Identication and Possible Redressal of Challenges Faced During Designing andImplementation of Early Clinical Exposure

Abstract

 Background: Recently, the Medical Council of India (MCI), now National Medical Commission (NMC) has developed the competency-based curriculum with the aim to produce medical graduates of global standards through curricular reforms. Proposed curricular changes begin early in the form of a foundation course; early clinical exposure (ECE); and properly designed integrated teaching and programs to develop the correct attitude and communication skills. ECE helps to integrate basic sciences with clinical subjects and plays a vital role not only in strengthening their academics but also paves a way for improving their clinical and communication skills. However, dedicated hours for ECE have raised certain concerns with basic sciences faculty members as the traditional clinical caseoriented teaching in basic subjects was well accepted and the applied knowledge of the subject was being delivered. In addition to these, various other apprehensions of the faculty members regarding this new concept have been raised. It is very important to address their concerns, so that they warm up to this concept and are able to deliver their knowledge in the best possible way to the students. Aim and Objectives: 1) To identify the apprehensions of the faculty members involved in ECE teaching. 2) To identify the challenges faced by the faculty members in designing the ECE module. 3) To identify the challenges faced by the faculty members in implementing the ECE module. 4) To propose the possible solutions for the challenges identied. Methodology: The study was carried out with the consenting faculty of the preclinical sciences at PGIMS, Rohtak after the IEC approval. Prevalidated questionaries regarding the apprehensions of the faculty members involved in ECE teaching and the actual challenges encountered while designing and implementing ECE sessions were given to them. Response to most of the questions was based on Likert scale and some open-ended questions were also included. The challenges were analysed and the possible redressal was sought through a 'focus group discussion' with the MEU members of the institute. The same was then conveyed to the faculty and their feedback and other suggestions were asked for. Findings: Major challenge faced during designing of the ECE session reported, pertained to the domain to be addressed while planning ECE (82%) followed by the extent of planning required that too by limited available faculty for the same. Major challenge reported during implementation was in respect to the non-availability of space (87%) and clinician at times during the ECE session (80%) in addition to other concerns. A number of other challenges were identied and the possible solutions to them were conveyed to the faculty. Conclusion: The study brings out the concerns of the faculty members involved with ECE designing and implementation. Various capacity building workshops should be carried for the purpose.