K.S. Bommi Rupa De i e al. The E ec o Compe ency Based Medical Educa ion on Medical S uden s. In . J Med.
Pha m. Res., 6 (6): 201-205, 2025
201
In e na ional Jou nal o Medical
and Pha maceu ical Resea ch
Online ISSN-2958-3683 | P in ISSN-2958-3675
F equency: Bi-Mon hly
A ailable online on: h ps://ijmp .in/
O iginal A icle
The E ec o Compe ency Based Medical Educa ion on Medical S uden s
K.S. Bommi Rupa Re i1, Gunwan Ramchand a Chaudha y2, Rakesh Kuma 3, Sa a Subhana Khan4
1,4 3 d Yea MBBS Pa -2 S uden , Zydus Medical College, and Hospi al, Dahod, Guja a , India.
2 P o esso & Head, Depa men o Ana omy, Zydus Medical College, and Hospi al, Dahod, Guja a , India.
3 Assis an p o esso , Depa men o Ana omy, Zydus Medical College, and Hospi al, Dahod, Guja a , India.
A B S T R A C T
Co esponding Au ho :
Sa a Subhana Khan
3 d Yea MBBS Pa -2 S uden ,
Zydus Medical College, and
Hospi al, Dahod, Guja a , India.
Recei ed: 14-10-2025
Accep ed: 29-10-2025
A ailable online: 10-11-2025
In oduc ion: The ansi ion om adi ional cu icula o Compe ency-Based
Medical Educa ion (CBME) ep esen s a majo shi in India’s medical aining
sys em. CBME emphasizes ou come-based lea ning, p o essional de elopmen ,
ea ly clinical exposu e, and e hical compe ence, aiming o p oduce mo e skilled
and con iden g adua es.
Me hods: A c oss-sec ional compa a i e s udy was conduc ed a Zydus Medical
College and Hospi al, Dahod, in ol ing 316 unde g adua e medical s uden s om
he p e-CBME ba ch (2018) and pos -CBME ba ches (2019–2023). A s uc u ed
ques ionnai e based on he DREEM (Dundee Ready Educa ional En i onmen
Measu e) amewo k was used o assess i e domains: pe cep ion o lea ning,
pe cep ion o eaching, academic sel -pe cep ion, pe cep ion o a mosphe e, and
social sel -pe cep ion. Due o non-no mal da a dis ibu ion, K uskal-Wallis and
Mann-Whi ney U es s we e used o s a is ical analysis.
Resul s: Signi ican di e ences we e obse ed be ween he p e- and pos -CBME
g oups, wi h he mos no able a ia ion be ween Ba ch 2018 and Ba ch 2023 (p <
0.000). Pos -CBME s uden s epo ed imp o ed men o -men ee suppo sys ems,
ea ly clinical exposu e, and inc eased con idence in clinical skills. A ound 70% o
s uden s no ed enhanced compe ence, communica ion, and e hical awa eness, and
65% c edi ed hese imp o emen s o he AETCOM modules. While no signi ican
di e ence was ound in he pe cep ion o eaching, eedback mechanisms we e
app ecia ed ac oss bo h g oups. Sel -di ec ed lea ning was also epo ed mo e
commonly in he pos -CBME g oup.
Conclusion: CBME signi ican ly enhances s uden s’ lea ning expe ience, clinical
p epa edness, and e hical de elopmen . Howe e , i s sus ained e ec i eness
depends on acul y aining, ins i u ional planning, and con inuous cu iculum
e alua ion. The indings suppo CBME as a p og essi e s ep in shaping compe en ,
con iden , and e hically esponsible medical p o essionals.
Copy igh © In e na ional Jou nal o
Medical and Pha maceu ical Resea ch
Keywo ds: Compe ency-Based Medical Educa ion (CBME), Medical Educa ion,
Ana omy eaching, Medical s uden s, Teaching me hods.
INTRODUCTION
We belie e ha in he u u e, expe ise a he han expe ience will unde lie compe ency–based p ac ice and ce i ica ion
[1]. Educa ion plays a pi o al ole in he p og ess o socie y, and i s co e lies in he con inuous de elopmen o cu iculum.
