Introduction
Over the past decade, all educational institutions in India are facing enormous challenges to meet the expectations of the various accreditation bodies apart from the norms of the regulatory guidelines to sustain in the competitive arena and also to prove their quality. Ever since the introduction of the National Education Policy 2020, the institutions are more concerned with the additional requirements over and above the existing challenges and the ways to align with them. This paper intends to lighten that perception, as many of the requirements proposed by the national education policy 2020 are already under practice.
The key points for the national education policy 2020 are to do with excellence, expansion, and equity. National Education Policy has insisted on multidisciplinary under graduation with research, the academic back of credits, academic flexibility, evaluation reforms, beginning of the online and open distance learning, and internationalization of education.1 The online and internationalization of education focuses on increasing access for students. Regarding the faculty, the policy emphasizes more on merit-based faculty recruitment and career promotion.
The policy has described only a few things related to health professions education. The healthcare education would be envisioned for the duration structure and design is a general statement that is proposed. It is up to the program regulatory bodies and the institutions to work on all these areas. For the medical undergraduates, it has been mentioned that the testing of the skills of the graduates should be done in the primary care and secondary care hospitals, which also holds good for the dental candidates. Also, the students of allopathy, are expected to have a basic understanding of AYUSH and vice versa. The possibility of lateral entry for dental students to MBBS is mentioned in the policy. There is going to be a greater emphasis on preventive healthcare and community medicine, which will hold good for public health dentistry as well. Those are the key points about the national education policy that are directly related to Health Professions Education.
The objective of this paper is to provide clarity to the administrators, the faculty, and the academic heads on how to move ahead with the National Education Policy (NEP) in close alignment with the other accreditation guidelines, and also to provide feedback to the regulatory authorities, to consider the issues that are there at present, so that the upcoming new curriculum, would be more comprehensive and abide by the directions of the policy. An important disclaimer: The recommendations here are based on the author’s personal views and earlier work done by the author in the field of health professions and dental education.
The Conglomeration
The conglomeration is drafted in three steps. The first one is how the NEP and UGC are already aligned with each other. The second one is how the NAAC and NIRF guidelines are aligned with each other. And the final one is how the NEP and NAAC guidelines are aligned with each other. This would enable the readers to appreciate that most of these already exist and are being followed in the respective institutions.
Alignment of UGC with NEP
In the year 2021, the UGC sent a notification to all the Vice Chancellors of higher education universities, to start work on the line of implementation of this national education policy. Currently, the UGC has detailed the key areas where the institutions have to start working, to form committees and nominate a person-in-charge for these areas so that in the future, they may have to represent with the reports, timely achievements, that includes the academic bank of credits, the multiple entry-exit options projecting the academic flexibility of the programs given in the university and the apprenticeship or the internship embedded undergraduate programs, online and distance learning, etc. The UGC has also instructed to set up an office of international affairs by the institutions and has also said to concentrate on the alumni connect.
Hence, it is very evident that the UGC had already aligned with the NEP, and they have instructed the higher education universities to go ahead in 2021 itself. They've also mentioned the UGC quality mandate book that has been released, which needs to be followed by all the institutions and the formation of the NEP cell. It's high time, all the universities and higher education institutions, follow the same pattern, and align with this. More than 18 books (Figure 1) have been published in the public domain on the UGC website for use, and all these guideline documents are in alignment with the national education policy. Each of the key areas of reform in NEP has got a respective guideline document in the UGC.2 The guidelines publishing commenced by the UGC from 2019 onwards well ahead of the draft implementation. Following the release of NEP 2020, the frequency of notification and circulars from UGC to educational institutions have raised several folds, which demands a dedicated workforce on the institution side to read all the relevant documents and provide recommendations for proper governance.
