16/12, 16:35]hu2: In reply to the first comment to this post:
Personalized medicine is for answering individual patient requirements! There's no personalized medicine for physicians who have to heal others.
Personalized curriculum can't apply to training physicians who have to understand and handle every human problem even as a specialist. However the nudge to curricular policy makers to use medical education as a tool to drive systems thinking holds good here.
NEJM competence based medical education CBME review journal club:
### Strengths of the Article
The NEJM review by Cooper and Holmboe effectively synthesizes evidence for CBME, highlighting its outcomes-based approach as superior to time-based models, supported by studies like the Canadian family medicine cohort showing reduced trainee deficiencies through early feedback. It emphasizes practical implementation via milestones, EPAs, and coproduction, aligning with global standards (e.g.,
ACGME,
WHO reforms), and addresses equity in training to meet societal health needs. The call for innovation, such as time-variable models like
Competence by Design, is forward-thinking and grounded in educational science.
### Limitations and Critiques
While advocating strongly for CBME, the article underplays implementation barriers, such as high resource demands for faculty development and data analytics, which could strain underfunded programs, especially in low-resource settings. It relies on early evidence (e.g., cohort studies) without discussing long-term outcomes or potential biases in self-reported assessments, and the focus on U.S./Canadian contexts limits generalizability to diverse global systems. Additionally, the moral imperative framing risks oversimplifying resistance as "flawed logic," ignoring valid concerns about workload and burnout for clinician-educators.
### Overall Assessment
This piece is a compelling, evidence-informed push for paradigm change in medical education, essential reading for leaders, but it would benefit from more balanced discussion of scalability and empirical gaps to guide realistic adoption.
Here's a detailed summary of the key insights from the article “Competency-Based Medical Education at the Front Lines of Patient Care” by Dawn Cooper and Eric S. Holmboe, published in The New England Journal of Medicine:
---
*🩺 Summary: Competency-Based Medical Education (CBME)*
*🎯 Why CBME?*
- The traditional time-based model of medical education is failing to consistently produce physicians who are fully prepared for clinical practice.
- Many graduates lack essential clinical, procedural, and teamwork skills, contributing to gaps in care and health inequities.
- CBME is proposed as a solution to align medical training with the quintuple aim: better population health, health equity, patient care, provider well-being, and cost reduction.
*🔄 Key Differences: Traditional vs. CBME*
- *Traditional Model*: Fixed duration, limited assessments, time as a proxy for competence.
- *CBME Model*: Flexible duration, frequent assessments, time as a resource for achieving competence.
- CBME emphasizes outcomes, direct observation, and readiness for unsupervised practice rather than time served.
*🧠 Core Components of CBME*
- *Competency Frameworks*: Define clear, assessable milestones across domains like clinical reasoning, communication, professionalism, and systems-based practice.
- *Programmatic Assessment*: Continuous, multifaceted evaluations (e.g., direct observation, multisource feedback) to track progress and guide learning.
- *Coproduction*: Trainees are active partners in their education, collaborating with faculty to shape learning and care delivery.
*👩🏫 Roles in CBME*
*1. Program Leaders*
- Design and implement competency frameworks and curricula.
- Ensure alignment with societal health needs and institutional goals.
- Use learning analytics and aggregated data to monitor and improve programs.
*2. Clinician-Educators*
- Deliver high-quality care while teaching and assessing trainees.
- Provide real-time feedback and coaching.
- Use milestones to tailor learning plans and identify gaps.
*3. Trainees*
- Engage as co-creators of their learning journey.
- Provide feedback to improve curricula and assessments.
- Progress based on demonstrated competence, not time.
*📊 Evidence of Effectiveness*
- Studies show CBME improves early identification of struggling learners and supports remediation.
- Canadian family medicine programs using CBME saw fewer residents flagged for deficiencies and better remediation outcomes.
*🔄 Continuous Improvement*
- CBME programs require ongoing evaluation and adaptation.
- Learning analytics and AI tools are being explored to enhance assessment and curriculum design.
