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 Table of Contents  
REVIEW ARTICLE
Year : 2016  |  Volume : 2  |  Issue : 3  |  Page : 141-144

Development of medical teacher: A prospective for challenges in India


Department of Community Medicine, G. R. Medical College, Gwalior, Madhya Pradesh, India

Date of Web Publication6-Jun-2016

Correspondence Address:
Anil Kumar Agarwal
G. R. Medical College, 4, Medical College Campus, Gwalior, Madhya Pradesh - 474 009
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2395-2296.183535

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  Abstract 

In India, medical education is challenged with the shortage of teachers. The teachers are not adequately prepared to handle tasks in response to the emergent needs. In spite of more than five decades of research on the educational process and the accumulation of significant understanding of the nature of learning, curriculum design, and evaluation, there has been surprisingly little opportunity for interested faculty members in medical college to obtain teaching experience other than by self-education, often by trial-and-error technique.[1] Studies addressing medical education have rarely used qualitative educational methods to contribute knowledge about the phenomenon under investigation. There are two possible reasons for this. First, in the past, the qualitative works were rejected due to the lack of objective evidence, considered to be “unscientific” and “anecdotal”[1] Second, medical educators have failed to communicate the methods, canons, and utilization of qualitative inquiry approaches to professional colleagues or undergraduate medical students.[1-3] It seems that the latter point is most pertinent here. In India, there are few studies which are grounded in qualitative methods, and doctors tend to scrutinize quantitative research designs in order to glean empirical data, which is rooted in objective reality.[2,3] We wished to acquire knowledge about several aspects of education in general and their specific application to medical education.

Keywords: Medical education, medical teacher, status evaluation


How to cite this article:
Agarwal AK. Development of medical teacher: A prospective for challenges in India. Int J Educ Psychol Res 2016;2:141-4

How to cite this URL:
Agarwal AK. Development of medical teacher: A prospective for challenges in India. Int J Educ Psychol Res [serial online] 2016 [cited 2022 Jun 25];2:141-4. Available from: https://www.ijeprjournal.org/text.asp?2016/2/3/141/183535


  Background Top


In 1969, WHO published a report entitled, “An International Program of Medical Teacher Training” that provided a framework for subsequent developments. Three levels of training were suggested:[4]

  • Education specialists, either health professionals who have advanced training in education or professional educators who would be familiarized with health professions
  • Educational leaders, at the second level, who are health professionals who would acquire sufficient educational science to integrate into programs of study in the institutions;
  • and
  • Educational practitioners who would be health professional teaching staff whose training would be limited to primarily improving their competence as classroom or clinical teachers.


With these purposes in mind, in 1999, Medical Council of India (MCI)[5] instructed to all medical colleges for establishing medical education unit for developing education plan and organizing medical teacher training workshop with the creation to train the specialists and the educational leaders.

Based upon such arguments, medical education unit of G. R. Medical College, Gwalior (MP), with cooperation from the MCI organized a workshop to introduce qualitative educational methods in medical education. The purpose of this workshop was to bring the attention of faculty members to acquire knowledge about several aspects of education in general and their specific application to medical education. The participants were the academic staff members of the G. R. Medical College with a range of academic ranking, from demonstrator, assistant professor to full professor, and different medical specialties. Forty-two academic staff attended the workshop. The faculty training workshop was held during three consecutive days, from 9.0 to 17.00. The first session of the 1st day of workshop consisted of an assessment of the faculty members' qualitative knowledge and skills, which revealed that the participants had poor knowledge of qualitative educational methods and most of the participants had a positivistic approach toward educational methodology. The assumptions of quantitative methods were more tangible and understandable to participants than qualitative traditions.


  Methodology Top


The study was conducted between October 2014 and February 2015. About 24 and 26 medical teachers from different faculty were selected randomly and assigned randomly to a session of teacher training lasting 3 days. For each medical teacher training course, a team of six experienced educators was responsible, at different levels of clinical and nonclinical teaching experience, which was part of the faculty development program of the MCI. The learning contents were as follows: “Role of the teacher,” “needs of learners,” “providing feedback,” “structure of session,” “defining learning objectives,” “activating learners,” “teaching of skills,” and “teaching with patients.”

The course of 12 full hours within 3 days followed a predefined structure. After an introductory interactive plenary session, teaching formats were based on scenario teaching and discussion groups, and focused on the acquisition of practical skills. After the course, medical teachers' performance was assessed by a structured clinical examination (SCE) and different multiple choice question (MCQ) test. The SCE was the official assessment at the end of the course, whereas the MCQ was an additional test after each topic.