Alignment of NIRF and NAAC
The second part is about the NIRF and NAAC. The other accreditation guidelines are not considered in this article as these two are the most bothering ones for all the institutions currently. The NAAC is a broader area that requires elaborate details on multiple parameters3 and NIRF ranking takes up most of the data from the NAAC in a slightly different template4 (Figure 2). The teaching, and learning resources of NIRF mostly to do with the NAAC criteria one and two that includes curricular aspects and teaching, learning, and evaluation. The research and professional practice, are more in alignment with criteria three of NAAC, that is research innovations and extension. The graduation outcomes of NIRF are the same as that of NAAC criteria 2.6, that is on graduate outcomes. The fourth parameter of NIRF namely outreach and inclusivity includes the details from the NAAC criteria parameters 2.1, 2.2, 5.1, and 4.1. The final NIRF parameter, perception is to do with academic peers and the public. This is also part of the feedback system in the NAAC criteria 1.4 because it is not only the feedback from the student on the curriculum but also includes the feedback from peers, and professional employers as well. Hence, the above discussion makes it clear that NIRF is in alignment with NAAC and further discussion on how NAAC and NEP are aligned with each other is sufficient to understand that NIRF is also in alignment with NEP.
Alignment of NAAC and NEP
The third and final part is the discussion on the alignment of NAAC and NEP with each other. The initial comparison refers to the existing guidelines of the NAAC health science manual3 before the NEP introduction chiefly to showcase how many of the points of NEP are already in place (Table 1). Later, the salient points in the revised manual after NEP will also be discussed.
Table 1
Conglomeration of key determinants between NEP and NAAC
The academic flexibility stressed by the NEP is there in the NAAC criteria 1.2 on academic flexibility. The value-added courses and the emphasis on ethics, human constitutional values, and life skills by NEP are part of the curriculum management reflected in NAAC criteria 1.3. The respect for the diversity and local context and curriculum forms part of the NAAC criteria 1.1.1 where it’s questioned whether the curriculum that you have developed and implemented in your university has relevance to this local national and global healthcare needs. Moving on to the multidisciplinary undergraduate education, though it’s not directly referred to as the multidisciplinary undergraduate program, however, the details of interdisciplinary programs and multidisciplinary programs, are reflected in both criteria one, and criteria four of NAAC. In criteria four, the question is framed to know whether the infrastructure resources are shared for multidisciplinary programs.
The undergraduate research, the undergraduate community-based projects, and then the internship with the local industry and communities, as well as a research internship are there in criteria three of NAAC, where the research is the main focus. In NAAC criteria 1.3.4, the industry internship, as well as, the details of the students who have attended field visits, and community research projects are reflected. NEP also emphasizes the student activity clubs to be very active in the universities which is already a part of the NAAC criteria 3.6.1. Regarding the student support system and counseling team, again, the majority of it is covered in criteria 5.1, which is to do with student support. The institutional developmental plan is going to determine the future of all the universities as per NEP. This is also partly reflected in criteria six, governance, where 6.1 and 6.2 have the details of the strategic perspective plan. The details are not restricted only to the plan, but also to how it arrived and the steps in deployment as well. The infrastructure for the digital classrooms is already deliberated in criteria four, which includes details about the ICT-enabled classrooms and teacher’s student ratio in criteria 2.2.2. NEP has mentioned that the ratio should be 1:10 or 1:20, depending on the program. More guidance is provided by the NEP in this aspect along with the merit-based recruitments and systematic performance appraisal of the faculty that is already reflected in NAAC criteria 6.3.5, the governance criteria on the performance appraisal system for both the teaching and the non-teaching faculty of the university.
The international research collaboration and student exchange, insisted by NEP facilitating the internationalization of education, is already part of NAAC criteria 3.7, about the collaboration. It's not the MoU and collaboration that the institute has, but the activities that are being undertaken such as the student exchange and faculty exchange. Gender balance in admissions is already part of criteria 2.1 which focuses on student enrollment and profile. In addition to that, the diversity of the student admission, inclusive admission process, and curriculum are part of NAAC criteria 2.1.1, equity and inclusiveness, and also it is reflected in criteria seven where the initiatives of the institution in providing an inclusive environment have been asked. The outreach on higher education opportunities and scholarships is nothing but the career guidance counseling program offered and how well the students are exposed to the opportunities is already placed in the 5.1 student support of NAAC.