This helps in shaping he u u e o s uden s h ough hei di e en lea ning expe iences, along wi h p o iding be e
solu ions o social issues. A cu iculum is designed by compa ing he s eng hs and weaknesses o di e en p inciples and
app oaches [5]. The p inciples include lea ne -cen e edness, p oblem-based lea ning, and social econs uc ion. The
app oaches include subjec -cen e edness, compe ency-based lea ning, and expe imen al app oaches [5,6]. The e a e
a ious in e nal and ex e nal ac o s such as social ac o s, echnological ad ancemen s, geopoli ical, and cul u al aspec s
ha demand he need o change in he design and implemen a ion o cu iculum. The implemen a ion o a new cu iculum
u he b ings ou a ious challenges aced by educa o s and ins i u ions such as cu iculum ad ancemen s, esis ance o
change, esou ce cons ain s, in as uc u al ad ancemen s, and ime limi a ions [1,2]. In he his o y o medicine, he idea
K.S. Bommi Rupa De i e al. The E ec o Compe ency Based Medical Educa ion on Medical S uden s. In . J Med.
Pha m. Res., 6 (6): 201-205, 2025
202
o he compe ency app oach was al eady p esen o abou 50 yea s, bu i has gained mo e a en ion ecen ly [3][2].
Compe ency-based medical educa ion was i s p oposed by WHO way back in 1978 bu has only been in conside a ion
o he las 20 yea s [12]. The o igin o compe ency-based app oaches se s back 60 o mo e yea s ago [3]. In he ea ly 20 h
cen u y, Tyle & Mage p oposed a wo k which ocused mo e on goals and objec i es, and i was widely accep ed, while
some o he s ocused mo e on p ocess a he han ou come. A e ha , ou come-based educa ion (OBE) became a highligh ,
which ocused only on ou comes and no on i s pa hways and p ocesses [4]. The adi ional educa ion sys em e ol ed
a ound knowledge-based objec i es ha ga e impo ance o p ocesses ega dless o he p oduc , while ou come-based
educa ion was o ally opposi e [5]. F om he abo e con ex , i is clea ha he compe ency-based app oach is a ype o
OBE, in which he ou comes help in he o ma ion o a new cu iculum sui able o he needs o socie y [6]. I is also an
old concep . The easibili y and p ac ical de ails o CBME a e s ill an a ea o explo e by educa o s and ins i u ions. The
wo ld app oached CBME no un il 2009, when he Council o Royal College o Physicians and Su geons o Canada passed
a esolu ion add essed o he O ice o Educa ion o uphold a CBME agenda o special y educa ion in Canada. The
esolu ion s a ed ha , The Royal College in collabo a ion wi h key pa ne s, will explo e oppo uni ies o inco po a ing
compe ency–based educa ion in esidency aining and ac oss he spec um o medical educa ion. This would ensu e ha
he 21s -cen u y PGME [pos g adua e medical educa ion] sys em is ocused squa ely on mee ing socie al needs as he
p ima y goal o aining. Implemen ing any such change would concei ably ake many yea s and equi e a coo dina ed,
esou ced, collabo a i e app oach [7]. The ques ion a ises as o why we need a compe ency-based app oach in medical
educa ion. Acco ding o he compe ency-based unde g adua e cu iculum o he Indian medical g adua e, a clinician mus
be a good communica o , e icien eam leade , mus be p o essional and a li elong lea ne [9,10,11]. In he e a in which
medical p o essionals a e wo king, hey mus be accoun able and sc u inized owa ds hei p o ession. This cu iculum
ensu es ha e e y g adua e mus be p epa ed o p ac ice, and no only ha , bu he g adua e mus also be a mas e o e e y
ield—be i p ocedu al skills, knowledge, a i ude, and communica ion—and CBME gi es he bes esponse o he abo e
ques ion [2,8]. The wo majo app oaches in he CBME pa e n a e p oblem-based lea ning and eam-based lea ning.
