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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 4  |  Page : 164-168

A study on feedback by undergraduate medical students for the foundation course under competency-based medical education: An institution-based cross-sectional study


1 Department of Community Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India
2 Department of Biochemistry, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India
3 Department of Anatomy, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India

Date of Submission30-May-2021
Date of Decision04-Jul-2021
Date of Acceptance08-Jul-2021
Date of Web Publication26-Nov-2021

Correspondence Address:
Dr. Chaitali Ashutosh Gore
D-605, Bren Celestia, Kaikondrahalli, Sarjapur Road, Bengaluru - 560 035, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjhs.mjhs_37_21

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  Abstract 


Background: There is provision of 1 month of foundation course at the beginning of MBBS course under competency-based medical education (CBME).
Objective: The objective was to study feedback by undergraduate medical students for the foundation course under CBME. It is important to know whether the students are satisfied with the content, quality, and the way in which the foundation course is conducted. This helps in providing clues to improve the quality. As this is a new initiative, adequate data on this subject matter is yet to come.
Materials and Methods: An institution-based cross-sectional study was conducted among the undergraduate batch of MBBS students admitted in 2019 at one medical college. Students who attended all sessions on all days of foundation course were included in the study. Students who have not attended all sessions (or missed even 1 session) of foundation course were excluded from the study. Out of 250 students, 134 (53.6%) had attended all the sessions on all days. The data were collected in the predesigned, pretested, and semi-structured study questionnaire. For each module, quality, content, and usefulness were scored by the students using a five-point Likert scale.
Results: In the present study, we observed that with regard to the content, quality, and usefulness of all the modules, more than 90% of students were happy and satisfied over the way in which this foundation course was conducted at this medical college
Conclusion: The students opined that foundation course was satisfactory. Challenges faced in conducting this program were to make all the students attend all the sessions on all days.

Keywords: Curriculum, foundation course, modules, students


How to cite this article:
Gore CA, Mangala S, Ammar M. A study on feedback by undergraduate medical students for the foundation course under competency-based medical education: An institution-based cross-sectional study. MRIMS J Health Sci 2021;9:164-8

How to cite this URL:
Gore CA, Mangala S, Ammar M. A study on feedback by undergraduate medical students for the foundation course under competency-based medical education: An institution-based cross-sectional study. MRIMS J Health Sci [serial online] 2021 [cited 2022 Jan 19];9:164-8. Available from: http://www.mrimsjournal.com/text.asp?2021/9/4/164/331243




  Introduction Top


Medical students when enter the curriculum are relatively young. Most of them are <18 years of age. They hail from diverse cultural and socioeconomic backgrounds. Many of them find it difficult to adjust to the new environment due to a variety of reasons and hence majority of them find it difficult to cope up with the curriculum. Some studies pointed out the need for foundation course for medical students immediately after admission to MBBS course to overcome the abovementioned difficulties.[1],[2]

Students experience homesickness during the first few months, some are pressurized by parents, some have language problems as they come to an entirely new state, some take time to adjust to the hostel life, some experience adjustment problems with the food, and some have one or more of these factors that compound their difficulties. All these things in totally new environment put an enormous amount of stress and pressure on the medical students who are yet to learn to tackle these difficulties. Moreover, the parents, family, friends, society, and relatives have a lot of expectations from them.[3]

To address this important issue, the Medical Council of India (MCI) has come up with the foundation course for 1 month as part of new competency-based medical education (CBME) for undergraduates in medical schools of India. This 1-month program will act as a bridge to connect the school education with the professional education. The students will get time to adjust to the new environment instead of directly going for classes immediately after admission. This will also help for smooth transition. This course offers opportunity for orientation and sensitization of the medical students. It also provides for addressing the basic problems of the students such as getting adjusted to hostel life, language problems, and computer knowledge by interacting with mentors and peers.[4]

