Quality Assurance in Medical Education

MCI can follow some of the NAAC guidelines

· Quality can be assessed based on alumni placements. It can be placement in a
reputed university or a hospital.

· Alumni feedback

· Any achievements of students at inter-varsity competitions

· Random patient feedback

· Standard of assessment system at the university
ü a. Level of assessment: does the assessment test only the cognitive component or
tests analytical skills also.
ü b. Type of formative assessments
ü c. Validity and reliability of the assessment tools.
ü d. Implementation of the examination system. This can assessed based on the
maintenance and secretiveness of the exams.
ü e. Logbooks or portfolio check

· Balance between teacher centered learning and student centered learning - Balance
between teacher centered and student centered learning: Balance between SPICES model
implementation (student centered, problem based, integrated, community based, electives,
systematic) and traditional lectures and hospital postings.

Inspection should be in 2 steps:
1. It should be well notified to colleges and this should be done by auditors and not by
Inspectors.

ü These auditors will be a permanent team of MCI but of real time honest professionals who
should be trained about MCI norms and what MCI wants them to look for. It will be similar to
one who are trained in ISO, NHBA, NHBL etc.

ü They are trained; they know what and how to look for. Professionally prepared questions etc.
to filter false out of truth.

ü These auditors must consist of 1-2 chartered accountants who can easily tell by seeing tax
certificates and salary statement that who is a ghost faculty.

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2- This should be surprise inspection by MCI team but not doing a fault finding job.
ü They will seriously triangulate information processed by auditors.
ü They should even talk to students of each batch separately under closed rooms.
ü This will give more information than late night head counting which looks
undignified. Students are real source of true information.

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Richa commented that:
NAAC is an autonomous body of UGC, to make quality the defining element in higher education
in India. Some key aspects and weightages given to 7 main criterias by NAAC.

Key Aspects and Weightages

Criteria Key Aspects Universities Autonomou Affili
s Colleges ated
1. Curriculum Colle
Aspects 1.1 Curriculum Design and 50 50 ges
Development
1.2 Curriculum Planning - - -
and Assessment
1.3 Academic flexibility 50 50 20
1.4 Feedback System 20 20
Total 150 150 30
20
100

2. Teaching 2.1 Student enrolment 10 30 30
Learning and and profile 20 40 50
Evaluation 2.2 Catering to Student 50 100 100
Diversity 50 60 80
2.3 Teaching-Learning 40 30 50
Process 30 40 40
2.4 Teacher Quality 200 300 350
2.5 Evaluation Process
and Reforms
2.6 Student Performance
and Learning Outcomes
Total

3. Research 3.1 Promotion of 20 20 20

Consultancy and Research

Extension 3.2 Resource 20 20 10

Mobilization for

Research

3.3 Research Facilities 30 20 10

3.4 Research Publication 100 20 20

and Awards

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3.5 Consultancy 20 10 10
3.6 Extension Activities 40 50 60
and Institutional Social
Responsibility 20 10 20
3.7 Collaborations 250 150 150
Total 30 30
20 20
4. Infrastructu 4.1 Physical Facility 30 30 30
re and Learning 4.2 Library as Learning 20 20 20
Resources Resource 100 100
4.3 IT Infrastructure 30 40 50
4.4 Maintenance of 20 40 50
Campus Facility 20 20
Total 100 100 100
10 10
5. Student 5.1 Student Mentoring 40 10 10
Support and and Support
Progression 5.2 Student Progression 40 30 30
5.3 Student Participation 20 20 20
and Activities
Total 100 30 30
100 100
6. Governance 6.1 Institutional Vision 10 30 30
Leadership and and Leadership 10 30 30
Management 6.2 Strategy
Development and 30
Deployment 20
6.3 Faculty
Empowerment Strategies 30
6.4 Financial 100
Management and
Resource Mobilization
6.5 Internal Quality
Assurance System
Total

7. Innovation 7.1 Environment 30
and Best Practices Consciousness 30

7.2 Innovations

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7.3 Best Practices 40 40 40
Total 100 100 100

Total 1000 1000 1000

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Responses in common discussion

1. Keeping the MCI inspections a surprise and managing to keep the surprise.

2. Less of paperwork by creating a central database and updating it annually. We can even go
paperless.

3. Give rights and IDs to each faculty to update their own data once or twice a year (similar to
form 16, where we take our own responsibility)
4. Head count has to be off our heads if this country needs to progress.

5. Don't reduce faculty requirement

6. MCI should lay a lot of emphasis on strengthening the infrastructure during inspections in
the coming years so that the Quality of work and research improves. Infrastructure needs to
be improved every 2 to 5 years (based on reports of previous inspections) until they reach the
optimal, rather than being endlessly maintained on the basic minimum.

7. Share good initiatives of Medical colleges on a common forum .Create a national forum.

8.Taking strict disciplinary action is of paramount importance in the face of declining integrity

9. MCI inspectors should not give permissions for new medical colleges for some time. Emphasis
should be to improve the existing.

10 .The MCI should talk about strengthening internship programs and inspect the system to see
if interns have acquired basic competencies or not.

11.Some fellows disagreed with surprise inspection suggestion for the following reasons:

There can be college cultural/ sports event on that day
It can be a local holiday
It can be exam time and staff are busy with exams
Many faculty members would have taken leave due to school holidays
It can be a festival season and there can be quite less patients in the OPD/ward
Dean/ Director may be on leave

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12. The proposal to grade the Medical colleges into Basic/ National standard/ International
standard may create inferiority /superiority complexes amongst the students and faculties of
the medical colleges in the country and this may again encourage further the present egoistic
attitudes of a large number of faculties of different colleges.

13. Concerns regarding the variability and bias in selection of Inspector and that many a times
these inspectors are themselves not very well versed in the norms of MCI.

