European Journal of Cardiovascular Medicine

The introduction of the AETCOM (Attitude, Ethics, and Communication) module by the MCI/NMC marks a significant paradigm shift in Indian medical education, emphasizing non-technical competencies. These skills are critical for fostering holistic patient care and enhancing doctor-patient relationships. The AETCOM module encourages medical students to internalize values such as empathy, ethical practice, and effective communication—qualities essential for becoming compassionate and competent physicians.

AIM AND OBJECTIVES

Aim: To explore the perceptions of medical educators regarding the teaching of the AETCOM module to undergraduate MBBS students in a tertiary care hospital in Tribal area. Objectives: 1. To understand faculty perceptions of the AETCOM module’s relevance and importance in undergraduate medical education. 2. To identify barriers and facilitators in the effective teaching and integration of AETCOM. 3. To provide recommendations for improving AETCOM implementation in resource-limited settings.

Study Design: This study employed a qualitative research design to explore the perceptions and experiences of medical educators teaching the AETCOM module. A qualitative approach was chosen to provide an in-depth understanding of complex, context-dependent issues. Study Setting: The study was conducted at a tertiary care teaching hospital located in Tribal area of Dahod, Gujarat, India,which caters to a diverse patient population and serves as a key medical education institution in the region. The hospital’s resource-constrained setting provided a unique perspective on the challenges and opportunities of implementing AETCOM. Sample Size A purposive sampling technique was employed to select faculty members who have been actively involved in teaching including AETCOM module. Inclusion criteria included:  Faculty members from various departments with active involvement in undergraduate• medical education including the teaching of AETCOM module Willingness to participate in an in-depth interview.• Exclusion criteria were:  unwilling to participate in the study and provide informed consent.• The final sample comprised 15 faculty members, ensuring a diverse representation across departments and years of teaching experience representing pre-clinical, para-clinical, and clinical disciplines. Efforts were made to include both senior faculty members and junior educators to capture a wide range of perspectives. Data were collected through semi-structured in-depth interviews, a method well-suited for exploring participants' perceptions and experiences. The data were analyzed using both thematic and content analyses to provide a comprehensive understanding of the faculty members' perceptions.ThematicanalysisContentanalysisusingNVivosoftware.Statisticalanalysis: Quantitative & Qualitative analysis was done using Microsoft Excel and, N Vivo software and calculation of mean, standard deviation, Z test, ANOVA test and percentage. Normally distributed data of post-test was subjected to ANOVA test to determine the significance. Study Limitations: The study was conducted at a single institution, which may limit generalizability. Future• research could include multi-institutional studies for broader applicability.  As a qualitative study, the findings are context-specific and may not capture all potential• perspectives.

Statistical Overview: summarizes the frequency distribution of the identified themes, and Figure 1illustrates this data through a bar chart. Additionally, Figure 2 provides a percentage breakdown of these themes.

Results of Thematic analysis:

The thematic analysis of the 15 interview transcripts revealed three primary themes: Perceived Benefits, Challenges in Implementation, and Recommendations for Improvement. 1. Perceived Benefits o AETCOM fosters empathy and professionalism in medical students. o 35% of participants highlighted its role in shaping ethical and interpersonal skills. o Interactive and clinical-based teaching methods were preferred. 2. Challenges in Implementation o Curriculum overload: 45% of respondents cited time constraints as a barrier. o Lack of faculty training: Many teachers lacked pedagogical expertise for AETCOM delivery. o Cultural resistance: Some faculty viewed AETCOM as a "foreign concept" requiring adaptation to Indian values. 3. Recommendations for Improvement o Clinical Integration: 20% suggested embedding AETCOM within practical, ward based learning. o Faculty Development: Emphasis on training programs to enhance teaching effectiveness. o Resource Optimization: Integration into existing courses to minimize additional burdens.

Results of Content Analysis:

The content analysis categorized responses into four main areas: Positive Perceptions, Negative Perceptions, Implementation Challenges, and Suggestions for Improvement. 1. Positive Perceptions (45 mentions, 23.7%) o AETCOM enhances professional development, patient care, and life skills. 38 o Teaching effectiveness and student growth were frequently noted. 2. Negative Perceptions (58 mentions, 30.5%) o Resource constraints (15 mentions) and time limitations (14 mentions) were major barriers. o Cultural misalignment and student resistance also posed significant challenges. 3. Implementation Challenges (52 mentions, 27.4%) o Infrastructure needs, faculty training gaps, and assessment difficulties were frequently discussed. o Regional barriers such as language

The present study explored the perception of medical teachers regarding the teaching of the AETCOM (Attitude, Ethics, and Communication) module to MBBS students in a tertiary care hospital in Tribal area.The findings provide valuable insights into the challenges and opportunities associated with the implementation of this module within the competency-based medical education (CBME) curriculum. A key finding of the study was that while the majority of medical teachers recognized the importance of AETCOM in shaping future doctors with strong ethical and communication skills, many faced difficulties in its practical implementation. These challenges included a lack of formal training in medical ethics and communication skills, limited time allocation for AETCOM sessions within the packed MBBS curriculum, and insufficient institutional support. Similar concerns have been highlighted in studies conducted in other regions of India, emphasizing the need for faculty development programs to enhance teaching effectiveness in these domains. Furthermore, the study revealed that teachers with prior exposure to ethics training or soft skills development were more confident in delivering AETCOM content, whereas those with minimal exposure expressed apprehensions about their ability to teach these concepts effectively. This finding aligns with existing literature, which suggests that structured training and continuous professional development can significantly improve faculty competence in teaching ethics and communication skills. Another important aspect identified was the varied perception of assessment methods for AETCOM competencies. Some faculty members preferred formative assessments, such as reflective writing and case-based discussions, while others felt that traditional summative assessments were insufficient in capturing students' attitudinal and ethical growth. This discrepancy suggests a need for well-defined, objective, and competency-based assessment strategies to measure students' progress in AETCOM effectively. These two analyses can be compared as follows:

 This study analyzing medical teachers' perceptions of Attitude, Ethics, and Communication (AETCOM) implementation revealed significant challenges despite acknowledging its importance. Faculty training programs and institutional support are essential for effective execution. Traditional assessments are inadequate for evaluating AETCOM competencies, and standardized teaching materials are lacking. Recommendations include integrating AETCOM into clinical teaching, using simulated patient interactions, and adopting competency-based evaluation criteria. Role-playing, small-group discussions, and experiential learning are effective teaching strategies. Institutions should prioritize faculty development, revise the curriculum to integrate AETCOM, and improve assessment strategies. Innovative teaching methodologies and enhanced student engagement are also crucial. Addressing existing gaps will ensure medical students develop necessary ethical and communication competencies for high-quality patient care. Strengthening these aspects will produce more empathetic, ethical, and competent medical professionals.

IMPLICATIONS

To implement Attitude, Ethics, and Communication (AETCOM) in medical education, several strategies are recommended:- Implementing AETCOM in medical education requires strategies like curriculum integration, faculty development, cultural adaptation, resource management, and institutional support, leveraging technology and innovative teaching methods.

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