Advances in Medical Education and Practice (Apr 2017)
Competency-based tool for evaluation of community-based training in undergraduate medical education in India – a Delphi approach
Abstract
Hemant Deepak Shewade,1,2 Kathiresan Jeyashree,3 Selvaraj Kalaiselvi,4 Chinnakali Palanivel,5 Krishna Chandra Panigrahi,2 1Department of Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, 2Department of Community Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, 3Department of Community Medicine, Velammal Medical College Hospital and Research Institute, Madurai, 4Department of Community Medicine, Pondicherry Institute of Medical Sciences, 5Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India Introduction: A community-based training (CBT) program, where teaching and training are carried out in the community outside of the teaching hospital, is a vital part of undergraduate medical education. Worldwide, there is a shift to competency-based training, and CBT is no exception. We attempted to develop a tool that uses a competency-based approach for assessment of CBT. Methods: Based on a review on competencies, we prepared a preliminary list of major domains with items under each domain. We used the Delphi technique to arrive at a consensus on this assessment tool. The Delphi panel consisted of eight purposively selected experts from the field of community medicine. The panel rated each item for its relevance, sensitivity, specificity, and understandability on a scale of 0–4. Median ratings were calculated at the end of each round and shared with the panel. Consensus was predefined as when 70% of the experts gave a rating of 3 or above for an item under relevance, sensitivity, and specificity. If an item failed to achieve consensus after being rated in 2 consecutive rounds, it was excluded. Anonymity of responses was maintained. Results: The panel arrived at a consensus at the end of 3 rounds. The final version of the self-assessment tool consisted of 7 domains and 74 items. The domains (number of items) were Public health – epidemiology and research methodology (13), Public health – biostatistics (6), Public health administration at primary health center level (17), Family medicine (24), Cultural competencies (3), Community development and advocacy (2), and Generic competence (9). Each item was given a maximum score of 5 and minimum score of 1. Conclusion: This is the first study worldwide to develop a tool for competency-based evaluation of CBT in undergraduate medical education. The competencies identified in the 74-item questionnaire may provide the base for development of authentic curricula for CBT. Keywords: competency-based education, questionnaire design, Delphi technique, community medicine, community education, India