It should be well notified to colleges and this should be done by auditors and not by
Inspectors.

These auditors will be a permanent team of MCI but of real time honest professionals
who should be trained about MCI norms and what MCI wants them to look for. It will be
similar to one who are trained in ISO, NHBA, NHBL etc.
These auditors must consist of 1-2 chartered accountants who can easily tell by seeing
tax certificates and salary statement that who is a ghost faculty.
14. The number of inspectors should be more and their prior training is a must. Presently your
only
qualification and training to become MCI inspector is that you should be a professor in a
government medical college.
15. Blueprint of different job responsibilities amongst the members of the inspecting team

16. CEO/Director in the private medical colleges must be held responsible and accountable for
the deficits found during inspection. By rule principal or dean is considered as the head of the
institution for all purposes but their hands are relatively tight in terms of making desired
changes in the college . From Inspectors perspective, it appears as if principal did not do
his/her job sincerely which is not true. Hence, it will be important for them to sign in the paper
so that they are held responsible to their commitments.

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Thread 5

Dear all,
A warm thanks from Team Conformance to all of you for such a nice participation in discussions
that are going on in different issues of Quality Assurance in ME..... we do believe that it will go
on with more colors and newer ideas.
But let us see meanwhile, what happened at "Intake Medical College"...
Task - Let us help Dr Gunwatta and Dr. Bharose to share your views and experience regarding
Internal Quality Assurance at your present &/or past institutes .......They are waiting for us.....
(Time 3 days i.e. 15th to 17th October 2015)

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Trigger 1 : Great inputs are coming and nice sharing of experiences…..

Yes, Dr. Gunwatta and Dr. Bharose are quiet sure that your suggestions can enrich them….
May we can make the entire “Medical Education Process” divided in a system-chain…..then

Inputs:

a) Students taking admission
a. Students’ attendance percentage
b. mentorship programme

b) Faculties
c) Organizing in-house teachers’ training programmes.

a. - Considering research projects and publications during promotion of faculties.
d) Curriculum, syllabus, teaching-calendar

a. We welcome innovations in the curriculum and teaching patterns in our institute.
PBL,UNCLE, flipped classrooms, integrated teaching, OSPEs and OSCEs are a
currently being followed.

b.

d) TL aids (i.e. Infrastructures)

e) Students’ help-aids (Anti-ragging cell/ mentorship-programmes etc.)

Process:

a) Teaching-learning activities/methods
a. Tutorials

b) More and more students are encouraged to apply for STS projects, a practice that
exposes the undergraduates to the nuances of research from the very first year of
their admission to medical college.
a.

b) Assessment Process (Continuous Internal assessment as well as University Exam)

a. minimum of 75% attendance in theory classes and 80% attendance in
practical classes

Minimum 35% of total marks allotted for internal assessment to be obtained
separately for theory and practical to become eligible to appear in professional exams.

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- Conducting number of class tests/ part completion tests in addition to
semester exams. and giving weightage of the marks obtained in those during internal
assessment.

Output:

a) Medical graduates

Feedback:

a) Students’ result (of both Internal assessment as well as University final exam)

Participants: Abhijeet, Bharti

1. Co-curricular activities like debate competition,cultural& sports week , celebrations of
various festivals etc. are organised; the students are also encouraged to participate in
the inter-college/ inter-university activities. (Humanities)

2. A week course for personality development is conducted for all the students.
(Communication, Professionalism)

3. The annual intake of students is restricted (hopefully) to 100.

FOR TEACHERS

1. Strict rules are formatted for one being eligible to be a postgraduate teacher & PhD
guide in terms of some required number oforiginal research publications
in Pubmed indexed journals. Review articles and the ones that are published in journals
not indexed in pubmed, are given less weightage. These stringent rules inspire the
faculty to achieve these goals.

2. Weekly CGRs (Clinical Grand Rounds) and CPCs (Clinico-Pathological Conference) are
organised to make the faculty aware of the recent advances in Medicine.

3. The faculty is encouraged to participate in national or international conferences,
trainings, workshops; for which the institute provides financial support and academic
leave. This gives faculty the opportunity to get exposed to different ideas and groom
itself.

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4. We are made to give an account of our annual achievements in terms of publications,
conferences attended, fellowship/awards, examinership etc. This gives us a chance to
interospect our yearly performance and to improve.

5. More and more faculty is increasingly applying for FAIMER fellowship.

Participant 1-

While talking about internal quality assurance in Medical Education, I would like to recall the
definition as a “ Way to warrant that the predefined goals or standards are met.” The quality
assurance could be external and internal quality assurance.

The internal quality assurance process is very important because ultimately the quality of
medical education depends on the interaction between the teacher and the student; and the
collective integrity and professionalism of the academic community. During this process the
medical institute develops its own goals and objectives that are relevant to local and national
health care needs as well as the methods to achieve the goals. This also involves the periodic
reviews for the assessment of the extent to which goals are met within the framework of the
guidelines, and whether the methods of teaching and learning, the facilities support the goals.
In my experience following measures are adopted to ensure internal quality assurance:

Evaluation of the Course :
Monitoring of classes and progression of courses in the prescribed time frame
Need to evaluate whether classes are as per the curriculum guideline or not. Micro-syllabus are
developed in each department to ensure this.
Development of academic Calendar and ensuring its implication.

Periodic evaluation of faculty: By implementing peer evaluation and student evaluation of
faculties ensures the quality of teaching faculties and academic staff .

Periodic assessment of students: To ensure the quality of students, quality of the progress of
education assessments are very important. These could be in the form of different types of
examinations. Following mechanism further ensures quality:

Maintaining criteria of requirement of 80 % of attendance to sit for the final university exam.
Students need to pass theory and practical exam separately.
Requirement of 50% marks to pass practical exam.
Those students who fail in the internal assessment exam are not allowed to sit in University
exam.

