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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 7  |  Issue : 2  |  Page : 258-261

Challenges faced by 1st phase MBBS students during online teaching of competency-based medical education curriculum – COVID times


Department of Community Medicine, Kurnool Medical College, Kurnool, Andhra Pradesh, India

Date of Submission08-Jan-2022
Date of Decision08-Feb-2022
Date of Acceptance11-Feb-2022
Date of Web Publication09-Sep-2022

Correspondence Address:
S Cynthia Subhaprada
Department of Community Medicine, Kurnool Medical College, Kurnool, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bjhs.bjhs_3_22

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  Abstract 


BACKGROUND: Competency-based medical education (CBME) is a learner-centered, outcome-based approach which motivates self-learning. Currently, the world is experiencing COVID-19 pandemic which led to shutdown of colleges, and hence, online teaching has become a key component in the continuity of medical education. The main aim of the study is to analyze the impact of COVID-19 pandemic on online teaching among 1st-year MBBS students and to assess the challenges faced during this time.
METHODS: After obtaining institutional ethics committee clearance, a mixed-method study design was used to collect data from 100 respondents among 1st-year MBBS students of Kurnool Medical College, Kurnool, during the month of September 2020. A prevalidated, semi-structured questionnaire was sent to the participants through Google Forms. The quantitative analysis was done through survey questions on a five-point Likert scale.
RESULTS: The reported challenges to online medical education during COVID-19 pandemic were lack of in-person communication (57%), technical issues while attending online classes (49%), difficulty in time management (50%), confusion in understanding course expectations/competencies (44%), and more focused on theory than practicals (59%). Some of them stated that “having online classes is really helpful than not having any classes at all.”
CONCLUSIONS: Hence, we conclude that though challenges mentioned above were faced during online teaching of CBME curriculum, effective leadership and student teamwork would be helpful in successful online teaching.

Keywords: Competency-based medical education, medical education, online teaching


How to cite this article:
Sofia B P, Subhaprada S C. Challenges faced by 1st phase MBBS students during online teaching of competency-based medical education curriculum – COVID times. BLDE Univ J Health Sci 2022;7:258-61

How to cite this URL:
Sofia B P, Subhaprada S C. Challenges faced by 1st phase MBBS students during online teaching of competency-based medical education curriculum – COVID times. BLDE Univ J Health Sci [serial online] 2022 [cited 2023 Jan 28];7:258-61. Available from: https://www.bldeujournalhs.in/text.asp?2022/7/2/258/355850



The Medical Council of India (MCI) has described the basic competencies required for an Indian Medical Graduate and designed a competency-based module on attitudes and communication. MCI suggested to implement competency-based learning in all medical colleges. Competency is defined as the ability to do something successfully and efficiently.[1]

Competency-based medical education (CBME) is an approach to prepare physicians for practice that is oriented to graduate outcome abilities and organized around competencies derived from an analysis of society and patient needs. It de-emphasizes the current time-based training and promises greater accountability, flexibility, and learner-centeredness.[2] The current traditional approach is teacher centered and is mainly focused on content and summative assessment, while CBME is learner centered and focuses on skills and formative assessment.[3] Many colleges have been implementing a transition from traditional face-to-face teaching to online teaching or a combination of online and traditional teaching.[4]

Currently, the world is experiencing COVID-19 pandemic caused by novel coronavirus. It showed a great impact on countries economy and education. On March 11, 2020, the World Health Organization has declared coronavirus outbreak as a pandemic.[4] The government has issued lockdown as a measure to contain the spread of COVID-19 pandemic, which led to shutdown of all educational institutions including medical colleges across the country. Teaching/learning in medical colleges shifted to entirely online mode the key component in the continuity of medical education.[4] Hence, there is a need to study the various challenges faced in online learning of CBME curriculum among the 2019 batch of undergraduate students as this is the first CBME batch who are currently in the 1st professional year of MBBS, as they have not been exposed to such mode of curriculum delivery in the previous months.


  Methodology Top


After obtaining institutional ethics committee (IEC) clearance from the IEC (Letter/IEC No. 07/2020-KMC, date September 14, 2020) and informed consent from the study participants, the study was conducted among 1st-year MBBS students of Kurnool Medical College, Kurnool, during the month of September 2020. One hundred participants were selected by simple random sampling, using the table of random numbers. It was a mixed-method study design (web-based study).

Study tool

A prevalidated, semi-structured questionnaire was sent to the participants through Google Forms. The questionnaire was validated by the faculty who are members of the Medical Education Unit, Kurnool Medical College, Kurnool. Both closed- and open-ended questions were included. Closed questions included participants' demographic details and their experience as a learner through online teaching before and during COVID-19 pandemic, and it also included questions related to perceptions of students on online teaching and the challenges faced by them. The study was piloted among ten students, and those students were not included in the present study. The quantitative analysis was done through survey questions on a five-point Likert scale. The data were entered in MS Excel version 2007.

  • Inclusion criteria: 1st-year MBBS students who consented
  • Exclusion criteria: (1) Students who did not give consent and (2) other UG batches.



