Process assessment of the attitude, ethics, and communication (AETCOM) sessions: student engagement and satisfaction among medical students in central India

BACKGROUND: The Attitude, Ethics, and Communication (AETCOM) module-integral to India's competency-based medical curriculum-has been designed to foster professionalism, empathy, and ethical decision-making among students graduating from medical colleges in India. However, the process of delivering AETCOM sessions remains insufficiently assessed. Focusing on Phase-III, Part-II MBBS students at R.D. Gardi Medical College, Ujjain, the present study examines how process assessment, based on student feedback and structured observer-based assessment, can provide insights into AETCOM session delivery and student engagement. METHODS: This observational study was conducted on 126 Phase-III, Part-II MBBS students (Batch 2021) over 3.5 months. Four AETCOM competencies-patient autonomy, medical error disclosure, confidentiality, and fiduciary duty-were taught in small groups by using interactive methods, such as role-play and discussions. Data were collected using the modified System for Evaluation of Teaching Qualities (SETQ) survey and an observer-based engagement checklist. The SETQ score ranges from 19 to 95. The actual scores were converted to percentages. Statistical analysis included Cronbach's alpha for reliability, one-way analysis of variance (ANOVA) for session comparison, and Pearson's correlation to link the learning environment with student engagement. RESULTS: The participants' attendance rate ranged from 92.0% to 99.2%. The modified SETQ demonstrated excellent internal consistency (α = 0.92). Satisfaction scores across the four sessions ranged between 87.97% and 89.86%, categorized as "very good." A one-way ANOVA revealed significant differences between sessions (p = 0.038), with the confidentiality module rated significantly higher than the patient autonomy module. Engagement metrics showed high levels of eye contact (91%-96%) and on-task behavior (84%-94.4%). Pearson correlation showed a strong positive relationship between the facilitator's professional attitude and student engagement (r = 0.70, p < 0.01). Note-taking was notably lower (30%-54%), which may reflect greater emphasis on active participation than traditional note-taking. CONCLUSION: Process assessment using validated tools like the SETQ provides useful insights into AETCOM session delivery. The findings suggest that interactive methods and positive facilitator-student rapport are associated with higher student engagement. These observations suggest that AETCOM sessions may support student engagement and reflective discussion in ethics-related learning.