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 Interms of infrastructure , recently our medical college bought equipments to establish
skill lab in the college. As of now, we have at least build up area for medical education
department and also the establishment of skill lab which is indirect effect of me
joining the FAIMER( one of my project goal).

 Nearly six months back only we took initiative and establish IRC which is accredited by
Nepal Health Research council and this has motivated faculty to do research activities.

 Our institute, through medical education department developed micro syllabus
 in all the subjects of Pre-clinical science department that is reviewed every year that

has enhanced the curriculum evaluation part of Internal QA.
 Medical education department also implemented an online MCQ project in which all the

students are given Login ID and they can take multiple online practice tests , this
project will enhance the attitude of self directed learning.
 We developed a system of notifying parents of their children's attendance at the end of
each month to have better monitoring of attendance.
 We keep computerised recordings of all the classes taken by teachers together with the
attendance of students.
 We started Mentosrship program in the college making a mentor group of six 8 students
with one designated faculty in each group . This has helped students a lot.
 For teachers at least 1-2 faculty development trainings are organised in a year.

These efforts aimed to ensure the internal quality assurance in the college.

S

At our Institute to maintain Internal Quality Assurance in Medical Education –regular feedback
is taken about teaching learning methods.

Foundation course is held for first year student and various midterm interactive sessions are
held with them so they can openly come up and share their learning difficulties as students
come from diverse background they are provided English and computer tutorial classes to aid
them in their studies.

As the Academic director of our Institute is a FAIMER fellow, so special emphasis is now being
give on curriculum revision, adopting innovative teaching learning methods and use of wide range
of assessment methods are encouraged to improve upon quality. Faculty are sent for training
from time to time for that.
Academic audits conducted by the institutions.

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We have biometric attendance for our students so they are more regular and do not give any
proxy, strict attendance record of the students are maintained.

We have a dedicated Skill lab at our institute for training undergraduates in core clinical skills
,recently we conducted 2 weeks training program for interns.

Regular workshops ,seminars,symposium are organized in various departments.

G:

Internal quality assurance is much needed in the present medical education.
To assure, institution needs to start an internal quality control cell.
Functions:
A] Teaching learning:
- Yearly schedule of teaching and learning activities of each department along with designated
faculty names including lectures, tutorials, seminars, journal club, bed side clinics, practicals,
demonstrations, small group activities etc.
- Surprise visit to the scheduled TL activity
- Use of checklist to decide the quality of the activity
- Time ti time feedback about the activity from the students
- Use of classroom assessment tests
- Use of educational technology and media as per the need
- Doing necessary revisions in the methods
B] Assessment:
- University has to have a strict vigilance on all the assessments
- Assuring objectivity in the assessment
- Validity and reliability of assessment tools should be considered
- Prevent unethical practices with strict laws
- Necessary blueprint along with use of structured questions along with MCQs testing HOTS
- Use of formative evaluations and feedback from both student and faculties
C] Professional development of faculties:
- Promote professional development among faculties
- Awards and incentives for those showing positive progress
- Ensuring that as a promotional criteria
D] Extension activities
- Promote outreach activities aligned with community health
- Develop extension to the present pre, para and clinical facilities like specialty clinics
- Programs like community health FM, Radio, mobile clinics, diagnostic camps
E] Publications and research:

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Dedicated research department with director
- Promote research
- Incentives and increments for research
- Publications of work in PUBMED and indexed journals
F] Parent teacher association
G] Alumni association
H] Anti ragging cell
I] Mentoring and bridge programs for academically poor students
J] Social and security cell
H] Collaborations with foreign universities and teacher and student exchange program

P:
Parameters of internal quality- some thoughts
1. In my department we take regular feedback (formal and anonymous) from the students and
discuss it with the faculty.
2. The head of the department also takes informal feedback from the students on a regular
basis( Just talk to the students individually). This has helped the department more than the
formal feedback.
3. Also talk to the other departments and see what they feel about us.
4. Popularity of the teacher does not necessarily mean there is quality.
5. The Dean’s office takes a final feedback when the student is leaving the institution. This has
helped the Dean to plan the future.
regards,

H:
The whole purpose of internal quality assurance is to assure the following and we have raised
many for their achievement.

Quality of infrastructure : By periodic inspection to make sure that the institution meets the
prerequisite set by the standard body.

Quality of students: Can be achieved by entrance exam or assesment of any type

Quality of Educational Program: This can be done through evaluation of program

Quality of Educational Progress: Assesed through periodic testing of students

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Quality of faculty: Evaluation of faculty by peers and also by students

Quality of Educational Outcomes: Follow up of graduates and their professional life.

Quality of patient care and safety: Monitoring of safe practice through quality and safety
department

If we assure above mentioned area then we move towards quality improvement(QI) . We need
to have a continuous and dynamic process of quality improvement rather than determining a
fixed level of quality at some point of time. Thus, Quality assurance leads to quality
improvement that ultimately leads to improvement in quality care and patient safety. From
the feedback at each level, we keep modifying the process of quality assurance internally.

J:

Some of the measures for Internal Quality assurance at our Medical college are:

1.Besides the measures for ensuring good student attendance similar to those mentioned
earlier,by many of us,we have daily electronic attendance for the faculty as well as staff.

2.Full time faculty to ensure Quality.

3.Fortnightly,CMEs are held on topics of common interest .CMEs are also held for diseases of
current concern,on a regular basis ,like scrub Typhus and Dengu that are cuŕently rampant in
our region.This helps to prepare everyone to handle tough situations that need more
manpower.

3.Students are involved in STS Projects and those not accepted by the ICMR,are given internal
grants to complete the project to encourage research among the students .

