Karthikeyan Padmanabhan, Pulimoottil Davis Thomas
Department of Otorhinolaryngology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondy-Cuddalore Main Road, Pillaiyarkuppam, Pondicherry, 607 403 India.
Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):671-678. doi: 10.1007/s12070-018-1474-5. Epub 2018 Aug 23.
The worldwide call for a shift towards competency based postgraduate medical education has until recently gone largely unheeded in India, despite the Medical Council of India enshrining the principle in its regulations for postgraduate institutions. This paper details the first concrete attempt at establishing a CBME curriculum in Otorhinolaryngology in India. The design and implementation of the CBME curriculum was carried out in four phases, in a time-bound manner over a period of 6 months. Phase I consisted of an extensive literature review and a clarification of the major objectives of the program. Phase II involved the listing out of 20-30 entrustable professional activities (EPAs) for each specialty and the 13 core EPAs common to all incoming residents and the subsequent mapping of these EPAs to their respective domains of competence and year-wise levels of competence. This was followed by the development of milestones for each EPA and appropriate clinical vignettes. Phase III focused on development of 360° assessment strategies, including the in-house development of an e-portfolio. Phase IV was dedicated to the implementation of the CBME curriculum, and involved various sensitization and orientation programs for faculty and the new residents. This exercise in designing and implementing a CBME program showed the important role that intra-departmental and inter-institutional cross-communication and exchange of ideas vies-a-vie workshops and personal communication play in bridging the lapses in knowledge in this emerging area, reaching consensus to achieve project goals and for finding relevant solutions to common problems. Medical education in India presents its own peculiar set of logistical and cultural challenges. Keeping in line with the recommendations of the Medical Council of India regarding Postgraduate Medical Education, it is essential that medical colleges in India not fall behind the international paradigm shift towards CBME.
尽管印度医学委员会已在其研究生机构的规定中确立了基于能力的原则，但直到最近，全球范围内要求转向基于能力的研究生医学教育的呼声在印度基本上未得到重视。本文详细介绍了印度首次在耳鼻喉科建立基于能力的医学教育（CBME）课程的具体尝试。CBME课程的设计和实施分四个阶段进行，在6个月的时间内按时间限制完成。第一阶段包括广泛的文献综述和对该项目主要目标的明确。第二阶段涉及为每个专业列出20 - 30项可托付专业活动（EPA）以及所有新入学住院医师共有的13项核心EPA，随后将这些EPA映射到各自的能力领域和逐年的能力水平。接下来是为每个EPA制定里程碑和适当的临床案例。第三阶段专注于开发360°评估策略，包括内部开发电子档案袋。第四阶段致力于CBME课程的实施，涉及针对教师和新住院医师的各种宣传和培训计划。这次设计和实施CBME项目的实践表明，部门内部和机构间的交叉沟通以及思想交流，与研讨会和个人交流相比，在弥合这一新兴领域的知识差距、达成共识以实现项目目标以及找到常见问题的相关解决方案方面发挥着重要作用。印度的医学教育面临着自身独特的一系列后勤和文化挑战。为了与印度医学委员会关于研究生医学教育的建议保持一致，印度的医学院校必须不落后于向CBME转变的国际范式。