The NEP emphasizes a lot about vocational courses to increase the employability potential of the candidates, irrespective of whatever continuum of education they are in. This point is already been reflected partly in the NAAC criteria 1.1.3, where the details about the courses that focus on competency, employability, and entrepreneurship are enquired, along with 5.1 students support system, on how the institution is, supporting the students in all these areas. The disabled-friendly infrastructure again has already got a place in the NAAC criteria seven, whether the institution is having a disabled-friendly barrier-free environment.
Regarding the development of bridge courses for students from disadvantaged educational backgrounds, the student's support criteria of 5.1 talks about these bridge courses, but it is not too specific about the disadvantaged education background. NEP has insisted on developing the technology tools for better participation and outcomes, and they have also proposed that the formation of a national-level common technology platform would enable everyone to provide technology tools. The goal number 4 on quality education of the Sustainable Development Goals by UN also emphasize on the inclusive and equitable quality education to promote lifelong learning, which needs technology enhanced education.5 This also has been already reflected in the NAAC criteria 2.3.3, about the ICT-enabled tools for teaching, the number of teachers trained, and tools developed. Counseling and mentoring program for the students are insisted on repeatedly in NEP. The 2.3.4 mentor-mentee system, and 5.1 student support of NAAC metrics, cover these.
According to the revised health science manual, which was released after the implementation of the National Education Policy,6 the self-study report that the institution has to submit to NAAC for the accreditation cycle, has got a new parameter under the profile of the health sciences university. The institution or the university is expected to submit the institutional preparedness for NEP. The constitution of the NEP cell and the steps that have been taken for aligning with the NEP will come into place. There are six sub-headings under which the description should be done in a maximum of 500 words.
This description in the future would be followed with multiple Tabular columns of data, that are expected as evidence of these. The six main areas of focus include multidisciplinary and interdisciplinary options, the academic bank of credits, efforts for skill development and integration of Indian knowledge systems, steps taken to include multilingual courses in higher education, the focus on outcome-based education, and also on distance education and online education. For the earlier manual of the NAAC, the best practices and institutional distinctiveness were covered as part of criteria seven, but in the revised manual, they have asked for good practices for all these six parameters of NEP implementation. Hence, all these points, clearly explain that the NAAC accreditation process is already compliant with the NEP, and we have only a few more additions that are included recently.
The Way Ahead
Having known that all the accreditation agencies and national education policy are almost aligned with each other in their requirements, and we have only the healthcare professional councils standing on the other side, it becomes a very difficult part for the university to run through the governance. The majority of the universities offer both regulatory and non-regulatory programs. Greater variation in the administration of the academic program affects the overall university policies and guidelines. Hence all the regulatory bodies need to take steps to be in alignment with the accreditation bodies and the National Education Policy so that governance becomes easier for the university and also benefits the student community. The health professions education cannot stand in silos not implementing the policy, at the least if not all, most of it can be accommodated to an extent.
As per NEP, the planning should be explicit in the Institutional Developmental Plan, which is the responsibility of the board of management and the university will be assessed based on that. The board of management in consultation with the NEP cell has to suggest a way to move ahead to the university administrative heads, which would then be implemented by the heads and the faculty at the next levels. The way ahead should start with a focus on Curricular revision, Training of Trainers, and governance. As far as the curricular revision, it’s not about the inclusion of updates but more important the exclusion of outdated areas. Enough curricular time must first be achieved by deleting the outdated and repetitive areas of the curriculum. The problem is that the physicians of tomorrow are taught by teachers of today using the curriculum of yesterday,7 when there is a curricular revision process, by the time it comes for implementation, those revisions get outdated because the knowledge doubling rate has become less than 73 days,8 as far as the health professions education is concerned right now. That’s the result of the rapid growth of scientific knowledge and technological knowledge, a part of the industrial revolution 4.0 & 5.0 and the education revolution 4.0 & 5.0.