P:

In our College also the attendance of students and the marks of internal
assessments decide whether the student shall qualify to appear in the University
exam or not. We have the provision for keeping track of students who are regularly
missing classes. They are counseled and if there is no improvement the parents are
informed. Time to time psychological counseling is provided to students who seek
help or to those who we observe to be requiring support.

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· In case, when a faculty is missing classes it is brought to the notice of the
Principal. There is one to one talk and the classes are rescheduled. The class
representatives ensure that the classes are held regularly. We have the provision
of collecting all information related to classes at the end of each month.

· The class schedules of each Department reaches the MEU most of the
times.

· We also try to check if regular classes are taken in the clinics or not.

· The classrooms have optimum T-L aids for the teachers and the students
and are quite comfortable.

· CME’s, seminars, integrated classes are regularly held.

· Students are encouraged to participate in both intra and inter college
activities. They are also involved in organizing major College events.

· Student elections are regularly held

· They are encouraged to apply for STS projects and this month two students
have submitted their reports

· Library facilities are optimum and they adequately utilize services provided

· Hostel timings are maintained, esp in Girls’ hostel. Time to time monitoring is
done during study hours

G:

Very nice initiatives from various universities have been shared.

Few of the measures we follow which have lead to positive results are

- regular sessional examinations for the students which will follow strict time table

- 2 sessional exams per semester

- for faculty strict guideline that 1/3rd of the subject syllabus should be finished by every
sessional

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- sessional exams results are posted to each parent along with the attendance update for each
student

- high attendance cut off- theory 80%, clinics- 90%

- regular updates to student and their parents about their attendance and IA so far so that
they have scope to improve and fulfil their eligibility for exams

- annual student feedback of each faculty's clinical and theoretical skills and best teacher
award on that basis

-annual HOD interaction with each of the UG and PG student to gain the feedback about faculty
and infrastructure

- Transparent IA calculation system for each student which consists of each faculty rating,
attendance, discipline and patient rating for each student

- Each faculty to submit the TL material for respective subject to the dept each year

- Formative clinical assessment for students for each patient they see based on the KAP
parameters.

- encouragement to student through travel support for presenting research paper to annual
speech and hearing conference

- additional bonus marks to those students who perform research and present / publish it.

- extra curricular activities at regular interval for students and faculty

- Monthly feedback about each student from respective class coordinators

- Mandatory certain annual faculty development programs, conference presentation, grant
submissions and publication for each faculty for their respective performance appraisal. The
grades on appraisals can vary faculty's salary by huge amounts. I do not know whether its good
or bad :-)

S:
I would like to add few IQA measures we practice:

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1. ISO 9001:2008 certification
2. Random check of e-learning material in Moodle by Dean to ensure the quality
3. An active vetting committee who check every question paper before test/ exam.
4. Performance based increments to faculty and staff members
5. Student-Parent-Teacher committee to discuss each other's concerns
6. Student feedback on each faculty member and each department every academic year
7. Course feedback from alumni
8. Exit feedback from faculty/ staff members who leave the job
9. Introduction of self directed learning, Moodle forum discussions and student elective
projects
10. Clinical audit every 6 months
11. Annual progress report sent to parents
12. Integrated CBL and General Dental Practice modules to encourage integrated learning

K:

We have a very active IQAC ( Internal quality Assurance cell) under chairmanship of Dean.
Coordinator MEU was always a member of IQAC.
Some of the measures all the departments including ophthalmology undertake to ensure
academic quality are-
1. The department conducts series of student enrichment programmes round the annual year.
All the PG students are involved in organization as well participate in them.
2. Students Projects: The students are motivated to develop research bend of mind,
undertake research project work, attend seminar/Symp./conference/workshop may are
encouraged to undertake ICMR STS projects. All the PG dissertations/projects are based on
Research work guided by the faculty. The details regarding the number of projects of students
are 16 in last 4 years.
3. Faculty research is encouraged by the university and as per MCI requirement 100%
faculty have required no. of publications for their
designation. For promotions also strictly this requirement is looked into.
4. D Y Patil University pays Rs 3000/- for national index and Rs 5000/- for publications in
international index journals to all the faculty.
5. Need assessment exercise undertaken before the development of new programme(s):
HOD is taking time to time opinion & inputs from the faculty as well as PG students during
departmental meetings. Innovative ideas are implemented for the best outcome regarding
development of the student. With this we have come up with the rotation of second year
resident in Microbiology & Radiology department and we recommend to the Board of Studies for
implementation
6. Department obtain feedback from Faculty on CDD and TLE, Students on faculty CDD and
TLE, Alumni and Emphasis on programmes.

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7. Code of ethics for research followed by the departments : According to ICMR code of
ethics and declaration of Helsinki with
reference to competency, practice, confidentiality and relationship to community.
8. The Department organize No.of Seminars, Symposia, Workshop and other FDPs at various
levels. Majority of them are sponsored by DPU and Departments. Prominent experts from India
and abroad are invited.

S:

Measures for quality assurance in my present institute

STUDENT FEEDBACK – A questionnaire consisting of open & close ended questions has been
prepared by each department. Student feedback is taken regarding the following

1. T/L Methods / Lectures & practicals – their duration, adequacy and effectiveness, use of
appropriate aids.

2. Assessment / Examinations – number of exams, balance between the type of exams (oral &
written), formative & summative assessment and the acceptability and efficacy of the
assessment tools.

3. Teachers – although individual teacher feedback is not asked but the open ended questions do
address any malpractices or inappropriate behavior by teaching / non-teaching staff can be
reported.

The feedback is anonymous and taken every six months. The responses given by students are
analysed and discussed in departmental meeting. All issues raised are responded to by
appropriate remedial measures. If situation demands certain issues are also addressed at the
college council meetings.

