Summary:
"...most of the certifiable competencies of the MBBS curriculum of NMC are to be acquired through simulation-based learning using the DOAP method of skill acquisition, and most of the certifiable competencies are procedural skills. The learners are not going to practice the learned skill on humans immediately. Learners will need multiple learning and remedial sessions, with recording of each session on logbook. So undoubtedly, combining RCDP for debriefing with DOAP for immersive simulation activity is the best bet for acquiring certifiable competencies."
Unquote
Morning medical education Journal club transcripts:
[31/10, 18:53] journal club article sharer JCAS: https://journals.lww.com/ijab/
[01/11, 08:52] journal club critical instigator JCCI: Thanks for sharing some remarkable articles for a morning "medical education" journal club:
Let me set the ball rolling for this one:
using a critical realist pedagogic framework shared earlier here: https://medicinedepartment.
In gist the article authors appear to have no issues with the fact that a good 5 years of MBBS be spent in medical simulations and spoon feeding through Rapid Cycle Deliberate Practice (RCDP)!
Have they even thought that 80% of these medical workforce for India will never even get to ever see a real patient ever in their later lives in this framework that the current medical educationists in their paper are insinuating?
How did I arrive at the 80% figure?
Oh well 50% will not get so called clinical branches in PG and 50% will become demotivated to ever see patients in their lives. We are already seeing this happening!
The government and policy makers will keep increasing number of seats and medical colleges and keep wondering why their patients aren't getting to see that many doctors and let's hope we can see that the problem lies in how our medical education simulation ecosystems have subverted real patient care and we need urgent integration of real patient centred CBMEs to subvert this well entrenched threat and weakness!
Just to clarify my stance: I'm role playing a critical realist pedagogic stance in this journal club to generate a sort of adversarial learning that is often popular among non biological neural networks as educationists like @Dr AI healthcare evengelist 1 and @AI healthcare Evangelist 2 can clarify.
[01/11, 09:00] AI healthcare Evangelist 2: This will require a deeper analysis and answers
[01/11, 09:04]JCCI: Yes I'm sharing this journal club primer into other Indian medical education channels such as the meu India email group
[01/11, 09:05]JCCI: Meanwhile let's ask meta AI or any other LLM for their "unbiased" or "their trainer biased" thoughts on this article?
[01/11, 09:27] JCCI: @Meta AI please share your unbiased thoughts on the editorial article pasted below. Please do share valid searchable references for any of your own statements.
Acquisition of Certifiable Competencies in Undergraduate Medical Curriculum of National Medical Commission: Role of Rapid Cycle Deliberate Practice
Mahajan, Rajiv
Author Information
International Journal of Applied and Basic Medical Research 14(4):p 211-213, Oct–Dec 2024. | DOI: 10.4103/ijabmr.ijabmr_478_24
Full text link: https://journals.lww.
[01/11, 09:27] Meta AI: The editorial article discusses the integration of Rapid Cycle Deliberate Practice (RCDP) in the Competency-Based Medical Education (CBME) curriculum introduced by the National Medical Commission (NMC) in India. Here's my analysis:
*Key Points:*
1. The NMC's CBME curriculum emphasizes simulation-based learning for acquiring certifiable competencies.
2. The DOAP (Demonstration-Observation-
3. RCDP is proposed as the best fit model for debriefing and learning procedural skills using simulation-based learning.
4. RCDP involves repeated performance of simulation activities with facilitator-led microbriefing, minimizing knowledge attrition.
*Strengths:*
1. The article highlights the importance of simulation-based learning in medical education.
2. It emphasizes the need for deliberate practice and feedback in skill acquisition.
3. The author provides a clear framework for learning and assessment of procedural skill-based certifiable competencies.
*Weaknesses and Potential Criticisms:*
1. Limited discussion on the challenges and resources required for implementing RCDP.
2. Lack of empirical evidence supporting the effectiveness of RCDP in the Indian medical education context.
3. The article primarily focuses on procedural skills, potentially overlooking other essential competencies.
*References and Support:*
The article cites relevant literature supporting the effectiveness of simulation-based learning and RCDP. However, some references are from specialized fields (e.g., urology), which may limit their generalizability to other medical disciplines.