The various components, such as teaching-learning principles, writing educational objectives, organizing and sequencing education materials, teaching-learning methods, microteaching, and assessment techniques, were incorporated in the workshop. A team of resource persons from GRMC and other college was involved. The collection data had two categories of responses: (1) A questionnaire survey of participants at the beginning and end of the workshop to determine their gain in knowledge and (2) a semi-structured questionnaire survey of participants at the end of workshop to evaluate their perception on the usefulness of the workshop. Questionnaire was based on a review of the literature on teaching quality in medical education and linked our questions to various fields of teaching performance: 'Interpersonal communication', 'structural aspects of teaching', student-teacher interaction, with teaching structure. Teachers reported their perceptions of competence, self-confidence, and their overall satisfaction with their teaching session on a 5-point Likert-like scale (from I2 “strongly agree” to −2 “strongly disagree”).


  Results and Discussion Top


An educational program can be thought of as a dynamic changing process continuous with time [Figure 1].[6]
Figure 1: Continuous process cycle for effective learning

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Within a medical college, there are likely to be three levels of objectives: Overall college objectives, from which will be developed the objectives of the individual department, and these, in turn, will suggest the objectives for each learning experience provided by the individual teacher.[7] As we studied and thought about objectives, it became apparent that these should be stated in terms of changes expected to occur in the student rather than in the specific type of assistance the teacher is to provide. Too often, we found that the curriculum was designed entirely around the knowledge the teacher had to give to the student. We saw little concern about the student's acquisition, understanding, and ability to manipulate this information. As health care advances and knowledge of effective educational strategies evolves, curriculum renewal in health profession education is a given. Ensuring that faculty members can effectively function within a new curriculum implies that faculty development has a key role to play in curriculum change at the individual, organizational, and systems levels. There is a reciprocal relationship between new curricula and faculty development. Preparing faculty is a necessary adjunct to facilitate the design, implementation, and evaluation of new curricula. As well, faculty development may derive change to a new curriculum, through creating a need or fostering a change in attitudes, increasing “buy-in,” or building capacity by improving knowledge or enhancing skills in a content area such that it can be taught better.[8]

As attempts were made to translate objectives into a curriculum, differences in interpretation, and inconsistencies were recurring problems. As these objectives were refined and restated to resolve these difficulties, they became more meaningful. For example, it may be considered desirable that medical students become “critical thinkers” in order to handle complex medical problems. In order to make this objective operational, we decided that one of the characteristics of a critical thinker is the ability to interpret data sufficiently to understand a phenomenon and to solve a problem. The curricular content could then be designed to give students data to interpret and later, we could evaluate their ability to do so.

After many years of research on pedagogical methods, it has become apparent that “as regards general methods of teaching, no one method can be demonstrated to produce more or better learning than another” and that emphasis should be “shifted from the tactics of teaching to the logistics of learning, to methods which in contradistinction to the pedagogical may be described as the methods of scholarship, of inquiry, of problem-solving or of critical thinking.[9] These studies have indicated that our criticisms of specific learning experiences are often misdirected. We often criticize “the lecture” when it is the unrealistic use of the lecture that we have in mind. If the objective of a specific educational experience is to give the student information, then the lecture can be used to do this. However, if we wish to have the student develop the ability to manipulate information in order to solve problems, the lecture is clearly inappropriate. Similarly, if a laboratory period is designed with a specific objective in mind; for instance, the analysis of data, this type of educational experience is being used to reinforce an important objective of the medical school. As we examined the teaching-learning process and re-examined some of our own experiences as students, as teachers in medical college, and as participants in this course, we recognized the highly individualistic nature of the learning process. To tell a student (if we could consider ourselves as examples) did not necessarily mean that he would know, and to know was not necessarily to understand. If these thoughts were to be incorporated into the design of a curriculum, we felt it was our responsibility to learn the technique that is best for the situation, not the one that we liked best. As teachers, we felt the responsibility to learn the tools of our trade, perhaps even to develop new ones. We felt that each educational experience that we as teachers attempted to provide should have an objective which was cognizant of the college's objectives. Once the objective had been decided, the type of instructional method required became apparent. However, for student objectives that reached beyond the acquisition of present knowledge, certain types of educational experiences were important. These included independent study, exercises in problem solving and other instructional procedures, which place more responsibility for self-education on the student.

