WHAT CHANGES IN IMPLEMENTING COMPETENCE-BASED MEDICAL EDUCATION IN INDONESIA: A QUALITATIVE STUDY

https://doi.org/10.22146/jpki.64125

Titi Savitri Prihatiningsih(1*), Hikmawati Nurokhmanti(2), Geraldine Baujea(3)

(1) Departemen Pendidikan Kedokteran dan Bioetika Universitas Gadjah Mada Gedung Radioputro Lt. 6, Jl. Farmako, Sekip Utara, Yogyakarta 55281
(2) Department Medical Education and Bioethics, Faculty of Medicine, Public Health and Nursing, Yogyakarta – INDONESIA
(3) School of Health Profession Education, Maastricht Medical School, Maastricht – NETHERLANDS
(*) Corresponding Author

Abstract


Background: Competence-based Medical Education (CBME) is the latest curriculum model adopted by many countries since 1970s. Reforming medical curriculum to adopt CBME implicates major changes in all aspects and research on this is still lacking. This study aims at identifying changes in implementing CBME from the aspects of organization and structural changes, curricular design, implementation and evaluation and cultural changes.

Methods: Retrospective qualitative method is applied using purposive sampling. Selected documents are used as the data and analysed using thematic analysis.

Results: Four themes are identified for the first aspect, i.e. the role of central authority, multidepartment committees, committed change agents, and decision-making procedures. Whereas for the second aspect, five themes are pinpointed, consisting of curriculum design at macro level, meso and micro level, faculty development program, learning resources, implementation, and monitoring and qualitative evaluation. For the third aspect, four themes emerge, namely enabling factor, inhibiting factor, the paradox of the new curriculum and quality assurance.

Conclusion: Major changes taking place in the design and implementation of CBME have been identified from three aspects inductively. Awareness of the kinds of changes and using them for curriculum planning could improve the success in shifting towards CBME.


Keywords


competence-based medical education, medical curriculum

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References

  1. McGaghie WC, Miller GE, Sajid AW, Thelder TV. Competency–based Curriculum Development in Medical Education: An Introduction. Geneva: WHO; 1978.
  2. Spady WG. Competency Based Education: A Bandwagon in Search of a Definition. Educ. Res. 1997; 6: 9–14.
  3. Malone K, Supri S. A critical time for medical education: The perils of competence-based reform of the curriculum. Adv Healh Sci Educ. 2012; 17: 241–6.
  4. Carraccio C, Wolfsthal SD, Englander R, Ferentz K, Martin C. Shifting paradigms: From flexner to competencies. Acad Med. 2002; 77: 361–7.
  5. Harden RM, Crosby JR, Davis MH. AMEE guide no. 14: Outcome-based education : Part 1-- an introduction to outcome. Med Teach. 1999; 21: 7–14.
  6. Frank JR, et al. Competency-based medical education: Theory to practice. Med Teach. 2010; 32: 638–45.
  7. Albanese MA, Mejicano G, Mullan P, Kokotailo P, Gruppen L. Defining characteristics of educational competencies. Med Educ. 2008; 42: 248–55.
  8. Caccia N, Nakajima A, Kent N. Competency- Based Medical Education: The Wave of the Future. J Obstet Gynaecol Canada. 2015; 37: 349–53.
  9. Epstein RM, Hundert EM. Defining and assessing professional competence. J Am Med Assoc. 2002; 287, 226–35.
  10. Swing SR. Perspectives on competency-based medical education from the learning sciences. Med Teach. 2010; 32.
  11. Konsil Kedokteran Indonesia. Standar Kompetensi Dokter Indonesia. Jakarta: Konsil Kedokteran Indonesia; 2006.
  12. GMC. Outcomes for graduates. GMC Publ. 2018; 1: 8.
  13. Eno C, et al. ACGME Milestones Guidebook for Residents and Fellows. Chicago: ACGME; 2020.
  14. Talbot M. Monkey see, monkey do: A critique of the competency model in graduate medical education. Med Educ. 2004; 38: 587–92.
  15. Squires G. Modelling Medicine. Med Educ. 2002; 36: 1077–82. Nousiainen MT, Caverzagie KJ, Ferguson PC, Frank JR. Implementing competency-based medical education: What changes in curricular structure and processes are needed? Med Teach. 2017; 39: 594–8. medical education: What changes in curricular structure and processes are needed? Med Teach. 2017; 39: 594–8.
  16. Ferguson PC, Caverzagie KJ, Nousiainen MT, Snell L. Changing the culture of medical training: An important step toward the implementation of competency-based medical education. Med Teach. 2017; 39: 599–602.
  17. Caverzagie KJ, et al. Overarching challenges to the implementation of competency-based medical education. Med Teach. 2017; 39: 588–93.
  18. Konsil Kedokteran Indonesia. Standar Kompetensi Dokter. Jakarta: KKI; 2006.
  19. Denzin NK, Lincoln YS. The Sage Handbook of Qualitative Research. Thousand Oaks: Sage Publications Inc; 2005.
  20. Bowen GA. Document analysis as a qualitative research method. Qual Res J. 2009; 9: 27–40.
  21. O’Leary Z. Doing Your Research Project. Thousand Oaks: Sage Publishing; 2017.
  22. Clarke V, Braun V. Thematic analysis. J Posit Psychol. 2017; 12: 297–8.
  23. Biggs J. What the student does: Teaching for enhanced learning. High Educ Res. Dev. 2012; 31: 39–55. Harris P, Snell L, Talbot M, Harden RM. Competency-based medical education: Implications for undergraduate programs. Med Teach. 2010; 32: 646–50.
  24. Hawkins RE, et al. Implementation of competency-based medical education: Are we addressing the concerns and challenges? Med Educ. 2015; 49: 1086-102.
  25. Norman G, Norcini J, Bordage G. Competency- Based Education: Milestones or Millstones1? J Grad Med Educ. 2014; 6: 1–6.
  26. Dath D, Iobst W. The importance of faculty development in the transition to competency-based medical education. Med Teach. 2010; 32: 683–6.
  27. Chuenjitwongsa S, Oliver RG, Bullock AD. Competence, competency-based education and undergraduate dental education: a discussion paper. Eur J Dent Educ. 2018; 22(1): 1-8.
  28. Griffiths J, Dalgarno N, Schultz K, Han H, van Melle E. Competency-Based Medical Education implementation: Are we transforming the culture of assessment? Med Teach. 2019; 41: 811–8.
  29. Scheele F, et al. Introducing competency-based postgraduate medical education in the Netherlands. Med Teach. 2008; 30: 248–53.



DOI: https://doi.org/10.22146/jpki.64125

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