Competency-based undergraduate curriculum has been introduced by MCI and it is applicable since 2019 batch Indian medical graduates.[5] Now, the learning is more student centric rather than teacher centric. It emphasizes more of practical-oriented approach for students, development of skills, orientation of ethics related to medicine, and better communication skills for them, especially focusing on doctor–patient relationship. It also includes incorporation of 1-month foundation course with the objective of sensitizing them about the new curriculum and other objectives which are already mentioned. It also emphasizes the need of five-star doctors with development of five important qualities by the time they complete their MBBS course, namely “clinician, lifelong learner, leader, communicator, and professional.” Thus, MCI envisages achieving these qualities among the Indian medical graduates by introducing new curriculum.[6]

The important objectives of the foundation course are orientating of the medical students so that they get familiar with the environment of the medical college at the entry time, to enhance certain important skills such as care of the patients, communication, computers, and language and learning skills.[7]

Now, it is important to know whether the students are satisfied with the content, quality, and the way in which the foundation course is conducted. This helps in providing clues to improve the quality. As this is a new initiative , adequate data on this subject matter is yet to come. Hence, the present study was carried out to study the feedback by undergraduate medical students for the foundation course under CBME.


  Materials and Methods Top


An institution-based cross-sectional study was carried out among the undergraduate batch of MBBS students admitted in 2019 (1st-year MBBS students) at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India, from September to October 2020.

Institutional Ethics Committee permission was obtained before conducting the study. Informed consent was obtained from all students. Confidentiality was maintained by not asking any identifying information such as name, registration number, or any information that will reveal their identity.

Inclusion criteria

Students from 2019 batch who have attended all sessions on all days of foundation course were included in the study.

Exclusion criteria

Students who have not attended all sessions (or missed even 1 session) of foundation course were excluded from the study.

Out of 250 students, 134 (53.6%) had attended all the sessions on all days and they all responded to the study. There was no one who did not respond to the study questionnaire; all these 134 eligible students consented and completed the study questionnaire, and hence, in the final analysis, they were included. As this study is a single center and the foundation course just started in 2019, we included all respondents as per eligibility criteria.

Data collection

A predesigned, pretested, semi-structured study questionnaire was used for data collection.

Methodology

Foundation course was conducted for 4 weeks in the month of August 2019. The major components of foundation course included six modules:

  1. Orientation module
  2. Skill module
  3. Field visit to community and primary health center (PHC)
  4. Professional development including ethics
  5. Sports and extracurricular activities
  6. Enhancement of language/computer skills/learning skills.


Each module had various competencies. Each competency was achieved by conducting lecture, small-group discussion, role play, or field visits.

Pilot testing of the feedback form could not be done. Feedback form was designed in which quality, content, and usefulness for each topic were graded by the students using a five-point Likert scale, where 5 is excellent, 4 is very good, 3 is good, 2 is average, and 1 is below average. Students were requested to scale every session accordingly and submit the form at the end of the day. The responses of good, very good, and excellent were further grouped together and labeled as satisfactory and average and below average was labeled as unsatisfactory.

Statistical analysis

The data were entered on Microsoft Excel worksheet. Percentages were used to present the data.


  Results Top


One hundred and thirty-four students were included in the study. The feedback given by these students on each module was analyzed. For the orientation module, all the students found the content of the sessions to be satisfactory and 93.3% of students expressed their satisfaction on the quality and usefulness of the sessions. Regarding skill module, all the students (100%) reported that the content of the sessions was satisfactory and 131 (97.8%) students found that the sessions were useful. One hundred and thirty (97%) students were satisfied with the quality and content of the field visit to PHC session and 96.3% of students said that it was useful. Satisfaction score for professional development including ethics module was 100% and 98.5% of them expressed that the quality was good and it was useful. Regarding sports and extracurricular activity module, 94% noted down it as satisfactory while 92.5% said that the quality was good and 91.8% expressed their satisfaction over it. For enhancement of language, computer skill, and learning skill module, 98.5% found the quality to be satisfactory, 98.5% found the quality to be satisfactory, and 94% found the usefulness of the sessions to be satisfactory. With regard to modules for quality, content, and usefulness, more than 90% of the students expressed their satisfaction [Table 1].
Table 1: Quality, content, and usefulness for each module of foundation course

Click here to view



  Discussion Top


In the present study, we observed that with regard to content, quality, and usefulness of all the modules, more than 90% of students were happy and satisfied over the way in which this foundation course was conducted at this medical college.