---
[16/12, 14:36]hu3: Recording of
*CME on Curriculum mapping vs Knowledge harvesting: Bridging the gap*
Conducted by MGMCRI, SBV
on
29.11.2025
[16/12, 16:18]hu2: 👆Can someone produce an infographic on this YouTube video?
Here's the perplexity summary of the above video:
### Event Overview
This 2-hour-57-minute YouTube video records a Continuing Medical Education (CME) session hosted by Sri Balaji Vidyapeeth Deemed University on December 9, 2025, titled "Curriculum Mapping vs Knowledge Harvesting: Bridging the Gap." It features expert discussions on enhancing medical education through structured curriculum design, emphasizing alignment between planned learning outcomes and actual student knowledge acquisition. The session targets educators and administrators, drawing from competency-based frameworks like those in India's
National Medical Commission guidelines.
### Curriculum Mapping Explained
Curriculum mapping involves creating visual or tabular representations of course elements—such as objectives, content, teaching methods, and assessments—to identify gaps, redundancies, and alignments across programs. Speakers highlight its role in ensuring horizontal (within-year) and vertical (across years) coherence, using tools like
Bloom's Taxonomy to progress from basic recall to advanced analysis in medical training. Benefits include data-driven improvements, accreditation compliance (e.g., NABH standards), and adapting to 21st-century skills like critical thinking for future doctors.
### Knowledge Harvesting and Bridging the Gap
Knowledge harvesting refers to systematically capturing and applying tacit student and faculty insights post-teaching, contrasting with static mapping by focusing on real-time feedback loops to refine curricula. The video contrasts the two: mapping plans the "intended" curriculum, while harvesting evaluates the "enacted" and "learned" versions, addressing discrepancies like omitted lectures or mismatched assessments.
Recommendations include integrating digital tools for ongoing mapping and harvesting to boost learner engagement and outcomes in medical schools.
### Key Takeaways
Participants learn practical strategies, such as using software for dynamic maps and case studies from Sri Balaji's programs, to bridge gaps and foster integrated learning. The session stresses that effective bridging reduces educational silos, improves student proficiency, and aligns with global standards like WHO's medical education reforms. For full details, view the video or university's CME archives.
[16/12, 16:29]hu8: Use NotebookLM to create a nice infographic about this video, Sir.
Then, please kindly share with us the infographic you obtained.
[16/12, 16:32]hu2: The notebook LM on my phone doesn't work any longer. Not sure why because in the initial phases it used to work like a dream.
[16/12, 16:42]hu8: Now it is part of
Gemini 3
[16/12, 16:42]hu8: So try using it through Gemini 3 and I am sure it will give you a very nice infographic.
[16/12, 16:43]hu9: Generating a Cornell notes would be more appropriate than an infographic for such a lengthy video. So sharing my Cornell notes for easy run-through.
[16/12, 16:46]hu10: You can try
MidJourney or
Nano Banana, but you need a summarized script for the video.
[16/12, 17:05]hu2: 👆 notebook LM or gemini 3 or deepseek?
Amazing how this video and perhaps many others that would otherwise languish in unclicked TLDS cognitive locks have suddenly been liberated with an at a glance infographic summary!
[16/12, 17:13]hu11: AI is becoming a kind of “instant lens” for information. Instead of spending hours distilling a long video, article, or dataset, AI can now scan the content, identify the core insights, and render them into a clear infographic in under a minute.
[16/12, 23:52]hu3: How much is the retention of AI Generated and learnt things vs traditionaly learnt things.
Simile
Old songs produced on traditional instrument
Vs
New songs made on one synthesizer.
Old song are still remembered.
New come and go.
[17/12, 00:05]hu8: How do you define an 'old song' vs a 'new song'?🤔
[17/12, 00:21]hu11: AI is an incredible tool for generation and pattern-finding, but it does not yet "learn" and "retain" in the human sense. It simulates the output of learning without the foundational process that makes knowledge sticky, meaningful, and durable for a biological mind
[17/12, 06:35]hu3: Born in 1980
Old Before you were born, mostly 1950 to 1980
Contemporary 1980 to 2000
New 2000 onwards
Recent 2020 to 2025
Just a wild division
[17/12, 06:39]hu3: Indian system depends on feeding 100%,
The retention depending on capacity can be anything from 100% rarely to 0%
AI summary according to maybe 20% of original text,
So if new generation is trained to read only AI Summary of PDF
They are fed on 20%,
So retention will be from 20% to 0
That also not the details,
Only the summary,
So human brain is not getting the full data to analyse,
But AI analysed data to train.
