Principles of MEDICAL EDUCATION
Principles of MEDICAL EDUCATION
Fifth Edition
Tejinder Singh MD DNB MAMS FIMSA FIAP MSc (Health Professions Education) (Maastricht; Hons) MA (Distance Education); PG Dip Higher Education (Gold Medal) Diploma Training and Development (Gold Medal) PG Diploma in Human Resource Management (Gold Medal) Certificate Course Evaluation Methodology and Examinations (AIU) FAIMER Fellow, SIDA Fellow, IFME Fellow, IMSA Fellow
Professor Department of Pediatrics and Medical Education SGRD Institute of Medical Sciences and Research Amritsar, Punjab, India
Piyush Gupta MD FAMS FIAP FNNF FAAP
Professor and Head Department of Pediatrics University College of Medical Sciences, New Delhi, India
Daljit Singh MD DCH FIAP FNNF FAMS FIMSA Diploma in Management (AIMA), FAIMER Fellow Certificate Course Evaluation Methodology and Examinations (AIU)
Vice-Chancellor Sri Guru Ram Das University of Health Sciences
Amritsar, Punjab, India
Foreword
Janet Grant
Jaypee Brothers Medical Publishers (P) Ltd
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Principles of Medical Education
First Edition: 1997, Indian Academy of Pediatrics Education Center
Second Edition: 2000, Indian Academy of Pediatrics Education Center
Third Edition: 2009
Fourth Edition: 2013
Fifth Edition: 2021
9789390281411
Printed at
Teach a student and you impact a life; Train a teacher and you impact generations of lives.
Hassezmusings
Foreword
The new edition of this handbook, Principles of Medical Education, is timely. Medical education in India is in the throes of fundamental change; from the promise of new regulation to the definition of a new curriculum with a new structure, new ideas about how students should enter medical school, new ideas about how they should learn, new areas of content and new assessment-based methods of progression.
As with any such sweeping educational innovation, it is not without its controversies. The apparent underlying intention to address the variability in quality of medical education seems laudable. Perhaps there was also a feeling that trying ideas that have been used elsewhere might improve medical education in India. While a number of guidelines for practice and planning have been provided, it is important to consider the development of a contextual curriculum as well as the new disability competences in foundation. These might appear in the next edition of this handbook.
It might be difficult to keep up with such a fast-moving landscape. And every teacher and educational leader will be expected to change their practice and planning in one way or another to meet the new demands. This book will help. It is a handbook that skilfully summarizes the salient points of many current concepts. I must congratulate the authors who have managed to be wonderfully clear in presenting the essence of each topic in a very few words. That makes this resource highly accessible.
Although the techniques detailed in the chapters are not supported by in-text citations, I can understand why this handbook has chosen this non-academic style. Medical education does not change as a result of a new and convincing evidence base. Medical education is a social science, and as such, it tends to change on the basis of social trends rather than evidence. In education, some ideas are integrated into practice simply as a political or regulatory imperative. Educational change is often based on current values and argument rather than evidence.
So, putting the risk of plagiarism aside, I hope that this approach liberates the reader to be critical, to question and to read around each topic. And then to reach your own conclusions about the contextual usefulness of the ideas so clearly presented. The essence of social science is critique.
On the other hand, I know that when there is the need to change, then a pithy summary can offer reassuring guidance. And as an introduction to the breadth of medical education, this handbook also sets out a lot of the terrain and explains terminology and basic concepts very well. It is a faithful presentation of some dominant ideas in medical education. Coming from the part of the world where most of these ideas originated, I know that what is said and what is done are often very different. As an educational psychologist, my personal bugbear is adult learning: that it continues to be touted as a theory is a mystery to me. It is an idea that has no evidence base, and did not arise from the context of professional training. And that is where your own critique and reflection come in.
Looking towards the future, I believe that such critique and reflection will lead to a book that includes theories and techniques that have been born in India, alongside those that were invented elsewhere. The richness of educational philosophy, values and practice in India should surely have given rise to new ideas that those of us from other parts should consider.
I am pleased to see the focus on assessment in this book. Although trends change in this field too, and the current trends seem to be towards more holistic approaches, there are clear, and possibly largely uncontentious, procedures for the development of examinations that must be followed. Nonetheless, even ideas such as workplace-based assessment have been driven by ideas of feedback, rather than by applying the rules of valid and reliable measures. And in that, as in all education, the principle of feasibility is fundamental.
I wonder whether, given the turbulent and exciting times in medical education in India, a chapter on management might not have been useful: managing the curriculum, managing resources, managing change. I have always believed that much of the success of education in practice is in its management rather than its rhetoric.
So in reading this wonderful resource, keep thinking and asking questions. I congratulate the authors for their ability to present complex ideas so succinctly and economically. This is neither an instruction manual, nor is it an academic treatise; it is a concise introduction to the current landscape of medical education. You will find yourself asking questions: and that is what should happen in this area of social science.
Janet Grant
Honorary Professor, University College London Medical School
Professor Emeritus, Department of Education in Medicine, The Open University, UK
Special Adviser to the President, World Federation for Medical Education
Senior Scholar, Department of Medical Education, University of Illinois Chicago College of Medicine
Adjunct Visiting Professor, Manipal Centre for Professional and Personal Development Manipal University, Karnataka, India
Director, Centre for Medical Education in Context [CenMEDIC] & FAIMER Centre for Distance Learning
Preface
We are happy to present the fifth edition of the book, Principles of Medical Education. The edition has been revised with some deletions and many additions. The driver for change has been the ongoing curriculum change in India to competency-based education and the book presents topics useful to teachers for delivery of this curricular model. Most of the chapters have been updated to address the contemporary curricular change, but we have retained the basic nature of the material and its conversational style. We have added in the Further Reading, a number of publications which we have published on competency-based medical education and related aspects. Most of these are free access papers and we do hope that interested readers will read them for a detailed and more theoretical coverage.
We are grateful to the medical teachers in India, for accepting the earlier editions of the book and we hope that this edition will continue to fulfill their needs. The additions and revisions make the book a useful training manual and also the resource for basic and advanced medical education workshops.
We are open, as usual, to suggestions, criticisms, brickbats (and bouquets!).
Tejinder Singh
Piyush Gupta
Daljit Singh