In a study done at Bhubaneswar, 10-day foundation course was conducted among 100 medical students. Four batches of 25 each were made. Didactic lectures, video clips, structured interactive sessions, role play, small-group activities, and hands-on experience were carried out. Feedback was taken regarding content, relevance of topics, appreciation of teaching–learning methods used, and whether they were involved during the sessions. Regarding content of session, more than 70% felt content to be adequate. More than 90% felt that they were involved in the sessions.[8]

Sobti et al. did a study on 100 students and 35 faculties. They were asked to give feedback on the foundation course. Positive feedback was given by 63% of students and 69% of faculty regarding overall experience of the course. Seventy-three percent of students voted for skill module as relevant. Fifty-two percent of students found enhancement of language skills and computer skill module relevant.[9]

A study done at Mahbubnagar included 100 students, but only 66 actually participated. Pre- and posttest was used to assess the knowledge and importance of each module included in the foundation course. Orientation module, skill module, community orientation module, professional development and ethics module (P and E), enhancement of language and computer skill module, and sports and extracurricular activities in all six modules. There was a statistically significant difference between pre and post mean score of perception of knowledge and importance.[10]

A study was carried out at Vishakhapatnam to assess the understanding levels regarding foundation course in 1st-year MBBS students at the entry level. Out of 150 students, 120 participated in the study. Orientation program to college campus and facilities and assessment methods were better understood by majority of the students in foundation course, followed by the topic on self-directed learning and communication skills.[11]

Patel J et al did study on students of Gujarat, 89% of students found foundation course useful, 78% found it to be effective. In our study, more than 90% of students found foundation course to be satisfactory.[12]

Before and after foundation course, a study was done by Chatterji A et al., in which knowledge, skills, and confidence of the students improved after attending foundation course.[13] In a study done among students of Hyderabad, initial feedback on foundation course was taken after the course and follow-up feedback was taken 1½ years after the course. In this study, the students who initially had difficulty in performing the skills were found to be skilled.[14]

In a study done among students of Ujjain, significant improvement was observed in the perception of modules before and after the foundation course. Furthermore, there was a positive correlation between the implementation and knowledge of students after the foundation course.[15] In a study done by Josephine et al. it was observed that foundation course was effective in improvement of knowledge of students.[16] In a study done in Kerala, the students found the skill module and community orientation module to be interesting. They also felt that foundation course helps in familiarizing with institution, faculty, and students.[17]

In a study done by Vyas et al., perception of students about learning through foundation course was assessed. Most of the students agreed that foundation course boosted their confidence and also eased the transition to medical college from school.[18] Similar findings were observed in the study done by Shah et al. among students of Maharashtra.[19]

Limitations

As this study was questionnaire based and Likert scale was used, qualitative data could not be collected. Students might express their feelings about the course if open-ended questions are included in data collection. This study was a single center with limited sample size and hence the results cannot be generalized. Hence, this study can motivate to carry out multicentric and representative studies so that quality can be improved for conducting the foundation course.


  Conclusion Top


The students opined that foundation course was satisfactory. Challenges faced in conducting this program were to make all the students attend all the sessions on all days.

Recommendations

We recommend giving some more time to enable students to attend all sessions by all students for the foundation course and get the benefit provided by the new curriculum.