And
AI might not include the important things of PDF or Video depending on the maker and maintainer.
Good Day
Happy Learning.
[17/12, 06:42]hu3: The dependence on AI is due time constraint of today's world.
24 hours have become less in today's world.
Have not read full pdf for long time.
1 to 2 pages you can think of reading.
3 to 5 depends on topic.
6 to 10 you think start or no.
More than 10 is hesitancy.
[17/12, 07:59]hu2: Every page depends on our interest in the topic!
If one is really interested in the topic 10 pages would appear too less and one could be thirsting for more.
One easy example of this is god forbid someone in our family starts suffering from a clinically complex chronic illness that at the same time has an urgency of becoming acute on chronic and we as well as our doctors could be having to deal with layers of medical uncertainty as the illness journey unfolds.
Hence when we start searching and reading more and more on the illness topic and continue till we find resolution regardless of how many pages it requires.
The healthcare curriculum hasn't been designed in that manner for health professional learning around real cases but as @hu11 knows even in real patient centred team based learning we do get stimulated in a similar manner and sometimes no amount of text appears TLDR as long as it remains contextual to the patient's requirements
[17/12, 08:13]hu2: Current traditional drivers need to change for CBME to take root.
Current drivers for CBME are student learning outcomes while it completely ignores any correlation between our learning outcomes and real patient illness outcomes. This needs to be addressed through real patient centred team based learning approaches to competence development
[17/12, 08:33]hu3: Agree to some extent.
My first Chat GPT Search was in 2023
And
Topic was Ca Oesophagus.
And
As you said someone in family had it
And
I was not aware much about it,
Types, Treatment and Prognosis.
But was not happy with the result as they were too generic,
So had to resort to traditional google search for articles.
NB
I was not trained in prompt engineering,
Even after training I am not a regular user
And
It has gone into disuse atrophy like many other things In learnt and could not implement.
[17/12, 08:39]hu2: My take was around PDF volume driven learning barriers as in overcoming inertia due to FOCO (fear of cognitive overload).
PDFs may not always be an outcome of AI driven searches.
AI has it's own set of challenges still evolving everyday as human cognition dances to keep pace
[16/12, 22:53]hu4: Is it old wine 🍷 in bottle 🍾
[16/12, 22:54]hu4: Some paradigm shift
[16/12, 22:54]hu4: Is going to happen
[16/12, 22:57]hu3: Every change takes time,
CBME came in 2019,
Still many things going on in Traditional way,
For a change to happen,
Half the dept should change.
[16/12, 22:58]hu4: Giving Sanskrit / Hindi
Names may give some perception about new change
Functional and implementation should be changed
Corruption should also be stopped
[17/12, 08:12) hu2: Current traditional drivers need to change for CBME to take root.
Current drivers for CBME are student learning outcomes while it completely ignores any correlation between our learning outcomes and real patient illness outcomes. This needs to be addressed through real patient centred team based learning approaches to competence development
[17/12, 08:19]hu5: EPAs entrustable professional activities
[17/12, 08:22]hu6: At level of internship with proper supervision
[17/12, 08:25]hu5: During clerkship
[17/12, 08:28]hu6: Possible
[17/12, 08:29]hu3: Theoretically there is enough framework,
Practically it is the problem,
Software as well Hardware and Humanware is the biggest problem.
[17/12, 08:30]hu6: It is true. It requires critical mass of faculties who are passionate about teaching-learning- training for EPAs to start working
[17/12, 08:36]hu6: Perhaps it's time to shake off our inhibitions and reasons 'for not performing' --- change in performance and implementation
[17/12, 08:46]hu2: We have first year MBBS students from various colleges in our professional real patient centered team based learning platforms 24x7.