  Results Top


Out of 100 participants, majority were females (55%) and 19 years of age. Results showed that 87% did not have online teaching experience before COVID-19 pandemic. Fifty-nine percent strongly agree that online teaching is more focused on theory rather than practical aspect, as shown in [Table 1]. Fifty-six percent agree that students' assessment and feedback is difficult in online teaching. Forty-nine percent stated that there are technical issues while attending online classes. Fifty percent stated that staying motivated is difficult during online classes. Seventy-four percent believe that there is a negative impact of shift from traditional to online teaching. There is uncertainty about future among the students because of this pandemic like for how long it persists, for how long colleges will be shut down, and it is causing stress and anxiety among students. Fifty-seven percent agree that there is a lack of in-person communication, as shown in [Table 2]. During qualitative analysis, it was found that most of them opined “blended learning would better address the practical aspects as well.” A combination of traditional/face-to-face learning activities blended with virtual or e-learning, i.e., online learning, constitutes a blended learning experience which harnesses the benefits of both methods of teaching/learning. Some of them stated that “having online classes is really helpful than not having any classes at all.”
Table 1: Perception of 1st phase Bachelor of Medicine and Bachelor of Surgery students on online teaching during COVID-19 pandemic 2020

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Table 2: Challenges faced by 1st phase Bachelor of Medicine and Bachelor of Surgery students during online teaching

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  Discussion Top


The framework for the initiation of implementing CBME in India was provided by the MCI. CBME curriculum was made mandatory for the batch of 1st-professional year MBBS students admitted in August 2019 for the first time. Thus, the implementation of CBME curriculum is an extremely new approach in India.[5] Due to this pandemic, most of the colleges have adapted entirely to online teaching. This sudden shift from traditional to online teaching is challenging for both faculty and students and requires a lot of preparation and other efforts in a short time in order to meet time line for the curriculum delivery.[6] Challenges faced by medical students during online education reported in the medical literature so far include issues related to time management, use of technology tools, students' assessment, communication, and lack of in-person interaction.[7] Experts have predicted that it may take some 5–10 years to recover from this pandemic based on previous experiences.[8] Most of the participants (87%) in the present study do not have online teaching experience before the pandemic, whereas in a study done by Rajab et al., 37.4% of the medical students have no online experience.[9] Most of the participants preferred combining online with traditional teaching. Similarly, previous studies have reported that hybrid learning is becoming more accepted because it combines “the best of both worlds.”[4]However, the effectiveness of hybrid learning depends on various factors, especially adequate training of faculty and institutional support.[10] Faculty training in effective curriculum planning and content delivery and support from institution by providing infrastructure, manpower, etc., and encouraging faculty pursuing medical education courses such as Advance Course in Medical Education and Foundation for Advancement of International Medical Education and Research would go a long way in successful blended learning.


  Conclusions Top


Lack of in-person communication during online teaching, technical issues while attending online classes, confusion among students regarding course expectations/competencies, lack of student engagement and active participation in online teaching, and difficulty in students' assessment and feedback are some of the challenges faced during the online teaching. These can be addressed by orienting the students about course expectations during online learning, allotting group work to enable them to interact with each other and their mentors, and making the sessions more interactive to keep the students engaged. More focus and emphasis should be put on self-directed learning, proper student assessment, and prompt feedback.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Medical Council of India. Curriculum Implementation Support Program of the Competency Based Undergraduate Medical Education Curriculum. New Delhi: Medical Council of India; 2019.  Back to cited text no. 1
    
2.
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.  Back to cited text no. 2
    
3.
Chacko TV. Moving towards competency based education: Challenges and the way forward. Arch Med Health Sci 2014;2:24753.  Back to cited text no. 3
    
4.
Orlearns M. In: DeMarco A, Wolfe K, editors. Cases on Critical and Qualitative Perspectives in Online Higher Education. Hershey, PA: IGI Global; 2014.  Back to cited text no. 4
    
5.
Medical Council of India. Medical Council of India Regulations on Graduate Medical Education, 1997; July, 2017. Available from: https://www.mciindia.org/documents/rulesAndRegulations/GME_REGULATIONS.pdf. [Last accessed on 2018 Oct 22].  Back to cited text no. 5
    
6.
Li L, Xv Q, Yan J. COVID-19: The need for continuous medical education and training. Lancet Respir Med 2020;8:e23.  Back to cited text no. 6
    
7.
Esani M. Moving from face-to-face to online teaching. Clin Lab Sci 2010;23:187-90.  Back to cited text no. 7
    
8.
How does the Pandemic Affect U.S. College Students? Temple University, Philadelphia. CN Interview; 2020. Available from: http://www.pbs.org/wnet/amanpour-andcompanyvideo/how-does-pandemic-affect-low-income-students-nufk5j/. [Last accessed on 2020 Apr 02].  Back to cited text no. 8
    
9.
Rajab MH, Gazal AM, Alkattan K. Challenges to online medical education during the COVID-19 pandemic. Cureus 2020;12:e8966.  Back to cited text no. 9
    
10.
Comas-Quinn A. Learning to teach online or learning to become an online teacher: An exploration of teachers' experiences in a blended learning course. ReCALL 2011;23:218.  Back to cited text no. 10
    



 
 
    Tables

  [Table 1], [Table 2]



 

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