P oblem-based lea ning has many ad an ages such as inc eased clinical e alua ion skills, imp o ed communica ion,
eamwo k, p esen a ion, and sel -di ec ed lea ning [2,8], whe eas eam-based lea ning goes hand in hand wi h p oblem-
based lea ning and bo h o hem in eg a e oge he o achie e ac i e lea ning s a egies in medical cou ses [3,4]. Team-
based lea ning was in oduced as a medical educa ion s a egy i s in 2001 and he impac was s udied by conduc ing
a ious examina ions [13]. The majo challenges in he implemen a ion o CBME ha ha e eme ged a e ime managemen ,
lack o planning and ins i u ional s a egies, in as uc u al and equipmen di icul ies, lack o clinical and p o essional
de elopmen , o e lapping o compe encies, and s uden engagemen .
MATERIAL & METHODS
E hical clea ance
The Ins i u ional E hical Commi ee (IEC) a Zydus Medical College and Hospi al p o ided e hical app o al o his s udy
(IEC no. ZMCH/IEC-03/33(21)-2025).
S udy Se ings:
The s udy o assessing he e ec s o CBME on Medical s uden s he p esen s udy was unde aken in Zydus Medical
College and Hospi al, loca ed in Nimnaliya, Mu aliya, Dahod. E e y yea 200 s uden s ake admission in his college
excep o 2018 ba ch which had 150 s uden s. This college holds good academic eco d.
S udy Design:
I is a compa a i e c oss sec ional s udy o educa ional assessmen whe e a ious me hods a e used o e alua e he
pe cep ion o lea ning among he s uden s om he CBME cou se. Su ey and open ended esponses we e e iewed using
Google o ms. We asked o al 22 ques ions ega ding he CBME cu iculum and a he end he sugges ion box is also gi en
o he open ended esponse on he basis o (Dundee eady educa ional en i onmen measu e). Hence bo h quali a i e and
quan i a i e da a was analyzed.
S udy Pa icipan s
We go oppo uni y o assess he e iews om he s uden s o 2018 ba ch (n=150) who had adi ional cu iculum and he
s uden s o 2019, 2020, 2021, 2022, 2023each o which is (n=200) who a e cu en ly s udying in CBME cu iculum
in oduced by he MCI.
Da a Collec ion
By he p e alence om he p e ious e e ence s udies we calcula ed p1 and p2 alue whe e p1 is p e alence o non CBME
ba ch and p2 p e alence o CBME ba ch which ga e us alue o p1= 0.89 and p2= 0.95 which was ob ained by aking a io
o numbe o esponses by o al numbe o s uden s. Then we go ou sample size (n) o 316. We ook s a i ied sampling
o his s udy.
The eedback o he su ey was ob ained om he s uden s o all ba ches. The s uden s we e gi en he ques ionnai e using
Google o m which was ci cula ed in hei espec i e g oups. The ba ches we e explained abou he pu pose o he s udy
and he ques ionnai e. They we e gua an eed wi h he main enance o hei anonymi y. The DREEM is he measu ing ool
K.S. Bommi Rupa De i e al. The E ec o Compe ency Based Medical Educa ion on Medical S uden s. In . J Med.
Pha m. Res., 6 (6): 201-205, 2025
203
which is used widely o s udy he educa ional en i onmen in he medical ins i u ions. DREEM was de eloped 10 yea s
ago by Delphi panel o acul ies o in e na ional boa d o s udy on a ious s uden s o he alida ion pu pose. [12,15]
DREEM is a ques ionnai e o 50 s a emen s ou o which he ollowing which we ha e aken 20 ques ions which comes
unde i e subca ego ies o DREEM. The subca ego ies a e as ollows:
S uden ’s pe cep ion o lea ning
a) S uden ’s pe cep ion o eaching
b) S uden ’s academic sel pe cep ion
c) S uden ’s pe cep ion o a mosphe e
d) S uden ’s social sel pe cep ion
Each s a emen has a sco e om(0-3) on a 4 poin Like scale ype ha is s ongly disag ee(0), disag ee(1), ag ee(2),
s ongly ag ee(3). An open ended ques ion ha was asked a he end o he ques ionnai e, also helped in unde s anding he
iews exp essed by he s uden s. Besides his he open ended ques ion was asked a las in he same Google o m as-
“Men ion he wo hings which you app ecia e abou you cou se ha has helped you become a be e lea ne .