One of them presented a case in one of our CMEs just 3 months into MBBS.
There is a lot of hidden curriculum in medicine that is in itself a joy to expose both at an individual personal as well as a team based global level.
[17/12, 08:53]hu7: Good morning sir
Will it possible to share more details of intervention
[17/12, 08:55]hu2: Sure
[17/12, 08:56]hu2: Have already shared in the group from time to time but will customise it again specially for you
[17/12, 08:56]hu7: Okey sir
[17/12, 09:17]hu2: We have been regularly engaging in real patient centred, global team based learning since two decades and it has currently grown by leaps and bounds especially after the advent of AI
[17/12, 09:18]hu2: We summarised our overall learnings in general recently here:
Let me know if you need to have the full text PDF.
[17/12, 09:20]hu2: This is a more focused description of our AI driven real patient centered team based learning published last week 👇
[17/12, 09:21]hu2: Off course the only way you can actually understand it is to participate in our regular team based learning sessions where we can add you. Every patient is a separate project and has a separate WhatsApp team based learning discussion group as described here:
[17/12, 09:23]hu2: This write up again published this year was written by the same student who presented a case in our CME just 3 months into his MBBS course 👇
[17/12, 09:28]hu7: Thank u very much sir
Regards
[17/12, 09:29]hu7: Yes sir.
We had discussed before I think 7-8 years
[17/12, 09:35]hu2: Yes you may remember this one 👇
*Thematic Analysis:*
1. *Need for Curricular Change:* The conversation highlights the need for medical education to move away from traditional teaching methods and focus on patient-centered, team-based learning approaches.
2. *Role of AI:* AI-driven tools are seen as a means to enhance learning, provide instant summaries, and facilitate global team-based learning.
3. *Importance of Context:* Participants emphasize the importance of contextual learning, where students learn from real patients and cases, rather than just theoretical concepts.
4. *Challenges in Implementation:* The conversation touches on the challenges of implementing CBME and EPAs, including the need for faculty training, infrastructure, and a critical mass of passionate educators.
5. *Global Collaboration:* The discussion highlights the benefits of global collaboration and team-based learning, leveraging platforms like WhatsApp and online forums to facilitate learning and knowledge sharing.
[17/12, 11:11]hu8: I really wonder what is the agenda behind this massive push for CBME. If you read the comments in the FB page, even in their own country people are quite confused. After all a curriculum is a guidance for designing learning experiences for students. Why should one way of looking at how it can be done be projected as 'best'? The authors themselves, as were all of us in this group, have received their training in what they have labelled as 'traditional'. Are they implying that we are ALL deficient as practitioners?? This hype about one framework has to be toned down. Let us get on with what we have been doing pretty well for so many decades. It is in OUR hands - we should, as teachers, and primarily responsible for shaping the healthcare workforce of the future, take over the design and implementation of the curriculum. A curriculum that includes educational experiences that match our way of thinking, doing and being.
[18/12, 10:05) hu 9 : With great pleasure, the Association of ...welcomes you to be part of the Theory and Practice of technology enhanced Competency Based Medical Education workshop. The sessions cover all aspects to enable faculty to implement CBME successfully, guided by well renowned and experienced resource persons. This physical workshop provides an excellent opportunity to all the medical educators to equip themselves with the use of innovative technology in implementation of CBME.
*Objectives* *of the workshop* :
By the end of this 5-day face-to-face workshop, participants will be able to:
• Understand the foundational concepts of Competency-Based Medical Education (CBME)
• Apply principles of Workplace-Based Assessment (WPBA) to evaluate higher-order thinking skills (HOTS)
• Integrate technology-enhanced digital tools such as LMS, FACE GT and E-Portfolios to support learning and assessment.
• Develop strategies to address the affective domain and AETCOM competencies
• Design personalized learning pathways and utilize tools like Exit OSCE and radar graphs for formative and summative assessments.
• Employ standardized patients and simulation-based learning technologies to enhance clinical training.