Acknowledgment

The authors would like to thank the Management and Medical Education Unit of Vydehi Institute of Medical Sciences and Research Centre for all the facilities provided for this study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Singh S, Ghosh S, Pandya H. Foundation program for MBBS students at entry level: Experience at an Indian medical school. South East Asian J Med Educ 2007;1:33-7.  Back to cited text no. 1
    
2.
David MA. Foundational orientation program for medical students. Educ Med J 2013;5:140.  Back to cited text no. 2
    
3.
Devi NJ, Kumari AS, Murthy DS. The impact of orientation program for first M.B.B.S students in the transformation of perceptual learning into experiential learning – An insight. Int Dent Med Sci 2016;15:40-5.  Back to cited text no. 3
    
4.
Medical Council of India. Foundation Course for the Undergraduate Medical Education Program. Medical Council of India; 2019. p. 1-46. Available from: https://www.mciindia.org/CMS/wp-content/uploads/2019/08/foundation-new_compressed.pdf. [Last accessed on 2019 Jul 15].  Back to cited text no. 4
    
5.
Medical Council of India. Available from: https://www.mciindia.org/CMS/information-desk/for-colleges/ug-curriculum. [Last accessed on 2019 Jul 15].  Back to cited text no. 5
    
6.
Medical Council of India. Available from: https://www.mciindia.org/CMS/wp-content/uploads/2018/01/UG-Curriculum-Vol-I.pdf. [Last accessed on 2019 Jul 15].  Back to cited text no. 6
    
7.
Medical Council of India. Available from: https://www.mciindia.org/CMS/wp-content/uploads/2020/01/UG-Curriculum-Vol-II.pdf. [Last accessed on 2019 Jul 15].  Back to cited text no. 7
    
8.
Mishra P, Kar M. Perception of students on foundation course conducted for first year MBBS students at AIIMS. Indian J Community Family Med 2017;3:16-9.  Back to cited text no. 8
    
9.
Sobti S, Gupta M, Gupta V, Gupta A, Parihar S, Singh V. Assessment of newly introduced foundation course for medical undergraduates: Students' vs faculty's perspective. J Family Med Prim Care 2020;9:3042-7.  Back to cited text no. 9
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10.
Dixit R, Joshi KP, Suhasini P, Jamadar D. Students' perception of foundation course – A new experience in MBBS curriculum in India. Int J Med Sci Educ 2019;6:1-7.  Back to cited text no. 10
    
11.
Gara R, Neelima P. Assessment of understanding Foundation course – A study in medical students at entry level. J Res Med Educ Ethics 2019;9:216-21.  Back to cited text no. 11
    
12.
Patel J, Akhani P. A study of perception of first-year MBBS students toward orientation program and foundation course at entry level. Natl J Physiol Pharm Pharmacol 2017;7:920-3.  Back to cited text no. 12
    
13.
Chatterjee A, Majumdar S, Dey A. A study on impact of orientation program and foundation course at entry level on first-year MBBS students. Glob J Res Anal 2020;9:62-5.  Back to cited text no. 13
    
14.
Devi JN, Kumari AS, Murthy DS. The impact of orientation program for first M.B.B.S students in the transformation of perceptual learning into experiential learning – An insight. IOSR J Dent Med Sci 2016;15:40-5.  Back to cited text no. 14
    
15.
Garg N, Chakraborty H, Kumari N, Choudhary A. A study on the impact of foundation course on 1st year MBBS students (2019 batch) at RD Gardi Medical College, Ujjain. Int J Physiol 2020;8:31-7.  Back to cited text no. 15
    
16.
Josephine IG, Nathira H. The impact of “competency-based assessment” – A foundation course topic in first-year medical undergraduate students. Natl J Physiol Pharm Pharmacol 2020;10:388-92.  Back to cited text no. 16
    
17.
Chandran P, George K. Perception of medical students towards MCI recommended foundation course at a medical college in North Kerala. Indian J Forensic Community Med 2020;7:77-83.  Back to cited text no. 17
    
18.
Vyas S, Joshi U, Sheth J. Perception of first MBBS students from a medical college in Ahmedabad, Gujarat about one month's foundation course during the year 2019. Natl J Integr Res Med 2020;11:72-8.  Back to cited text no. 18
    
19.
Shah S, Kulkarni K, Sarode V, Singh M. Feedback of foundation course in students of first MBBS course in a Government Medical College in Maharashtra. Int J Med Sci Educ 2020;7:18-22.  Back to cited text no. 19
    



 
 
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