FACULTY DEVELOPMENT & EDUCATIONAL RESEARCH PROJECTS –

1. MCI making it mandatory to attend Basic course workshop

2. With more and more faculty pursuing fellowships in medical education (FIME and
FAIMER)

It has given a big boost to improving the quality of medical education in medical colleges in
India.

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R:

For Internal Quality Assurance besides the Infrastructure , activities for students support like
mentoring ,anti ragging cell , Teaching -Learning & Evaluation , Research projects ,curriculum
reforms and Faculty development programs enhancing both Speciality and Medical Educational
Technology skills, Feedback system I think one very important aspect is monitoring all the
activities at regular interval by a body like Internal Quality Assurance Cell (IQAC) every 3 to 6
months .
This ensures the process is continued keeping up the quality and suggesting reforms where
ever needed . We have one at our Institute which helps us to be on the track .

S: Quality Assurance at my College
Infrastructure

1. Adequate infrastructure-hospital, college building, hostel, library.
2. Large lecture theatres with teaching-learning aids like multimedia and
blackboards/whiteboards.
3. Demonstration rooms in all departments for small group teaching.
4. Modern library with all the necessary textbooks available. Multiple copies of undergraduate
books available for students.
5. Hospital with adequate inflow of patients.
6. Modern facilities in the hospital so that the student can gain the latest in knowledge.

Faculty
7. Adequate number of faculty in all departments.
8. Introduction of Biometric Attendance System (BAS) linked to Aadhar card. All
faculties have to mark their presence twice during the day which ensures their presence in the
college.

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9. Vibrant Medical Education Unit (MEU) which has conducted Basic Course Workshop for all
faculties, though this is a new college.

Others
10. Commissioner, Department of Health and Family Welfare, Govt. of Gujarat is sent

the fortnightly teaching schedule of all departments.
This ensures that classes ( both in the college and clinics ) are

regularly taken, and that all faculties have adequate academic duties.

ISSUE of MISSED LECTURES

M:
Dear all, we all are talking of student's attendance in theory/ practical classes as one of the
measure for 'Internal measure of QA'. What about the faculty missing their assigned
jobs (teacher's attendance). We took the data of all 'missed lectures' and discussed it in
faculty meeting and found that few faculty members were infrequently taking their assigned
lectures. I think this should also be a measure of internal QA.

Just to add on to this 'personal experience'. The teachers missing their lectures cited their
unavailability because of their OPD and OT, this gave us the opportunity to prepare a teaching
roster (although with much hard work) to ensure that the teachers don't have their classes on
their days of professional commitment or even if they have it is out of usual working hours
(lecture from 8-9).

A:
Mohit has very aptly brought forward the issue of 'missed lectures' in connection with internal
quality assurance. This is a genuine concern for many of the institutes. When a particular
department makes its teaching schedule with allotment of classes to various teachers, the issue
should be kept in mind and to be dealt with accordingly. Assigned duties in OPD/OT should not
collide with assigned classes. I understand, to avoid this deficiency, we need to spend more
time while making the teaching schedule. At the same time, it is also true that some of the
teachers habitually want to avoid classes and not willing to make any internal adjustments
on their own to avoid those 'missed lectures'. I feel, some amount of self efforts on part of
concerned teachers in this respect can also sometimes solve the issue. So counselling of such
class avoiding teachers is a necessity here as a measure of internal quality assurance.
Congrats to Mohit and his departmental colleagues for making a teaching schedule which is
immune to this ailment.

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J:

I would like to add that at our institute, one day salary is deducted on missing a lecture by the
faculty.
I don't know if this will be a very acceptable method elsewhere,but this is done at our institute.

M:
OMG deducting a day's salary is too much of a punishment. I feel that the 'TEACHER' should
be enthusiastic and passionate about teaching. We have seen that the committed teachers
never miss their assignments. The problem of habitually missing the classes is with 'the so
called 'TEACHERS BY DEFAULT ', who become teacher by having a PG degree and getting a job
in a teaching institute.

I know this discussion is deflecting us from the question in discussion: Parameters of internal
QA
I congratulate Dr.Hem and his team for their efforts in improving the infrastructure, keeping a
tight vigil on student and teacher's attendance and initiating the student mentorship program.
I feel the number of research publications authored/ co-authored by students can also
serve as a good measure of the quality of ME being imparted by an Institute.

H:
I agree with Mohit and Juhi and add further that in Our institute it has been decided that the
classes can not be missed at the cost of OT or OPD. There is a system of notification by
academic section to the principals office and a notice is issued to the faculty on the same day if
he/she misses class. HOD is also held responsible to make that duty roster.

Academic coordinator makes the draft of roster and get approval from the HOD before
implementation so HOD can not escape either. At the end of year best academic faculty is
nominated and one of the criteria for selection includes this as well.

P:

Regarding the issue of missing lectures. I use to miss at least 2 to 3 lectures per year. (mainly
because I had forgotten). Even my secretary had failed to remind me. For the last two years I
have used google calendar (which sends you a SMS reminder about the lecture), and I have not
missed even one lecture. (not missed other “ dates” also. Try google calendar and see.
This year we have been introduced e learning through Moodle. We export the calendar onto our
desktop. This is another way of reminding.

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Thread 5.1
Dear all,
Members of 'Team Conformance' have been posting threads and triggers for
discussions. This is what happened when the team members met 2 days ago!

It was thus decided to refer the matter to Fellow friends for their comments.
Task - Please do a 'quality check' of all the threads posted in this month till now
and point out the possible 'lacunae/deficiencies' in them and then any 'corrective
measures' that were taken or could have been taken.. Please also state what
measures should be taken to prevent such lacunae in future... Please share your
individual observations on this thread .... Achievers will be awarded certificates
and gifts from Team Conformance.

