Assessment of Performance in Cognitive vs Affective Domain among First Year MBBS Students: A Cross-sectional Study

Introduction: National Medical Commission (NMC) has revised MBBS curriculum and incorporated Competency Based Medical Curriculum (CBME) which describes various competencies. Most of the competencies are based on cognitive, psychomotor and affective domain, which an Indian medical graduate should attain. Both cognitive and psychomotor domains were taught as a part of curriculum however, students learned affective domain as a hidden curriculum only. Now CBME has incorporated affective domain as a part of MBBS curriculum in the form of Attitudes Ethics and Communication (AETCOM) module, teaching and evaluating the affective domain demands attention. Aim: To evaluate the performance of first year MBBS students in cognitive domain vs affective domain from their routine curriculum. Materials and Methods: This cross-sectional study was conducted in SRM Medical college Hospital and research center from September 2019 to October 2019 among 149 1st year MBBS students. Three students were absent on day of assessment. Hence, 146 students were assessed in both domains. The performance of both domains (cognitive and affective) were assessed in the form of Objective Structured Practical Examination (OSPE). Chi-square was used to compare the qualitative data and Unpaired t-test was used to compare the means. Results: The mean age of the students was 18.66±0.64 years. About 76 (52.1%) were male and 70 (47.9%) were female students. Out of total, 22 (15.1%) of students had scored less than minimum mark for pass in cognitive and 8 (5.5%) of students had scored less than minimum mark for pass in AETCOM. Only 2 (1.3%) of students had scored less than minimum mark for pass in both OSPE examinations. In addition, 49 (33.5%) students had scored more than average marks in cognitive and 94 (64.4%) students had scored more than average in AETCOM and 34 (22.8%) of students had scored more than average in both domains. The difference in the mean score was found to be statistically significant (p-value<0.0001). Conclusion: This study concludes that the learners performed better in affective domain, when compared to cognitive domain.