 88.19% to 92.69% found reflective writing as an interesting exercise. Overall 87.00% graded FC as beneficial and a good program. Besides these sessions, an essential computer learning skills, community health care visit, sports, and extracurricular activities were appreciated. In addition, medical students gave mixed reviews on problems like   duration of FC, didactic teaching, and language barriers in terms of English and local.
Conclusions: FC provides a roadmap from a knowledge centric curriculum towards a competency based performance centric curriculum. Facilitating and nurturing such programs can play a pivotal role in fostering holistic development of students.

Keywords


  1. Medical Council of India. Vision 2015. New Delhi: Medical Council of India; 2011. Available at: http://www.mciindia.org/tools/announcement/MCI_ booklet.pdf. (Last accessed on 16.04.2019).
  2. Touchie C, Ten Cate O. The promise, perils, problems and progress of competency-based medical education. Med Educ. 2016;50:93–100
  3. Frank JR, Mungroo R, Ahmad Y, Wang M, De Rossi S, Horsley T. Toward a definition of competency-based education in medicine: A systematic review of published definitions. Med Teach. 2010;32:631-7
  4. National Medical Commission. Competency Based Undergraduate Curriculum. Available from: https://www.nmc.org.in/information-desk/for-colleges/ug-curriculum(Last accessed on 04.04.2021).
  5. Harden RM. Outcome-based education: The future is today. Med Teach. 2007; 29:625-9.
  6. Clark J. Indian medical education system is broken, Reuters investigation finds. 2015;350:h3324
  7. Khilnani AK, Patel J, Khilnani G. Students’ feedback on the FC in competency based medical education curriculum. Int J Res Med Sci. 2019;7(11):4408.
  8. Singh S, Ghosh S, Pandya H. Foundation program for MBBS students at entry level: experience at an Indian Medical School. South East Asian J Med Edu. 2007; 1: 33-7.
  9. Sharma R, Bakshi H, Kumar P. Competency-based undergraduate curriculum: A critical view. Indian J Community med. 2019;44(2):77.
  10. National Medical Commission document https://www.nmc.org.in/wpcontent/uploads/2020/08/FOUNDATION-COURSE-MBBS-17.07.2019.pdf.(Last accessed on 04.04.2021).
  11. Barbour R. Making sense of focus groups. Med Educ. 2005, 39(7): 742–50.
  12. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psych. 2006; 3: 77– 101.
  13. King, N. Using templates in the thematic analysis of text. In Cassell, C., Symon, G. (Eds.), Essential guide to qualitative methods in organizational research. London, UK: Sage;2004.p. 257–270
  14. Nabeiei P, Amini M, Ghanavati Sh, Marhamati S. Research priorities in medical education at Shiraz University of Medical Sciences: categories and subcategories in the Iranian context. JAMP. 2016; 4(1):26-32.
  15. Singh S, Ghosh S, Pandya H. Foundation programme for MBBS students at entry level: experience at an Indian Medical School. South East Asian J Med Edu 2007; 1: 33-7.
  16. MCI Document: FC for the Undergraduate Medical Education Program (2019) Medical Council of India, Pocket-14, Sector-8, Dwarka, New Delhi 110077. Available at: https://www.mciindia.org– (Accessed: 02/02/2020).
  17. Mittal R, Mahajan R, Mittal N. Foundation programme: A student's perspective. Int J App Basic Med Res. 2013;3(1):52.
  18. Shrivastava SR, Shrivastava PS. Qualitative study to identify the perception and challenges faced by the faculty of community medicine in the implementation of competency-based medical education for postgraduate students. Fam Med Community Health. 2019;7(1):e000043.
  19. Mishra P, Kar Manisha. Perception of Students on FC conducted for First year MBBS students at AIIMS Bhubaneswar. Indian J Community Fam Med. 2017;3(2):16-9
  20. Misra S, Fichadiya N, Kariya V. Implementation of Foundation Program under “Graduate Medical Regulations 2019” for first professional MBBS students at a Medical College located in western India-A transformative learning experience. MedEd Publish. 2020;9(1):64.
  21. Kerdijk W, Snoek JW, van Hell EA, Cohen-Schotanus J. The effect of implementing undergraduate competency-based medical education on students' knowledge acquisition, clinical performance and perceived preparedness for practice: a comparative study. BMC Med Educ. 2013;13:76
  22. Vyas S, Joshi U, Sheth J. Perception of first MBBS students from a medical college in Ahmedabad, Gujarat about one month’s FC during the year 2019. Natl J Integr Res Med. 2020; 11(1): 72-8
  23. Srimathi T. A study on students’ feedback on the FC in first year M.B.B.S curriculum. Int J Med Res Health Sci. 2014;3(3):575-9.
  24. Rege N. Towards competency-based learning in medical education: Building evidence in India. J Postgrad Med 2020; 66(1):9.
  25. Frank JR, Linda S, Snell LS, Cate OT, Carraccio C, Swing SR, et al. Competency-based medical education: Theory to practice. Med Teach. 2010;32:638-45
  26. Graffam B. Active learning in medical education: strategies for beginning implementation. Med Teach. 2007; 29(1):38-42.
  27. Kaur D, Singh J, Seema MA, Kaur G. Role of interactive teaching in medical education. Int J Basic Appl Med Sci. 2011;1(1):54-60.
  28. Mishra S. Violence against doctors: the class wars. Indian Heart J. 2015; 67(4): 289–92.
  29. Joshi AS, Ganjiwale JD, Varma J, Singh P, Modi JN, Singh T. Qualitative assessment of learning strategies among medical students using focus group discussions and in-depth interviews. IntJ App Basic Med Res 2017;7Suppl 1:S33.
  30. Suman S, Sarmishtha G, Himanshu P. FC for MBBS students at entry level: experience at an Indian medical school. South East Asian J of Med Edu. 2007;1(1):33-7.
  31. Dixit R., Joshi K.P., Suhasini P, Jamadar D., Students’ perception of FC – a new experience in MBBS curriculum in India. Int.J.Med.Sci.Educ. 2019;6(3):1-7
  32. Hawkins RE, Welcher CM, Holmboe ES, Kirk LM, Norcini JJ, Simons KB, Skochelak SE. Implementation of competency‐based medical education: are we addressing the concerns and challenges?. Med Educ 2015; 49(11):1086-102.
  33. Goldie J. AMEE education guide no. 29: evaluating educational programmes. Med Teach. 2006; 28(3):210–24.