73

Hem - This is an interesting aspect of discussion. I always found the threads and triggers really
creative, rich and interesting. Now, I need to see all the thread again to see if at all there were any
lacunae. I am finding this job much harder than posting responses to the thread itself.

Sanjoy - Hem and all,
Please do this little hard
work.
There are certificates and
gifts waiting.

Responses :

Gagan : Observation on one of the administrative step by team conformance.

It was for the first time in our discussions that an external thread was created
to perform the group discussions. The respective groups were told to maintain the
mail records and post. I am not saying it was right or wrong but it was a different
experience. I felt that since team conformance members were a part of each of
those external groups, they could have maintained records for each group as a
part of their monthly protocol. But it was different (and smart move). Not sure if
someone seconds my observation.

Sumanth : I remember my teachers words" to find out others mistake is the
easiest job on earth". I post my observations here with apologies, if am wrong:
Other than 2015 fellows, 2014 and faculty were posting triggers and I was
confused which trigger to answer. Not sure this was deliberately done !
Before we could answer the triggers, new triggers were posted which is quite
unlikely to happen in listserv discussions ( based on my few months experience) .
I second Gagan's findings. Till date am confused if we have keep a track of
intragroup discussions or we can ask the group to maintain!

74

Bharti: A very interesting task given by team Conformance......a lucrative offer of
certificates and gifts have added the interest!
Most humbly I want to point one issue-
As external threads were created and we were told to keep the mail records of
those threads, I being the mail recorder came across a problem. In listserv we
have a habit of posting the responses by clicking the feature 'reply' and it goes to
each one of us on listserv....but in external thread we had to use 'reply to all'
feature, to which we are probably not habitual. On using "reply" feature, the mail
went to only one member of the group and it was not recorded and it created a
confusion when the final mail record was posted on the thread.

Gita Corrective measure Timeline

NC (non Rechecks Before posting next
conformance) thread
1st October- 12.45
More members should Before next thread
Wrong spelling of be ready in case
quality there is an issue with
Posted at 12.45 internet connectivity
instead of 12.00

Sukhinder

Thread 1 - The spelling error was soon rectified by Team Conformance. So we
know that they have an internal quality assurance in place. Good work.

Thread 4 - A new question was posted by Team Conformance on the common

75

thread “ Please imagine yourself to be an (MCI) inspector and you have been asked
to go to a particular medical college for inspection. What would be your approach
to conduct the inspection to identify the ongoing good / innovative practices and
also the deficiencies, if any in that college? please try to be as creative /
innovative as possible !”

It was not specified that the responses should be posted in the group threads. So
it created a little confusion in our minds – was it a part of the group activity or a
parallel discussion being started?

It must be specified – alongwith the timeline the thread / subthread where the
responses must be posted.

Thread 6 - Manjinder & Clarence , the names have been misspelt ( Manjunder ,
Clerence).

Abhijeet :

Mail What was What is should be
details written :Just a suggestion …..
Hironmoy : Just a
suggestions, ….. Good depiction ……
Thread 6_
Team God depiction
distinction Abhijit. ……
(10.58 AM
21/10/15)
Sanjoy

Thread6_Team
Distinction

((.01 AM

76

21/10/15)

Hironmoy Off course, @dear Of course, …
Abhijit ….
Thread 6_
Team Time : 18th- Time : 18th-22nd Oct
distinction
(10.28 PM 22ND Oct 2015….. 2015…..
20/10/15)
Hironmoy …Shuchi, Swapnil, …. Sanjoy…..
Abhijit, Sanjay…
Thread 6_
Team A curriculum will A curriculum will also
Perfection also describes the describe the way of
way of continuous continuous monitoring
(18/10/15) monitoring
Hironmoy
The name The name of CLARENCE have
Thread 6_ of CLARENCE have been wrongly got typed
Team been as CLERENCE unintentionally.
Distinction unintentionally
wrongly got typed (Two adverbs can not be
(18/10/15)
Hironmoy

Thread 6_
Team
Excellence
(10.49 AM
21/10/15)
Hironmoy

Thread 6_
Team
Excellence

77

(18/10/15) as CLERENCE. used together)
Hironmoy ….moderation team liked to
…moderation team percolate the message that
Thread 6_ liked to percolate the entire medical…
Team the massage that
Excellence the entire
medical….
(19/10/15)
Sanjoy …I have started ….I have started keeping the
keeping the mai mail record…
Thread record…
6_Team
Distinction

(19/10/15)

78

Team Conformance presents you with a certificate and a token gift :

79

Thread 6

Dr. Bharose and Dr. Gunwatta are getting soooo many lights-and-clues on
Internal QA in ME from dear FAIMER fellow-friends.……..now, let us have a
glance, by this time what is going-on in our beloved “INTAKE MEDICAL
COLLEGE”………….So on the request of Dr. Gunwatta and Dr. Bharose, let all
of us help them by drafting the policies/steps/questionnaire (as considered to
be suitable) of Internal QA in ME as the group-task. The “Team
Conformance” do request you to make your draft/questionnaire (as be felt
suitable by your group) on the “Themes” as mentioned against the Group-
name; maintaining the model as “Input-Process-Output & Feedback chain” of
Medical Education System. Our entire team is with all of you as Group-
moderator.