Our studies and discussions on the principles and techniques of evaluation were particularly interesting since all of us had personal experience in evaluating students and courses. When we studied the evaluation of medical students by written examination, we were to discover that about 80% of examination questions required only recall of factual material. When one compared this level of evaluation with the intellectual processes capable of being tested, as outlined by Bloom et al.[10] It was apparent that we were examining students merely at the lower end of the intellectual scale. In trying to prepare for more realistic evaluation, we had access to newer methods of evaluation such as analysis at higher intellectual levels, simulation techniques using patient problems and various audiovisual aids. Again, we were to recognize the difficulty in evaluating when specific educational goals had not been defined. The need for some systematic instruction of medical teachers in educational theory and practice is becoming more and more important. The explosion of knowledge makes it impossible for the medical student to understand or to be exposed to all the types of medical problems he is likely to encounter in his practice. It is, therefore, necessary that we look to the science of education for new understanding of the nature of learning in order that the most advantageous use may be made of the undergraduate educational period. If some understanding of the science of education, of learning theory, curriculum design, implementation, and evaluation is felt to be necessary for a teacher in medicine.


  Conclusion Top


During the workshop, a few participants discussed how to rely on narrative information and many participants argued that such approaches are practical for conceptualizing social problems rather than clinical issues. However, many of the medical teachers tried to link the application of such educational methods to their own areas of interest as part of their daily.

One of the most frequent criticisms of the present lock-step type of medical education is that it does not recognize the individualistic nature of the learning process. Thus, a fixed requirement of time for the novice or established medical educator to gain an understanding of the learning process is inappropriate. In all probability, curriculum change, emphasizing competencies, and the evolution of our understanding of competence, lies at the forefront of 21st century medical education. Teaching and assessing fundamental competencies to learners (e.g. leadership skills, health advocacy, and professionalism) implies the incorporation of new content and emerging (and potentially unfamiliar) teaching and assessment strategies. Faculty development is essential, as it both supports and drives curriculum renewal and change.

Since there has been an explosion of knowledge in education and the behavioral sciences, some specific knowledge content and the ability and concern to continue to learn about education for him and acquisition of skills in conducting these methods on the Nominal Group Technique (NGT). However, the NGT findings highlighted the need for additional emphasis on analyzing qualitative data, particularly the grounded theory approach.

During the next decade, there will be a greatly increased demand for, and employment of, new graduates for undergraduate teaching. It is clearly time to call for the recognition of the science of education in India and to ask medical educators to provide in India a center that Miller et al.[7] has developed, where new medical school appointees could learn the fundamentals of education as applied to medical education. The trial-and-error, sink-or-swim technique as presently employed is too wasteful of both teachers' and students' time.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Ananthakrishnan N. Acute shortage of teachers in medical colleges: Existing problems and possible solutions. Natl Med J India 2007;20:25-9.  Back to cited text no. 1
    
2.
Srinivas DK, Adkoli BV. Challenges facing faculty development in India. Faculty development in medical education in India: The need of the day. Al Ameen J Med Sci 2009;2:6-13. Available from: . [Last accessed on 2015 Mar 19].  Back to cited text no. 2
    
3.
Supe A, Burdick WP. Challenges and issues in medical education in India. Acad Med 2006;81:1076-80.  Back to cited text no. 3
    
4.
Abeykoon P. Training of Medical Teachers in South East Asian Region. Available from: . [Last accessed on 2015 Feb 16].  Back to cited text no. 4
    
5.
Medical Council of India. Minimum Standard Requirements for the Medical College for 100 Admissions Annually Regulations 1999. New Delhi: Medical Council of India; 1999. Available from: . [Last accessed on 2015 Feb 03].  Back to cited text no. 5
    
6.
Kinley and Langley: Observations on a Medical Teacher Training Program. Available from: . [Last accessed on 2015 Apr 09].  Back to cited text no. 6
    
7.
Miller GE. editors. Teaching and Learning in Medical School. Cambridge: Harvard University Press; 1961. Available from: . [Last accessed on 2015 Mar 14].  Back to cited text no. 7
    
8.
Snell L. Faculty Development in Health Professions; Faculty Development for Curriculum Change: Towards Competency-based Teaching and Assessment. Springer Link; 2011. p. 265. Available from: . [Last accessed on 2015 Jun 29].  Back to cited text no. 8
    
9.
Hatch WR, Bennet A. Effectiveness in Teaching. United States, Washington: Department of Health, Education and Welfare, Office of Education; 1960. cited in New development in teaching by Wilbert J. Mckeache, U.S Department of Health Education and Welfare. available , [Last accessed on 2015 Feb 11].  Back to cited text no. 9
    
10.
Bloom, B., Englehart, M. Furst, E., Hill, W., & Krathwohl, (1956). Taxonomy ofeducational objectives:The classification of educational goals. Handbook I: Cognitive domain. New York, Toronto: Longmans,Green. www.colorado.edu/AmStudies/lewis/1025/bloomtax.pd. [Last accessed on 2015 May 20].  Back to cited text no. 10
    


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