The curricular revision needs to be in alignment with the NEP and also the educational revolution. It’s not sufficient to follow only the competency-based curriculum, we also need to shift to a Choice Based Credit System (CBCS).9 The multidisciplinary under graduation which is the strong proposal of NEP can see the light of day only by adopting CBCS. Additional training extending to research, entrepreneurship, palliative care, emergency medicine, Basic and Advanced Life Support, geriatrics, and special care, will enable the students to be part of interprofessional team members, other Value-Added Programs, and the possibility to continue their passion in non-scholastic abilities would be facilitated through electives that make the curriculum entirely student-centered.10, 11 The evaluation system would see a major change in the form of a continuous assessment process with more weightage to internal assessment and the results in grades and grade point average.1 This makes the system more transparent and makes the midcourse interinstitutional transferability feasible. In this way, the Academic Bank of Credits would become part of Health Professions Education too which has got several advantages. There should be an intensive training trainers’ program for all the teachers involved in academics in all the institutions to implement these changes.
The universities/ institutes need to finalize whether they want to become a research-intensive university or teaching university, or an autonomous degree-granting college, like short-term midterm and long-term plans in the continuum, which could be changed over some time. The vision statement should focus on bringing about these changes by 2035. A significant factor to be considered while planning and implementing the vision is that all the universities/institutes need to expand to align with these changes. Empowering the same faculty doing multiple roles as a researcher, a clinician, and an academician is one way. The other way is recruiting more qualified people appointed with specific job responsibilities to increase productivity. Long-term sustainable goals to be set for achieving maximum quantitative and qualitative outputs demands expansion in all four zones viz., Man (workforce), Money (expense on all resources), Minutes (adequate time), and Materials (infrastructure and all other resources). If in case a university proposes to become a research-intensive university, it will be reflected in the institutional developmental plan that includes details on faculty recruitment for the research area. Just like outcome-based education, outcome-based employee recruitment with a proper job description is the need of the hour.
The success of the governance relies heavily on the functional performance appraisal system. The performance appraisal cannot have a standard format for all, for the simple reason that a person involved in the administration would not have adequate time for doing research publications or clinical work and vice versa. Good governance should have a flexible performance appraisal with differing weightage to match the job needs. This essentially starts with a proper job description for each faculty. The final assessment should match the prescribed job description. One who spends maximum time in teaching should be assessed for innovative teaching methods, educational resources created and the support rendered for the student's academic performance. For a person who is predominantly a clinician, the assessment should focus on the number of clinical beneficiaries, novel techniques used in patient care, and case reports. An administrator needs to be assessed for the development and implementation of policies, leadership and team management, and the growth of the sector under their administration. A person with predominant work in the research domain needs to be assessed with research projects, grants, intellectual property rights, and publications. A transparent, fair, and promising performance appraisal that is devoid of any sort of disparity, enhances the work culture of the faculty and maintains a holding working environment. This also enhances faculty retention and career progression. The current performance appraisal prevailing in India comprises more sticks than carrots. Practically, it's neither the carrots nor the sticks but more to do with a non-toxic, conducive working environment. Faculty should have adequate protected time to perform the expected work.
Summary on the Strength and the Scope
The strength is most of our institutions and universities have a strong teaching-learning system. There are adequate potential leaders, qualified faculty, supportive students, and the best-of-the-class infrastructure. Innovative programs, intellectual property rights, certificate courses, fellowship courses, and continuing education programs are already existing. Technology-enhanced learning opportunities have seen a breakthrough due to the pandemic and almost all institutes and universities are well-equipped for the new generation's learning process. Hence it is not very difficult for us to design or adapt to something new in the teaching process.
The existing university-level elective programs could be opened up for both internal and external candidates. This will be beneficial to both institutions so that the candidate will have a student exchange program at the same time. It will also give them external credits to be included in the transcripts. And if the institution or university is part of a trust, which has other schools and colleges, then there is a possibility of teaming up with all these institutions together to make it a strong multidisciplinary educational organization. Existing international collaborations and memorandum of understanding can be strengthened with an increase in the number of collaborative activities. Internationalization of institutions and more avenues for prospective growth is on the way through National Education Policy. Indian graduates moving abroad for higher education or job always faced the question of their degree recognition in the host institute. Globalization of education and standardization of the curriculum with transferrable credits would solve those issues. “Who dares to teach must never cease to learn” – John C. Dana. Being proactive and positive leads to a more promising future.