Assessment of self-directed learning module in community medicine – A quantitative study

INTRODUCTION

Competency-Based Medical Education (CBME) represents a paradigm shift in medical training, emphasizing the acquisition of specific competencies required for effective healthcare delivery. Unlike traditional, time-based models, CBME focuses on outcomes, ensuring that medical graduates possess the necessary knowledge, skills, and attitudes to meet the health needs of the population. The approach aligns with global trends in medical education, advocating for learner-centered methodologies that prepare students for real-world challenges in a dynamic healthcare landscape.^[1,2]

In the field of Community Medicine, CBME is particularly significant. It underscores the importance of preventive and promotive healthcare, public health policy, and addressing the social determinants of health. The curriculum is designed to foster a deep understanding of health systems and equip future physicians with the ability to analyze and respond to community health needs. Within this framework, self-directed learning (SDL) emerges as a cornerstone of the educational process, encouraging students to take responsibility for their own learning.^[3,4]

SDL is critical in community medicine, as the discipline requires continuous learning to keep pace with evolving health trends, emerging diseases, and changing societal needs. By engaging in SDL, students develop lifelong learning skills, critical thinking, and the ability to apply evidence-based practices in diverse settings. It empowers learners to identify knowledge gaps, seek relevant information, and synthesize insights to solve complex health problems.^[5]

Furthermore, SDL in the context of CBME fosters active participation in community health initiatives, enhancing students’ capacity for collaboration and leadership. As students engage with real-world scenarios, they cultivate practical competencies and a deeper appreciation of their role as health advocates. Emphasizing SDL within CBME not only improves the quality of medical education but also ensures that future physicians are well-prepared to contribute effectively to the health and well-being of the communities they serve.^[6]

In the CBME curriculum prescribed by the National Medical Commission for the Indian Medical Graduate, the total number of hours allotted for SDL in Community Medicine is 20 h. These hours are distributed across the second professional and third professional (Part I and Part II) phases, with the aim of encouraging students to independently explore topics related to epidemiology and biostatistics, health programs and policies, social determinants of health, public health challenges and solutions, and preventive and promotive healthcare strategies. The SDL hours in Community Medicine focus on developing critical thinking, problem-solving abilities, and evidence-based decision-making skills by engaging students in identifying and addressing community health issues.^[7,8]

MATERIAL AND METHODS

Data collection procedure

The SDL sessions were conducted as per the instructions mentioned in the [Table 1]. It is explained with an example of National AIDS Control Program (NACP). Duration of each contact session was for one hour. Intertwining (intersession) period is for 1–2 weeks, which is the crucial period in SDL, where the actual learning takes place [Figure 1]. To assess the knowledge, formative assessment was done in the form of post-test at the end of every module. Detailed methodology is mentioned elsewhere.^[9]

Table 1: Instructions for the self-directed learning session on NACP.

Sessions	Details
First contact session	Goals and milestones to be achieved on topic NACP was set WhatsApp group were created for easy communication
Intersession period	Resources were shared such as link for the pdf document on programs and videos from NACO websites were shared
Second contact session	Self-study modules were shared during this period
Assessment	Formative assessment was done in the form of post test

NACP: National AIDS control program, NACO: National AIDS Control Organization

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Figure 1:

Conduct of self-directed learning.

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RESULTS

The 3^rd-year MBBS batch consists of 158 students in total. Among them, students with roll numbers 1–150 belong to the regular batch, while the remaining students are part of the additional batch.

DISCUSSION

The present study evaluated the effectiveness of a SDL module in Community Medicine, specifically in the context of National Health Programs. The results demonstrated a significant improvement in students’ knowledge, as evidenced by the increase in median post-test scores across all modules. The findings highlight the utility of SDL in enhancing learning outcomes in a competency-based curriculum.

For the NACP, the median post-test score showed a significant increase from 5 (3–7) to 8 (6–9), indicating that SDL effectively bridged knowledge gaps in this critical area. Similarly, the National Tuberculosis Elimination Program module recorded a notable improvement, with scores increasing from 6 (4–9) to 10 (8–10).

Interestingly, the Reproductive, Maternal, Neonatal, Child, and Adolescent Health module, while showing improvement, had a relatively smaller increase in scores (from 5 [4–8] to 7 [4–10]). This could be attributed to the complexity of the module or potential variability in student engagement during the SDL process. Similar challenges were noted in a study by Murdoch-Eaton and Whittle (2012), which highlighted that students might require additional guidance for more intricate topics in self-directed formats.^[4]

The Universal Immunization Program and the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke recorded the highest post-test scores, underscoring the effectiveness of SDL when supported by comprehensive and well-structured resources, as also noted by Bhattacharya and Singh.^[6]

In addition, a study by Cadorin et al. emphasized the importance of learner readiness and the role of structured frameworks in successful SDL implementation. Their systematic review found that SDL effectiveness significantly depends on learners’ self-efficacy, motivation, and the educational environment’s ability to support independent learning behaviors. This finding aligns with the present study, where modules with more structured and accessible content yielded better learning outcomes.^[10]

The findings reinforce the relevance of SDL in fostering lifelong learning skills, critical thinking, and evidence-based decision-making. However, some challenges must be addressed. For instance, the variability in improvement across modules suggests the need for tailored strategies to optimize SDL for complex topics. Furthermore, active faculty involvement during intersession periods could enhance student engagement, as highlighted in the literature.

Future studies could explore the long-term retention of knowledge and the impact of SDL on practical competencies. Despite the limitation, the study affirms the significant role of SDL in achieving the objectives of CBME, particularly in Community Medicine.

CONCLUSION

The incorporation of the Self-Directed Learning (SDL) module within Community Medicine demonstrated substantial enhancement in students’ understanding of National Health Programs. These results emphasize SDL’s efficacy in strengthening competency-based medical education and demonstrate the critical role such educational approaches play in equipping students for practical public health scenarios. Additional research is suggested to investigate sustained knowledge retention and the practical implementation of acquired concepts in clinical environments.