Time : 18th-22ND Oct 2015

Group task (18th-20th October 2015: 3 days) – discussion in Group threads

Submission in Common Thread_6 after 10 pm of 20th October, for discussion
in Common thread for two days (21st & 22nd October 2015)

4 Groups:

Group Group 2015 2014 Group
name Theme fellows fellows Moderator

Team Curriculum Amir, Juhi, Clarence, Neeti
Excellence Bharati Gokul, Neeti,

Vijay

Team TL Methods Hem, Gagan, Majunder, Zia
Sukhinder, Mohit,
Commitment Purnima
Mullai, Zia

80

Team Assessment Upreet, Gita, Nilima, Gita
Vanita, Sabita, Sanjay
Perfection Sumanth, Peter
Kavita
Team Faculty Ruchi,
Shuchi, Simer,
Distinction Development Swapnil, Krithica,
Abhijit, Tapasya,
Sanjay Hetal

81

Trigger 1
Please be kind to share any 'questionnaire or feedback forms' currently
being used in your colleges and then use it with their own creativity to move
further on QA issues............
(within your group)
Trigger 2
A small suggestion from the moderation-team to all the groups (Excellence/
Perfection/ Commitment/ Distinction) regarding the template (also find in
attachment), which you may use, or, may not use, but please try to frame
your own template quiet similar to this.
The bell will ring on 4 pm @ 22/10/2015 for submission in Common thread_6.
This is to maintain the similarity and uniformity in the final reporting.

82

Drafts prepared by FAIMER fellows on Quality Assurance & Total Quality
Management for different aspects of Medical Education

Curriculum/ TL Methods/ Input Process Output Feedback
Assessment/ faculty
development

Quality defining

Quality implementing

Quality monitoring

Error rectification

Quality improving

Team Excellence on Quality Assessment of Curriculum.

Group Group 2015 fellows 2014 Group
name Theme Fellows Moderator
Team Curriculum Amir, Juhi, Clarence, Neeti
Excellence Bharati Gokul,
Neeti,
Vijay

Goal : …… Total Quality Management (TQM)/ Continuous Quality Improvement
(CQI) of the Graduate Medical Curriculum…..

83

The quality of a Curriculum is reflected in the standards on which it is set.
To ensure quality, the planning medical curriculum need to adopt comprehensive
approach by integrating theoretical learning with practical understanding honed
with professionalism, ethics and interpersonal skills.

A good curriculum should to be SMART
S=Specific
M=Measurable
A=Achievable
R=Relevant
T=Time bound

Curricu Input Process Output Feedback
lum

Quality Goals Educational Implem Evaluation & Feedback
entation
definin and Strategies

g objective Is Feedback system inbuilt
s Assessment into your curriculum and
methods essentially taken from all
stakeholders –Yes/No
Educatio 1. What
nal need Learning changes
assessme Environment

84

nt 1. Are the have you Is learning reflected in

objectives aligned implement student's

with Teaching - ed in behavior? Yes/No

1. Are Learning - curriculu

the assessment m in last How did you measure
1yr, 2yr, behavior?
institutio 5yr
nal goals 2. Annual report has
aligned a mention of these
Were

with components? changes

National 3. Are the implement
goals as competencies
in GMER defined and ed –
? addressed to?
Yes/No

2 . Are 4. What measures 2. Was
the are taken to analyze implement
objective these ation of
s defined comprehensively? changes -
for partial
or
institute complete

and 3. What
were the
across all hindrance
s in
professi Implemen
tation of
onals? curricular
reforms?
3. Does
it 4. How
includes,
besides
the

85

course were the
materials hindrance
, scope s
for overcome
teaching ?
skills of
professi 5. Lesson
onalism, s learned
communi from
cation, above
humaniti experienc
es for e?
the
students 6. Were
? the
lessons
learned
shared
with the
stakehold
ers
?Yes/No

Quality Q1. Do 1. Do you have 7. Give
implem you have frequent curriculum Student
and
Faculty
publicatio
n details
1. Does 1. How did you ensure
the that desired objectives

86

enting a assessment at your curriculu have been met?

curriculu institute? m clearly
defines 2. Do you think that your
m the must students have acquired
Committ 2. Is learning
environment essential Professional
ee at know/
conducive for good to Skills?Yes/No
your
Institute stakeholders?
know 3. List these Professional
? 3. What makes it areas? Skills

Q2.Does conducive? 4. Enlist your achievements
your in terms of Job
curriculu 4. What is the scope placements/
m fit for change in the Awards/honors/recognitio
into working ns/ Innovation/Field work
criteria environment?
of IMG
5. What is the scope
Q3. Do for change in the
all Learning
departm Environment?
ents
have 6. How do you
their engage your faculty
in research?

represen
7. Do you have some

tatives in
incentives/Grants

the
for

curriculu
research/Conferenc

m
es/Workshops?

Committ

ee?

87

Q4.If
not,
which
departm
ent has
no
represen
tation &
why?

Quality Q1.How Q1.Have you Q1.Do you Q1. When did you last
monito far your introduced some
ring curriculu innovations in the think that revise it

m fulfills curriculum to make Curriculu
the curriculum student m needs Q2.Is revision done by a
objective centric. modificati committee or an individual
s
mentione ons? Q3. What are your criteria
d in
GMER? Q2. What for revision?

prompted

you to

think so?

Error Q1.
rectifi Enlist
cation the
changes
in the
curriculu
m

88

Quality 1. 1 . What were the 1. What were the results
of reforms?
improvi Write reasons for

ng measures introducing these

taken reforms in teaching-

for learning and

improve assessment

ment in methods?

teaching

-learning

and

assessme

nt

methods

in past

1yr

Quality Assurance checklist for Assessment procedures – prepared by Team
Perfection
Team members
2014 Fellows: Gita Negi, Nilima Shah, Sabita, Peter
2015 Fellows: Upreet, Kavitha, Sumanth, Vanita
Group moderator: Gita Negi

Items Item under What is Check-list Co

89

consideration expected,
ideally
(Policy
issues)

Input Assessment Resources as Do you have adequate resources to conduct
plan per theory exam?
MCI/DCI
regulations

Do you have adequate resources to conduct
clinical exam?

How many of your faculty members are
trained in assessment techniques?

Are there any rules/regulations related to
examination available?