RESULTS
A o al o esponses om six ba ches (2018–2023) we e analyzed.
Tes o No mali y
No mali y es ing (Kolmogo o –Smi no and Shapi o–Wilk) indica ed ha he da a did no ollow a Gaussian dis ibu ion
in any ba ch (all p < 0.001). The e o e, non-pa ame ic es s we e applied.
Table 1. Tes s o No mali y
Ba ch
Kolmogo o –Smi no S a is ic
d
Sig.
Shapi o–Wilk S a is ic
d
Sig.
2018
0.391
567
0.000
0.688
567
0.000
2019
0.414
401
0.000
0.585
401
0.000
2020
0.384
440
0.000
0.684
440
0.000
2021
0.378
421
0.000
0.679
421
0.000
2022
0.339
522
0.000
0.704
522
0.000
2023
0.282
549
0.000
0.722
549
0.000
All p < 0.05 → Null hypo hesis ejec ed → Da a no no mally dis ibu ed.
K uskal–Wallis Tes
Since he da a we e non-no mal, he K uskal–Wallis es was pe o med ac oss ba ches. A signi ican di e ence was
obse ed among he g oups (χ² = 119.306, d = 5, p < 0.001).
Table 2. K uskal–Wallis Tes
Tes
χ²
d
p- alue
K uskal–Wallis
119.306
5
0.000
Mann–Whi ney U Tes (P e-CBME s Pos -CBME)
To compa e he p e-CBME ba ch (2018) wi h each pos -CBME ba ch (2019–2023), he Mann–Whi ney U es was applied.
Signi ican di e ences we e obse ed in all pai wise compa isons (p < 0.05).
Table 3. Pai wise Compa isons (2018 s O he Ba ches)
Compa ison
Mean Di e ence (I–J)
S d. E o
Sig.
95% CI (Lowe –Uppe )
2018 s 2019
-0.175*
0.040
0.000
-0.29 o -0.06
2018 s 2020
-0.178*
0.039
0.000
-0.29 o -0.07
2018 s 2021
-0.124*
0.039
0.008
-0.24 o -0.01
2018 s 2022
-0.105*
0.037
0.000
-0.15 o -0.06
2018 s 2023
0.127*
0.036
0.007
0.02 o 0.23
*p < 0.05, signi ican di e ence.
I em-wise Compa ison (2018 s 2023)
Two speci ic i ems we e analyzed u he be ween he 2018 (non-CBME) and 2023 (CBME) ba ches.
K.S. Bommi Rupa De i e al. The E ec o Compe ency Based Medical Educa ion on Medical S uden s. In . J Med.
Pha m. Res., 6 (6): 201-205, 2025
204
Table 4. Men o –Men ee P og am
Ba ch
N
Mean Rank
Sum o Ranks
2018
124
146.07
18,112.50
2023
111
86.64
9,617.50
Mann–Whi ney U = 3401.50, Z = -7.111, p = 0.000 → Signi ican di e ence.
Table 5. Social Pe cep ion Abou S uden s Who Go S essed
Ba ch
N
Mean Rank
Sum o Ranks
2018
124
91.42
11,427.00
2023
111
149.00
16,539.00
Mann–Whi ney U = 3552.00, Z = -8.529, p = 0.000 → Signi ican di e ence.
DISCUSSION
This s udy analyzed six consecu i e ba ches o unde g adua e medical s uden s (2018–2023) o assess di e ences in
expe iences be o e and a e he implemen a ion o Compe ency-Based Medical Educa ion (CBME). The esul s
demons a ed s a is ically signi ican di e ences ac oss ba ches, indica ing ha he ansi ion o CBME has in luenced
s uden pe cep ions and expe iences in measu able ways.