*Future Research Directions:*
1. Investigating the feasibility and effectiveness of RCDP in Indian medical education settings.
2. Exploring the impact of RCDP on knowledge retention and transfer to real-world clinical practice.
3. Developing strategies to address potential challenges and resource constraints in implementing RCDP.
*Unbiased Evaluation:*
The article presents a well-structured argument for incorporating RCDP in medical education. While it provides valuable insights, the discussion could benefit from:
1. More nuanced exploration of potential challenges and limitations.
2. Greater emphasis on the importance of faculty development and training in RCDP.
3. Discussion on integrating RCDP with other educational theories and models.
Overall, the article contributes to the ongoing conversation on competency-based medical education and simulation-based learning. Its recommendations and framework can inform educators and policymakers seeking to enhance medical education in India.
*Searchable References:*
1. National Medical Commission. (2024). Guidelines for Competency-Based Medical Education (CBME) Curriculum.
2. Blankstein et al. (2015). Simulation-based flexible ureteroscopy training using a novel ureteroscopy part-task trainer. Canadian Urological Association Journal, 9(5), 331–335.
3. Jones et al. (2014). Measuring intravenous cannulation skills of practical nursing students using rubber mannequin intravenous training arms. Military Medicine, 179(12), 1361–1367.
Would you like me to clarify or expand on any specific points?
[01/11, 09:32] JCCI: @Meta AI what are your thoughts on this input(pasted below) on that editorial you just dissected by one learner who appears to have adopted a critical realist pedagogic framework?
Let me set the Inputs ball rolling for this one:
using a critical realist pedagogic framework shared earlier here: https://medicinedepartment.
In gist the article authors appear to have no issues with the fact that a good 5 years of MBBS be spent in medical simulations and spoon feeding through Rapid Cycle Deliberate Practice (RCDP)!
Have they even thought that 80% of these medical workforce for India will never even get to ever see a real patient ever in their later lives in this framework that the current medical educationists in their paper are insinuating?
How did I arrive at the 80% figure?
Oh well 50% will not get so called clinical branches in PG and 50% will become demotivated to ever see patients in their lives. We are already seeing this happening!
The government and policy makers will keep increasing number of seats and medical colleges and keep wondering why their patients aren't getting to see that many doctors and let's hope we can see that the problem lies in how our medical education simulation ecosystems have subverted real patient care and we need urgent integration of real patient centred CBMEs to subvert this well entrenched threat and weakness!
Just to clarify my stance: I'm role playing a critical realist pedagogic stance in this journal club to generate a sort of adversarial learning that is often popular among non biological neural networks as educationists like @Dr AI healthcare evengelist 1 and @AI healthcare Evangelist 2 can clarify.
[01/11, 09:32] Meta AI: The learner's critical realist pedagogic framework-driven analysis offers a thought-provoking critique of the editorial. Key points:
*Challenging assumptions:*
1. Questioning the extensive use of simulations, potentially limiting real-patient exposure.
2. Concerns about the impact of Rapid Cycle Deliberate Practice (RCDP) on clinical experience.
*Highlighting potential consequences:*
1. 80% of medical workforce may never engage with real patients (50% not getting clinical branches in PG and 50% becoming demotivated).
2. Simulation ecosystems may subvert real patient care.
*Advocating for change:*
1. Integration of real patient-centered Competency-Based Medical Education (CBME).
2. Addressing the disconnect between medical education and actual patient care.
*Strengths of this critique:*
1. Encourages critical thinking about the implications of simulation-heavy education.
2. Emphasizes the importance of real-patient experience.
*Potential areas for further exploration:*
1. Evidence supporting the 80% figure and its implications.
2. Investigating the effectiveness of RCDP in various medical education contexts.
3. Exploring alternative pedagogical approaches balancing simulation and real-patient experience.
*Critical realist pedagogy:*
This framework helps uncover power dynamics, assumptions, and potential consequences of educational approaches. By role-playing this stance, the learner:
1. Challenges dominant discourses (simulation-centric education).
2. Highlights potential weaknesses (limited real-patient exposure).
3. Advocates for transformative change (integrating real patient-centered CBME).
*Adversarial learning:*
This approach fosters critical thinking, encouraging learners to question assumptions and engage in constructive debate.
*References:*
1. Bhaskar's Critical Realism (2013)
2. Archer's Social Realism (1995)
3. Sayer's Realism and Social Science (1992)
The learner's critique offers valuable insights, sparking essential discussions on medical education's future.
Would you like me to elaborate on any points or provide additional references?
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