[18/12, 10:21]hu2: Addressing the last point made in the flyer around employing standardized patients and simulation based learning technology to enhance clinical training in CBME:
In the real world of real patients, medical uncertainty from clinical complexity can pose a formidable challenge in the form of epistemic uncertainty, which concerns gaps in knowledge that could, in principle, be filled through additional information or improved methods but then there's also hermeneutic uncertainty lurking, which in contrast, concerns the inherently open and contestable nature of interpretation itself: the fact that the same situation can be legitimately interpreted in multiple ways. Within this hermeneutic domain, ethical uncertainty—the uncertainty that stems from the inherently dynamic and unfinished nature of human values themselves, rather than from limitations in our knowledge or reasoning capabilities—occupies a crucial position.
The ability to engage with and remain open to ethical uncertainty is an inherent component of professional expertise across domains like healthcare and real patient centred team based learning could be an effective approach to accommodate both
https://academic.oup.com/rssdat/article/1/1/udaf002/8317136
[18/12, 16:28]huai: Based on the transcripts, the meu CBME Journal Club was a virtual professional discussion focused on the need to fundamentally redesign medical education.
Unlike a structured course, it was an informal dialogue among educators debating how to connect student learning to real patient outcomes.
The discussion centered on three main themes, which I've summarized in the table below.
| **Thematic Cluster** | **Core Idea from the Discussion** | **Key Questions & Debates Raised** |
| :--- | :--- | :--- |
| **📈 The "Why": Need for Change** | The traditional, time-based model is failing to reliably produce competent physicians ready for modern healthcare demands. | Is this a real paradigm shift or "old wine in a new bottle"? How do we move from theory to practical, widespread implementation? |
| **🎯 The Goal: Linking Learning to Patient Outcomes** | The primary driver for curricular change should be **improved patient care**, not just internal educational metrics. | How can we directly correlate student learning outcomes with real patient illness improvement? |
| **🛠️ The "How": Tools & Implementation** | **Team-based learning (TBL)** around real patient cases and **AI-driven tools** are seen as key methods to achieve patient-centered CBME. | What are the practical, human, and technological barriers to implementing Entrustable Professional Activities (EPAs) and using AI effectively? |
### 🔍 How the Discussion Aligns with Broader CBME Practice
The journal club's themes are central to the ongoing global shift toward CBME. Here is how they connect to established principles and challenges:
* **Foundational CBME Principles**: The core idea—that training should start by defining the competencies needed for patient care and then building the curriculum backward from there—is a central tenet of CBME. This represents a fundamental shift from a time-based, process-oriented system to an **outcomes-based, learner-centered model**.
* **Recognized Implementation Challenges**: Participants correctly identified major hurdles. Implementing CBME and new tools like EPAs requires a **critical mass of trained faculty** and significant institutional support. Similarly, integrating AI faces barriers like a **lack of faculty training, ethical concerns about bias, and unclear implementation strategies**.
* **The Role of AI as an Enhancer**: The discussion's view of AI as a tool to distill information and enable new learning formats aligns with current research. AI is seen not as a replacement for educators, but as a **"digital co-tutor"** that can power virtual patients, provide personalized feedback, and facilitate team-based learning in virtual spaces.
### 💡 What the Discussion Didn't Cover
While the conversation touched on high-level themes, here are some practical aspects of CBME and AI integration that are part of current best practices:
* **Specific CBME Teaching Methods**: Beyond general TBL, established interactive techniques are used in clinical settings, such as the **"One-Minute Preceptor"** model for case discussion and the **DOAP (Demonstration-Observation-Assistance-Performance)** framework for procedural skills.
* **Structured AI Integration**: Leading institutions are moving beyond ad-hoc AI use. This involves **formal needs assessments** with both faculty and students, followed by **targeted training workshops** to build literacy and address ethical concerns proactively.
* **The Importance of Programmatic Assessment**: A key technical aspect of CBME is moving away from single high-stakes exams. It relies on **continuous programmatic assessment**—collecting numerous low-stakes observations in the workplace—to form a complete picture of a learner's competence.