The non-pa ame ic analysis e ealed ha s uden s om pos -CBME coho s (2019–2023) di e ed signi ican ly om he
p e-CBME coho (2018) in se e al domains. Speci ically, while he 2018 ba ch a ed he men o –men ee p og am mo e
posi i ely, s uden s om la e ba ches—pa icula ly 2023— epo ed g ea e social s ess and al e ed pe cep ions o pee
suppo . This sugges s ha al hough CBME was designed o os e holis ic de elopmen and con inuous men o ing, i s
p ac ical impac on he lea ning en i onmen emains complex.
These indings align wi h p io li e a u e emphasizing bo h he p omise and he challenges o CBME implemen a ion in
India. Bhaga e al. (2025) epo ed ha while s uden s app ecia ed CBME’s ocus on compe ency and in eg a ion, many
aced inc eased wo kload and s ess due o equen assessmen s and unclea expec a ions (16). Simila ly, Sulena e al.
(2024) highligh ed ins i u ional and acul y-le el di icul ies in ansla ing CBME’s in ended lexibili y in o consis en
s uden suppo , pa icula ly du ing he ini ial yea s o ollou (20). Ou s udy’s obse a ion o heigh ened s ess among
pos -CBME ba ches esona es wi h hese epo s.
The inding ha he p e-CBME coho iewed men o ing mo e posi i ely may e lec di e ences in men o ship quali y o
accessibili y. Ea lie , Sonawane e al. (2013) emphasized ha s uc u ed men o ing humanizes medical educa ion by
p o iding emo ional and academic guidance (21). Howe e , la e wo k by he same g oup (Sonawane e al., 2021) showed
ha despi e men o ing’s p o en bene i s in educing dep ession, anxie y, and s ess , p og am e ec i eness depends on
men o engagemen and con inui y (17). The educed posi i i y in men o –men ee pe cep ions pos -CBME may hus s em
om agmen ed men o in e ac ions amid inc eased cu icula demands.
Inc eased s ess pe cep ion among CBME coho s is consis en wi h in e na ional s udies linking medical cu iculum
e o m wi h heigh ened pe o mance p essu e. McKe ow e al. (2020) obse ed p og essi e declines in s uden s’ physical
and emo ional well-being ac oss aining yea s, pa icula ly in pe iods o cu icula ansi ion (18). Be gmann e al. (2019)
simila ly epo ed ha academic s ess in medical s uden s o en spills in o pe sonal and social domains, e lec ing he
b oade s ain o adap ing o changing pedagogical sys ems (19). Ou esul s ein o ce hese indings by demons a ing ha
e en well-in en ioned cu icula shi s, i no ma ched wi h adequa e psychosocial suppo , may ampli y s ess and social
ension.
Limi a ions
This s udy is limi ed by i s c oss-sec ional design and eliance on sel - epo ed da a, which may in oduce subjec i e bias.
The use o a single ins i u ion’s coho es ic s he gene alizabili y o indings. Longi udinal esea ch inco po a ing
quali a i e eedback would help cla i y how CBME impac s s uden g ow h ajec o ies o e ime.
CONCLUSION
In summa y, his s udy highligh s ha CBME implemen a ion has meaning ully al e ed he educa ional expe ience o
unde g adua e medical s uden s. While compe ency-d i en lea ning aims o p oduce be e clinicians, i s success depends
on balancing academic igo wi h emo ional and social suppo sys ems. S eng hening men o ship and p io i izing s uden
well-being a e essen ial s eps owa d ealizing CBME’s ull po en ial in medical educa ion.
Con lic s o In e es s: None
K.S. Bommi Rupa De i e al. The E ec o Compe ency Based Medical Educa ion on Medical S uden s. In . J Med.
Pha m. Res., 6 (6): 201-205, 2025
205
LIST OF ABBREVIATIONS USED:
CBME – Compe ency Based Medical Educa ion
DREEM (Dundee Ready Educa ional En i onmen Measu e)
AETCOM – A i ude E hics & Communica ion
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