Till date our teaching and learning is is mostly theoretical in nature, a very few are competent to perform some skills, which are essential after for a medical graduate . Previously, there was trend to join house-man ship after the internship training . But last few decades, the internship training suffered a lot and house man ship is only available in super specialty departments.
I think learning in the medical field is still substantially practice based.
In the UK we have OSCE's which are essential and they test practical skills:
"The objective structured clinical examination (OSCE) is part of the Nursing and Midwifery Council (NMC) registration process for nurses and midwives trained outside of the European Union (EU) / European Economic Area (EEA)". Those on all(?) medical training courses are required to undertake placements in practice - certainly Dr's and Nurses.
More information on OSCE's here:
https://www.nhsemployers.org/your-workforce/recruit/employer-led-recruitment/international-recruitment/immigration-rules-and-the-points-based-system/overseas-nurses-and-midwives/new-immigration-rules-published/osce-information
Yes in Kenya practical skills are not included in learning.it is more theoretical.hopefully cbe will come with another approach
It is a shame we are not train to develop linguistical skills and we do not create nets in this area, few people are concerned about multiple intelligences certaintly there is a need in the universities and also in our institutions to develop these spaces in real language practices. I guess we have to be more versatil and be part of the solution
Health professionals are of a challenge because of their busy and accurate requirement of their diagnosis and clinical workloads. Competency-based learning is better applicable to anagogical (adult learning approach) where systems and training approaches can be use d in multiple ways to transfer knowledge and provide opportunities for application and measurement of outcomes with trainees foundation knowledge-based to evaluate accurate diagnosis and learn more.
Plus health professionals who are part of the competency training need lesser workloads in their career.
Most of graduates for Medical colleges end up in clinical practice which is skills based therefore, if we are to ensure significant learning for out graduates then the Competence Based Education is the way to go.
Cbc is the way to go .health professionals better embrace it for accurate diagnosis.Hands on
Competency based learning has its place in a health professional's development when new staff or students are being exposed to a specific topic for the first time eg oxygen administration. After a good grounding in the topic it is then important to understand that specific competency's integration in real life which can be more appropriately assessed in scenario based training eg paramedic management of a patient who fell from 3 m and sustained a mid-shaft femur fracture. This scenario would then cover the following competencies in one evaluation: Ambulance dispatch communication; Scene size up and safety; XABCDE; Spinal and C-spine immobilization; Oxygen therapy; Pain management; Log rolling or scoop stretcher use; Long board use; Staff ergonomics; Stretcher use; Secondary assessment (Head to Toe examination; Vital signs and SAMPLE) and could also incorporate documentation, communication and SBAR handover. Teaching a physician about ICDs is a great foundation but then add the stress of a multi casualty incident and include triage; ATLS assessment management of a simple haemo-pneumothorax or tension h/p-thorax; pain management etc. When the basics are understood introduce a simulated real life situation and have your 'patient' deteriorate during ICD insertion to see how the practitioner manages.
Theory is important in the health sciences, especially in understanding the origins of disease and how the body works. However, competency is essential in many areas of health care or the patient will die. Therefore both are needed.
Both knowledge and skills are important in the health professions and both must be tested. There is Millers pyramid which says that first you need to know, then know how, before shows how and does. Each level can be tested. Written tests are better for knows and knows how, OSCEs are better for shows how and ultimately work based observations such as the mini-CEX can be used to show hoe the professional practices in the workplace.
The AMEE guides on assessment are a good place to start to give the basics of these type of assessments.
In my view, competency-based learning is a key ingredient of health professionals’ education. As we know, the core space of every health system is occupied by the interaction between people who need services and those who deliver. Those who deliver the services earn trust through a blend of technical competence and service orientation, navigated by an ethical commitment and social accountability. Developing such a blend requires high-quality health professionals education and competency-based learning is the right means to effect this. Through a chain of events flowing from competency-based learning, it is possible to ensure the happenstance of deep learning and high-quality services to improved health. Therefore, the orientation toward competency-based learning at its best makes an essential contribution to the health professionals education, thereby to the overall well-being of individuals, families, and communities.
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