Basics of CBME. May be apt to have the concept of Competency based Medical Education.

1. CBME
Competency Based
Medical Education
Dr. Hironmoy Roy
MD, MBA, DHM, MHPE, FAIMER
Asst. Secretary to GoWB
Dept. of Medical Education

2. Learning objective
After the end of the session, a learner will be able to:
a) Identify the needs of CBME
b) Know the differences of CBME and traditional
medical education

3. Dr. Smart is a Principal of a medical college. He is very
much proud for his students, where the entire final year
batch has done a glorious result.
After certain day, in one college council meeting Dr.
Health, the HOD-Community Medicine, reports that the
internees are not confident enough to serve the common
ailments in the community.
………………….Where is the problem?

4. In Quality Medical College, one day, when two internees,
who were on duty, were assaulted by the patient party on
the allegation of negligence to a patient.
As per the opinion of the mob, it flashed out that the patient
was declared to be well in the morning, and the patient died
after two hours. That’s why they assaulted the junior
doctors.
…..where is the problem?

5. Problem lies………….
A medical graduate not becomes competent
enough, in all domain, what s/he suppose to be.

6. Problem lies………….
We the teachers, teaches them, but not
facilitates them.
We, the teachers, neither address all domains,
nor assess all domains.
We, the teachers, always try to cover the
syllabus, but not try to uncover it, so that a
student can discover it.

7. Problem lies………….
What we suppose that all student should learn in
same speed. But in fact, every student learns in
his/her own pace and own speed.
Have we ever practiced the feedback to the
students after semester examinations?
We mug up before class, student mugs up before
exam; both parties become happy at the end.

9. Competence
• ‘Competence’ is specific, measurable dimensions of
Knowledge, skill and behaviour; that a learner is to
display at the end of a programme.
(More than the acquisition of knowledge-skill and attitude. It
guides one to apply these abilities in the concerned setting
and practice)

10. Competency
An observable ability of a health professional,
integrating multiple components such as knowledge,
skills, values and attitudes.

11. Competent
Possessing the required abilities in all domains in a
certain context at a defined stage of medical
education or practice.

12. Competency Based Medical Education
• Focuses on outcome
• Emphasizes on ABILITIES
• De-emphasises on time-based learning
• Promotes greater learner-centredness
• Segmented achievement & segmented assessment

14. Differences between the traditional teaching method
& competency based teaching method
Points of difference Traditional teaching method CBME
Curriculum Drives it It drives
Goal Knowledge acquisition Knowledge
application
flow Teacher  learner Teacher & Learner
Evaluation Norm referenced
Summative
Criteria referenced
Formative
Programme
completion
Fixed time Variable time

15. Differences between the traditional teaching method
& competency based teaching method
Points of difference Traditional teaching method CBME
Learners’
motivation
Immaterial, a student is
taught a topic in class; and it
is supposed to be that all
the students get the topic
learned. Have we ever
thought of it? NO
Motivated self-learning
is the main theme. Here
a teacher only
facilitates. The learner
learns a topic spanned
through the entire
course.
Assessment 2 methods:
1. Cont. Assessment
2. Final Assessment
Of each mile-stones; so
a learner gets feedback

16. The AIM of the GME is to
produce Competent Indian
Medical Graduate (IMG)
To achieve this we need to
set certain GOALS

17. Goal in GME

18. For this the ROLES of an IMG
need to be identified

19. Roles of an IMG
Clinician
Leader
Member of a
health care team
Communicator
Life-long
learner
Professional

20. In each ROLES an IMG need
to achieve some
Competencies

21. Competencies of an IMG
Clinician
Leader
Member of a
health care team
Communicator
Life-long
learner
Professional

22. Triple C
Comprehensive Care
Continuity of Education
Centred in family medicine

23. CBME
is……..
Outcome
based
Integrative
Learner
centred
Time
Independent
Individualized
Work-place
based

24. CBME
“Time independent”
The holistic aptitude of a lesson is divided in
“mile-stones”
Each milestone is to be covered in a particular
time
Assessment & feedback, for that milestone, to
be undertaken
So it is the learning in Phased-manner

25. Essence…..
Can we teach/ assess the Professionalism &
ethics in traditional medical teaching?
But possible in CBME

26. Mile-stone to be achieved at 8-9th
semester
Mile-stone to be achieved at 6-7th
semester
Mile-stones to be achieved at 4-5th
semester
Mile-stones to be achieved at 1-3rd
semester

28. Mile-stones
One competency is broken in different mile-stones,
which ought to be achieved by the end of a defined
time period and get assessed; so at the end of the
journey, the competency is wholesome achieved.

29. A Competency
Theme: Professionalism & ethics
A medical graduate should show proper respect to a
patient while examining him at OPD

30. Its components
A medical graduate should
• Properly greet the patient
• Passionately hear his problems
• Explain the examinations what he likes to do with the
patient and assure him/her that the procedures will not
do any harm to him/her
• Be respectful while to asking the patient to expose the
areas to be examined.
• Maintain the privacy of the patient
• Do the examination on the patient with proper empathy

31. Milestones domain To be
achieved by
A medical graduate should properly greet the
patient
AC 3rd-4th sem
A medical graduate should passionately hear the
problems of the patient
AC 5-6th sem
A medical graduate should explain the clinical
examinations, what he is going to do and should
assure that it would not harm him
SAC 5th-6th
semester
A medical graduate should to be respectful while
asking to expose the areas of the patient
SAC 7th- 8th
semester
A medical graduate would maintain the privacy of
the patient
S 9th semester
A medical graduate would do the examination with
proper empathy
S 9th semester

32. A student can
measure BP
The student can show how to measure
BP to a patient, on a simulator
The student need to know about the Anatomy & Physiology of the
circulatory system; the peripheral blood vessels, and the area where
pulses can be felt
The student knows how to measure BP

33. All domains
to be achieved
in parallel,
NOT
step-by-step

34. In summary
Spanned through the entire MBBS curriculum, a
competency is to be learned
What to be learned, to be determined by the
feedback of the beneficiaries
The segment/component of the competency, to
be learned by the end of a semester, is framed as
MILE-STONES
Assessment goes on in aligned with each mile-
stone

35. Challenges to implement….
• Think yourself…………….
Mass sensitization
BOS reluctant
Needs integration

36. Thanks to tolerate me…….