Is there any committee to handle malpractice
issues?

Outline Is the outcome/objective/output of the
assessment defined?

Is there a blue-print of assessment in place?

Are you following the mandatory guidelines as
prescribed by the regulatory body?

90

Are there any formative assessments? If yes,
what are the types.
Tabulate the frequency, type, who conducts,
who assesses, and how much each contributes
towards the Internal Assessment

What are the types of evaluation tools used in
the summative assessment?
Tabulate student eligibility criteria to appear,
the type, who conducts, who assesses, and how
eligibility of internal and external examiners
is decided

Are these formative/summative assessments
timed (end of block/ semester/ year)?

Are these formative/summative assessments
suitably spaced (after each
block/semester/year)?

Are these formative/summative assessment
relevant?
Briefly describe methods used to ensure
relevance

Formative Is there any portfolio assessment followed in
assessment every subject?

91

How is the class room activity/daily clinical
posting assessed?

Are there any subjects which are tested only
by formative assessment?

Summative Does the weightage of the internal
assessment assessment comply with regulatory guidelines?

Does the student have to pass theory and
practical/clinical separately?

Is there any structured viva-voce/case
presentation/ practical exam?

Assessment Training Have you attended advanced faculty training
preparation workshops in assessment techniques?

Have you conducted advanced faculty training
workshops in assessment techniques for in
house faculty?

Does the question paper have higher order
KAS levels of questions?

Is the blueprint shared with faculty members
and students?

Are there any integrated questions?

92

Process Assessment Is there any subjective and objective peer
verification evaluation system?

Output Assessment Is there any vetting process/committee
implementation which verifies the questions?

Do you prepare the answer key prior to the
exam?

Are there any observers during the time that
the assessment is conducted?

Are there different sets of examiners for
theory and practical or same set of examiners
for both?

Is your assessment system fair/non-biased?
Describe the steps that you take to ensure
that your assessment system is fair/unbiased

Is the assessment system transparent?
Describe the steps that you take to ensure
that the assessment system is transparent

Is the assessment system confidential?
Describe the steps that you take to ensure
that the assessment system is confidential

Is there any system of video recording the

93

practical exam/ viva-voce exam?

Is there any facility to store exam materials
safely?

Are there any innovative methods of
maintenance of confidentiality of exam
questions?

Describe any innovative methods of
maintenance of confidentiality of exam
questions that you use, if any

Is there any system to ensure fairness in
marking? If yes, briefly describe.

Is there a double marking system? If so, what
are the guidelines for third evaluation?

Do you practice standard setting? If so, which
method?

Assessment Feedback Is there any student/alumni feedback on the
validation assessment system?

Describe if you use student/alumni feedback
on the assessment system

Is there any external examiner feedback on
the assessment system?
Describe if you use external examiner

94

feedback on the assessment system

Does the assessment match the learning
objectives?

What steps do you take to ensure that the
assessment match the learning objectives?

Statistical Is item analysis done? If yes, have you sorted
validation the questions based on the reliability?

Do you retain acceptable questions in the
question bank after discrimination index and
facility value calculation?

Error Is there any system to implement preventive

rectification measures/ rectification of errors?

Are these errors documented?

Assessment Do you revise/update your assessment system
improvement regularly?

Which is the most recently included
assessment method at your institution?

Do you have a system to decide on the
inclusion/exclusion of any new method of
assessment into the curriculum?

Do you have a committee to take care of

95

assessment system (or curriculum)?

96

Draft of TEAM DISTINCTION on ' Quality Control in Faculty Development. '

Group Name Group Theme 2015 Fellows 2014 Fellows Moderator
Team Faculty Shuchi, Ruchi, Simer, Sanjoy
Distinction Development Swapnil, Kriithica,
Abhijit, Tapaysa,
Sanjay Hetal

Team Leader –Abhijit
Reporter -Swapnil

QUALITY CONTROL IN FACULTY DEVELOPMENT

“It goes without saying that no man can teach successfully who is not at the same
time a student.” – Sir William Osler

Definition of Faculty Development :

Broad range of activities that institutions use to renew or assist faculty in
their roles

Planned activity designed to prepare institutions and faculty members for
their various roles AND

To improve an individual’s knowledge and skills in the areas of teaching,
research and administration[1].

97

Goals of faculty development :

Improve practice in teaching, research, and institutional service

Manage change by enhancing individual strengths and abilities as well as
organizational capacities and the overall culture.

Recommendations for Quality Control in Faculty Development :

Faculty Input Process Output Feedback
Development
Quality 1. Framing of -
Defining a National
Health
Profession
Education Policy
:

Policy should

include all

aspects of

running a

medical college

98

in the country .

Quality Support for 7. 8. Change
Implementing
Faculty Incorporation from

Development of Medical Inspection to

: Education Accreditation

Technology in :
Setting up of Postgraduate
Academic Staff The present

Colleges system of

Periodic Training : recognition of

teacher training medical

colleges in
form should an ‘catch them India by the
essential young’ and MCI focuses

requirement for incorporate mainly on the
career elements of number
of
development, education
teachers,
promotion and science and building,
empanelment as technology in infrastructure
examiners.Leave postgraduate and
of absence and training. other

travel grants facilities

should be which are not

provided to measures

faculty to related to

attend such quality of

workshops/ medical

training. education.

Emphasis

99

3. Revival should shift
of NTTCs from
4.Revival of quantitative
Fellowships and judgement to
Travel Grants a continuous
monitoring of
Functional the quality
Medical throught
Education Units institutional
(MEUs) : self study and
peer appraisal.
Particularly in
newly
established
medical colleges
and they should
contribute
towards faculty
development.

6. Enlarging

the scope of

Medical

Education Units

(MEUs) to

Centers

of
Health
Professions’

100