At the Armed Forces Medical College, the course called Attitude, Ethics and Communication was introduced as part of the medical education project in 2018-19, which was subsequently recommended to the Medical Council of India. Major General Madhuri Kanitkar, Dean and officiating Commandant at Armed Forces Medical College, and a key member of the Prime Minister’s scientific and technical advisory board, tells The Indian Express about the course and its importance.
Q. What exactly is this course?
The new curriculum promulgated by the MCI has a specific module on ethics added to the previous module on attitude and communication. It is not that the subject of ethics was not taught earlier; it has now been packaged in a new mode for implementation in a continuous and seamless way, and it has been given adequate time weightage throughout the course. Today, ethical practice is the need of the day and therefore, more importance has been given to it.
Q. Why was such a course introduced?
With more advances in medicine and time pressure as well as examination stress, students were losing out on soft skills. Students were learning the science of medicine but not the art of healing. Ethics were being questioned and a number of court cases as well as untoward incidents of patients displaying violence against doctors are being reported. To give adequate importance to these aspects, the MCI has introduced this much-needed module.
Q. What is the course modelled upon? How has the experience been so far at AFMC?
The course is modelled upon a competency-based programme wherein a student is expected to acquire skills from pure “Knows to Knows How” to “Shows and Does”. The syllabus had been introduced last year for the module at the AFMC, and teachers were being trained. However, there was no implementation plan. It had to be seamlessly amalgamated with the existing syllabus without increasing the burden on the students. It was important to bring about a gradual change in their attitude and practice. A project was undertaken by the Medical Education Department of the AFMC. We are lucky to have a highly trained and motivated pool of teachers. Some of the projects undertaken included preparing a student portfolio with a reflection by the student and continuous feedback and workplace-based assessment by faculty as part of a formative assessment for the module. The portfolio has been appreciated by the MCI and colleagues from other medical colleges.
Q. What were the other innovative aspects of the ethics module at AFMC?
We have prepared teaching videos using the novel concept of “standardised family”. These are used to teach communication skills in both out-patient and in-patient situations. The participants in the video are our own students and faculty and the students can relate to the situations. Solemn oath taking ceremonies like the ‘Cadaver My Teacher’ and ‘White Coat Ceremony’ have been introduced, which help convey the importance of ethical practice. The subject of ‘Ethics and Attitude’ cannot be taught in lectures. It requires strong role models and mentors. At AFMC, we have introduced a formal mentorship programme.
Q. How will students be assessed?
The assessment is inbuilt and also in a continuous formative way. There will be some aspects covered in the university summative assessment as well. In addition to this, we have introduced faculty to the concept of WPBA (workplace based assessment) with multi-source feedback as part of the assessment.
Q. It has been over a year since you took charge as Dean and Deputy Commandant at AFMC. What have been the highlights during your tenure?
The tenure so far has been exciting and fruitful. I think it’s the lively environment of being with young intelligent minds. Our TedEx AFMC and Marathon AFMC have now become annual events. The dental faculty and post-graduates conducted an innovative health camp on wheels into rural Maharashtra. The cadets at the College of Nursing have done well and participated in a number of community outreach programmes. They will soon have a new Nursing Officers and Cadets Mess. The Department of Pharmacy has been started at the AFMC. Next on our radar is to get in a separate Medical Research Unit to undertake collaborative projects in both Basic and Applied Research. We also are in the process of starting an MD Geriatric Medicine programme. The aim is to prepare our doctors for tomorrow’s medicine while honouring traditions and values of yesterday.