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Journal of Postgraduate Medicine, Vol. 47, Issue 1, 2001 pp. 42-44 Evolution of Medical Education Technology Unit in India Bhuiyan PS, Rege NN
Medical Education Technology Cell, Seth G. S. Medical College and K. E. M.
Hospital, Parel, Mumbai - 400 012, India. Code Number: jp01012 Abstract It has been observed that nature
is at its selective best, mediating quality control in human reproduction. This
is evident from the fact that 50% of the pregnancies with chromosomal aberrations
abort spontaneously. As early as 1859, Charles Darwin in his book, The Origin
of Species, stated about natural selection of species.
The mankind, homosapiens are the highest evolved and also natures selected
best on this earth. Their caretakers are the doctors i.e. medical profession.
To maintain quality in Medical Education shouldnt they be the selected and
trained best? Since time immemorial health has been a continuous concern of the mankind. Charaka mentioned that diseases and mankind coexisted all along. In India and perhaps in the whole world, during Arsha period (period of the rishis), two great universities came into existence, where course included medicine and surgery. One was Banaras and the other was Takshashilla. The heads of the medical sections were Sushruta and Atreya, respectively. (1) The universities grew in the Buddhist period, producing medical literature not only for students to learn, but also for the teachers to teach. During the pitish rule, in 1835 the first medical school was set up in Calcutta and Madras simultaneously. Medical training was also set up in different parts of the country in addition to medical colleges. During the post - independence era there was a spurt of setting up of private medical colleges without adequate resources and expertise. The content of medical education needed to be streamlined. It was felt that the curriculum must highlight the problems of healthcare of the society and must be a need based one. Systems Approach to Medical Education A medical institution could be considered as a system. The input is the students; process includes the teaching learning activities and the output is the young medicos, who are the products of an institution. The role of environment in a system is quite significant. The environment in this context is the society at large. We take the students from the society and after training them leave them back to the society. The society would accept them only if they can take care of it and its needs, hence it is very important that the training imparted to them is a need based one. Here lies the importance of medical teachers. Responsibilities of Medical Teachers Medical teachers are the architects and builders of students behaviour using a standard curriculum. They are also the curricular developers and transactors and thus have a pivotal role in shaping the future medicos. Charka samhita lays down that teacher should be one whose doubts have been all cleared in respect of medical scriptures-possessed of experience-clever in the practice of his profession - compassionate towards those who approach him-clean in person and clothing - having a practised hand in surgery-possessed of all the implements of his organs of sense perfect - conversant with nature-his knowledge of medical science supplemented with a knowledge of other panches of study -without malice-of a peaceful disposition-capable of bearing privation and pain-well affected towards disciples and disposed to teach them-capable of communicating his ideas etc........... (2) How many of our present day teachers
have these qualities? The
Need to Train Teachers
Selecting the right trainer may not be always possible but improving them
by periodic training programme is feasible. An effective teacher will be one
who is competent (has knowledge and skill) and is a performer (can use knowledge
and skill in a classroom) to accomplish teacher goal. The Medical Council
of India while formulating its recommendations in 1981 declared that the recommendations
were oriented towards training students to undertake the responsibilities of
a physician of first contact. But while depicting the situation analysis, draft
Medical Education Policy in 1993 laments that Advancements in medical education
both in quantity and quality have not resulted in parallel achievements in the
field of health care. (3) To pidge this gap, Medical Council of India (MCI)
outlined need based curriculum. The steps to be taken were (1) Clear delineation
of goals and objectives of education (2) Adoption of innovative teaching and
learning methodology (3) Adjustment in the course structure (4) Updating course
content (5) Rationalizing assessment strategy and (6) Emphasis on structured
and skill oriented internship.4 The President, MCI while concluding his foreword
to the document embodying the revised curriculum adopted by the council rightly
mentioned that This curriculum can only be successfully implemented through
appropriately oriented and properly equipped teachers. These felt needs prompted
the Medical Council of India to recommend setting up of Medical Education Unit
in all medical colleges in 1981 (curriculum of graduates) and 1992 (Need Based
Revised Curriculum for graduates). (5) The National Conference on Training
Teachers Today for Tomorrows Needs held under the auspices of MCI in September
1994 and also the workshop on Medical Education - An Appraisal held under
the auspices of MCI in May 1996 have made recommendations for establishment
of Medical Education Unit in each medical college. The MCI also in their revised
regulations have recommended the establishment of such units in each medical
colleges. The Parliamentary Committee on Subordinate Legislation has also strongly
recommended that MCI should make it compulsory for all medical colleges to prescribe
for a minimum number of lectures to be imparted using audio-visual techniques
in substitution of conventional lectures by teachers/professors in the classrooms.
