Teaching and Learning Methods under CBME
CBME emphasizes diverse teaching and learning methods to ensure comprehensive skill
development. These include:
Lectures: Traditional and interactive lectures for foundational knowledge.
Small Group Discussions: Facilitating active learning, critical thinking, and
collaborative problem-solving.
Bedside Clinics: Direct patient interaction for history taking, physical examination, and
clinical reasoning.
DOAP Sessions (Demonstrate, Observe, Assist, Perform): A practical session format
where students observe demonstrations, assist performers, perform in simulated
environments, and eventually perform independently under supervision. This is crucial
for skill acquisition.
Skill Labs: Dedicated facilities for practicing and mastering procedural skills in a simulated environment.
Role Play: For developing communication and ethical skills, particularly in sensitive
patient interactions.
Case-Based Discussions: Integrating knowledge from various disciplines to understand
and resolve clinical problems.
Self-Directed Learning: Encouraging students to take ownership of their learning
journey.
Assessment in CBME: Beyond Rote Learning
Assessment under CBME is designed to evaluate the attainment of competencies rather
than just rote memorization. It includes:
Written Examinations: Short notes, structured essays, and theory papers.
Viva Voce: Oral examinations to assess understanding and critical thinking.
Skill Assessment: Evaluating practical skills in clinics, skill labs, or skill stations. This
often involves Objective Structured Clinical Examinations (OSCE) or Objective
Structured Practical Examinations (OSPE).
Logbook Documentation: Tracking and certifying the performance of essential skills,
especially those requiring independent performance.
Clinical Assessment: Evaluating performance in real clinical settings.
Levels of Competency (Miller’s Pyramid):
CBME defines levels of competency based on Miller’s Pyramid:
Knows (K): Basic knowledge (e.g., enumerates or describes).
Knows How (KH): Higher level of knowledge (e.g., discusses or analyzes).
Shows How (SH): Skill attribute (e.g., identifies or demonstrates steps,
interprets/demonstrates complex procedures).
Performs (P): Mastery and independent performance (rarely required in pre-internship,
often done under supervision).