International Medical Education

The competency-based medical education (CBME) curriculum was introduced recently for undergraduate courses in medical institutions in India. The program needs a paradigm shift in the teaching and assessment methods. Therefore, challenges at the individual as well as organizational level are expected in the initial years of implementation. We used a mixed-method approach through focus group discussions (FGD) and an online survey to assess the perception and attitude of MBBS phase 1 and 2 teachers towards CBME. Themes were generated from FGD, and quantitative data were collected using a structured questionnaire through an online survey. Nearly 80% of the participating faculty perceived that the CBME curriculum was better than traditional teaching methods. Major challenges were either related to a deficiency of curriculum-optimized learning material (85%), material infrastructure (38%), and manpower (46%), or increased documentation (74%), and time constraints (52%). The faculty felt attitudinal change (63%), better acquaintance with the professional environment (60%), improved participation (58%), and the performance of students (38%) were major commendations of CBME. The CBME curriculum is a welcome change in Indian medical teaching institutes, and faculty intend to improve it through feedback mechanisms. The perceived complexities need to be addressed at different levels through collaborative approaches.

The integration of artificial intelligence (AI), particularly large language models (LLMs), into education, marks a profound shift in how knowledge is accessed, processed, and applied. These tools offer clear advantages—including improved efficiency, immediate support, and high productivity—but it may simultaneously weaken foundational skills. This Perspective examines the dual impact of AI on education, arguing that over-reliance on AI may displace essential cognitive processes that reinforce professional competence. Emerging evidence points to troubling associations between frequent AI use and diminished critical reasoning. We propose a model of critical alliance, in which AI augments but does not replace core intellectual processes. Unlike existing AI competency or digital literacy, this model centers on preserving human cognitive agency, judgment, reflection, and intellectual ownership, as primary educational outcomes. This framework not only emphasizes cognitive independence, but also equitable access, ethical vigilance, and faculty development as cornerstones of AI literacy. Addressing these questions is essential to safeguard both intellectual growth and educational equity in an AI-augmented era. Unlike existing digital literacy or AI competency frameworks, the critical alliance explicitly centers on preserving human cognitive agency and intellectual ownership as educational priorities, particularly in environments increasingly shaped by high-performing generative systems.

Simulation-based learning experiences (SBLE) are widely used in health professions education to enhance clinical skills, confidence, and decision-making in a safe environment. In Doctor of Physical Therapy (DPT) programs, peer simulation offers a cost-effective alternative to high-fidelity simulation and standardized patients, though its effectiveness across different instructional formats remains underexplored. This study examined the differences in student confidence in outpatient physical therapy between cohorts of students from three educational delivery methods, which included face-to-face (F2F), virtual instruction (VI), and F2F combined with integrated clinical experiences (F2F + ICE), prior to their first clinical experience. Using a three-group comparative design, 107 students across three academic years (2019, 2020, and 2022) completed pre- and post-course surveys assessing confidence in four domains and interest in outpatient care. A two-way ANCOVA, controlling baseline interest, revealed significant differences in confidence across all cohorts between pre- and post-course assessment time periods (p < 0.001), with no significant differences between cohorts under the various delivery formats at post-course assessment. While the F2F + ICE group demonstrated higher baseline confidence, this difference was not found post-course. Findings suggest that peer simulation effectively improves perceived confidence in outpatient physical therapy regardless of delivery mode. These results support the integration of SBLE in DPT curricula to prepare students for clinical practice and highlight the need for further research across multiple programs.