(6) Role of Medical Education Technology Unit These units are supposed to carryout the following activities which can strengthen the quality of Medical Education.
The process of becoming a doctor and a member of the medical profession is a social one. Professional socialization requires a medical curriculum, which would include training in communication skill, medical ethics, health economics, consumers right besides clinical skills and subject knowledge. (9) The Medical Education Units should pay attention to the development of this collateral curriculum. The role of MET unit or department is to train the trainers so that a need based curriculum can be formulated, implemented and revised from time to time. It should plan a curriculum for Tomorrows Doctors where core and options curricula are exemplified. Communication, patient autonomy and doctor -patient relationship must underpin the whole educational process. (10) In one of the SEARO publication (1998) Dr. Myatu had mentioned that if doctors are to remain relevant to the changing needs of the society they have to shape their roles with in the context of total human development. (11) The scope of MET cell can widen if and only if there is a perfect blend of M-E-T, where M stands for Management of Education, E stands for Educational Research and T stands for Technology of Education. For M-E-T to gel there is a need to include an educationist and human resource development manager as a part of the team. (12) Members of the
MET Unit
Our experience tells us that the MET cell requires like-minded, willing, devoted
teachers for its active and productive functioning. There is no hard and fast
rule for the number of members in a MET unit or for their designation and qualifications.
However, considering scope of MET units, it is better that most of the disciplines
get represented in the unit. The teachers who are in the position to make and
implement policies should be the members. As per Dr. S. P. Mehtas article on
Establishment of MET Unit (13) it is mentioned that at least there should
be 5-6 motivated teachers who are willing to spare at least two hours a week
as honorary faculty. One of the honorary faculty member who can devote about
6 hours a week may be designated as co-ordinator of the MET unit. The co-ordinator
should be trained in educational science and technology. The teachers appointed
as honorary faculty must have undergone training in National Teachers Training
Centre (NTTC). The MET cell being a resource unit besides having audio-visual
aids, should have its own lipary housing books and journals on medical education
technology. There must be computers with internet facilities, so that communication
with other education centres is easily established and sharing and exchange
of information is a smooth process. Functioning of
ME Units in India
In India the institutions which have intimated MCI about establishing ME Unit
include (14) PSG Inst. of Medical Sciences, Coimbatore, Tamil Nadu, St. Johns
Medical college, Bangalore, JNL Medical college, Belgaum, Karnataka, Krishna
Institute of Medical sciences, Karad, Maharashtra, Seth GS Medical college,
Mumbai, Medical college, Thrissur, Kerala, Christian Medical College, Vellore,
Tamil Nadu, SMS Medical college, Jaipur, JN Medical College, Sawangi, Wardha,
Maharashtra, Maharashtra Institute of Medical Education and Research, Talegaon,
Dadhade, Maharashtra, JN Medical College, Bhagalpur, Bihar, Dayanand Medical
College, Ludhiana, Punjab, TN Medical college and BYL Nair charitable Hospital,
Mumbai, Maharashtra, Armed Forces Medical college, Pune, Maharashtra, Tiruneveli
Medical college, Tiruneveli, Tamil Nadu. Two of the postgraduate institutes,
NIHFW, New Delhi and Tata Memorial Centre, Mumbai also have MET units. JIPMER,
Pondicherry, Maulana Azad Medical College, New Delhi, Institute of Medical Sciences,
Banaras Hindu University, Varanasi, PGI, Chandigarh , and KLWigs Centre, AIIMS,
New Delhi have NTTC centres. In Maharashtra a meeting of co-ordinators of Medical Education Technology Units was called by the Maharashtra University of Health Sciences in July 2000. Various Medical colleges in Maharashtra responded and stated that they have established MET unit in their institution. However while interacting with them, it was realised that the so called units were non-functional in many colleges. If this is the state in educationally progressive state of Maharashtra, one can imagine what could be the situation in educationally backward areas. There is thus a dire need for educational networking to get established amongst MET Units and MCI. This should be further strengthened by a continuous dialogue with feedbacks. Such interaction can make the MET units more effective to reach their desired goals. References
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