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Alt L, Walter R, Harris M, Hari R. Optimal timing of faculty teaching when combined with near-peer teaching: A mixed methods analysis. MEDICAL TEACHER 2024:1-8. [PMID: 38301624 DOI: 10.1080/0142159x.2024.2308788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 01/18/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Near-peer teaching is increasingly used in medical education, supporting or replacing faculty teaching. It has positive aspects for learners and tutors, some of which are explained by higher social and cognitive congruence between learners and near-peer tutors (NPTs). This study investigates the optimal combination of faculty tutors (FTs) and NPTs in an abdominal ultrasound course. METHODS Sixty-four third-year medical students underwent a basic ultrasound course, with 75% of lessons taught by NPTs and 25% by FTs. Each of four groups had a different faculty teaching timing. A mixed methods approach used a survey and semi-structured interviews at the course end to elicit learners' preferences, and end-of-course examination scores to look for differences in outcomes. RESULTS Most learners preferred having faculty teaching in the second half of the course, saying it would be overwhelming to start with FTs. Learners preferred between a quarter and a third of the teaching to be from FTs, with NPTs rated better at teaching basics, and FTs contributing unique, helpful clinical knowledge. There was no significant between-group difference in examination scores. CONCLUSIONS Medical students preferred most of their teaching to be from NPTs, with some faculty input in the second half of the course.
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Affiliation(s)
- Leander Alt
- Dean's Office, Medical Faculty, University of Bern, Bern, Switzerland
| | - Robin Walter
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Michael Harris
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- College of Medicine & Health, University of Exeter Medical School, Exeter, UK
| | - Roman Hari
- Dean's Office, Medical Faculty, University of Bern, Bern, Switzerland
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
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Liu L, Chen B, Nyhof-Young J. Primary Care Perspectives on Education Scholarship: A Qualitative Synthesis. Fam Med 2024; 56:84-93. [PMID: 38055856 DOI: 10.22454/fammed.2023.477983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
BACKGROUND AND OBJECTIVES A significant portion of medical education takes place in primary care settings with family medicine clinician teachers that have variable backgrounds in teaching. Ernest Boyer's concept of education scholarship calls on faculty to systematically study and innovate their teaching practices. This meta-ethnographic review synthesizes the literature on primary care clinician teachers' perspectives and experiences of integrating education scholarship in practice. METHODS We conducted an electronic database search in PubMed/Medline, Scopus, ERIC, and Web of Science for primary research articles published between January 2000 and August 2021. In the included articles, researchers studied primary care physicians' and/or residents' perspectives of clinical teaching and reported qualitative results (eg, interviews, focus groups). Of the 1,454 articles found in the search, we included 33 in the final synthesis. We used line-by-line descriptive coding of the qualitative data to develop analytical themes. RESULTS Four main themes emerged from our synthesis: (1) perceptions of clinical teaching (lack of confidence, presumed teaching competency, lack of formal recognition); (2) clinical teaching strategies (learner-centered teaching, ad hoc teaching, role modeling, mentorship); (3) benefits of clinical teaching (shared learning experience, networking, personal interest, career satisfaction); and (4) challenges of clinical teaching (inadequate time, compensation, conflicting responsibilities). CONCLUSIONS Clinician teachers identified several common factors regarding their scholarly roles but had difficulty describing them in relation to education scholarship. Institutional support, resources, and awareness are needed to assist family medicine clinician teachers to further implement Boyer's concept of education scholarship in practice-specifically, to study, evaluate, and innovate current clinical teaching strategies.
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Affiliation(s)
- Laura Liu
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Betty Chen
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Women's College Hospital, Toronto, ON, Canada
| | - Joyce Nyhof-Young
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Women's College Hospital, Toronto, ON, Canada
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Chen KL, Yuan SE, Asfaw EK, Sim MS, Ntim GMJ, Ma MW, Pessegueiro AM. Near-Peer Supervision in Primary Care: Bringing Teaching Teams From the Wards to the Clinic. J Grad Med Educ 2023; 15:481-487. [PMID: 37637346 PMCID: PMC10449350 DOI: 10.4300/jgme-d-22-00830.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/14/2023] [Accepted: 05/30/2023] [Indexed: 08/29/2023] Open
Abstract
Background Teaching near-peers yields numerous benefits to residents. Opportunities for near-peer teaching are typically restricted to hospital settings. Little is known about the educational potential of outpatient near-peer teaching. Objective To describe Primary Care Teaching (PC Teach), a novel outpatient near-peer teaching experience for residents in a large, urban, internal medicine residency program; characterize its feasibility and acceptability; and evaluate changes in residents' self-reported confidence in outpatient teaching and attitudes toward teaching and primary care/outpatient medicine. Methods In 2020-2021, following a didactic workshop, 43 postgraduate year 3 (PGY-3) residents at continuity clinics assigned to PC Teach completed a series of half-day sessions acting as preceptor to interns under attending supervision. Worksheets facilitated post-session feedback for residents and interns. Eighteen PGY-3s at nonparticipating clinics, who also completed the workshop, served as controls. We assessed process measures for feasibility and acceptability and analyzed resident attitudes using pre-post surveys. Results Participating residents completed 2 to 8 sessions each. Post-intervention scores for confidence in outpatient teaching and attitudes toward teaching were greater, relative to pre-intervention group means, for intervention residents (median pre-post changes +0.60 [IQR 0.26, 1.26] and +0.46 [-0.04, 0.46], respectively) vs controls (-0.15 [-0.48, 0.85] and -0.36 [-0.86, 0.39]; between-group differences +0.75 [P=.03] and +0.82 [P=.02]). Changes in attitudes toward primary care/outpatient medicine did not differ significantly between intervention and control groups (+0.43 [-0.07, 0.68] and 0.04 [-0.58, 0.42]; between-group difference +0.39 [P=.12]). In multivariable analyses, odds of gains in confidence in outpatient teaching remained significantly larger for intervention residents vs controls. Conclusions Implementing PC Teach with existing resources was feasible and acceptable, with program flexibility highlighted as a strength. Resident participation was associated with greater confidence in outpatient teaching.
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Affiliation(s)
- Katherine L. Chen
- Katherine L. Chen, MD, PhD, is Clinical Instructor and Postdoctoral Fellow, Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine, University of California, Los Angeles (UCLA)
| | - Stanley E. Yuan
- Stanley E. Yuan, MD, is a Hospitalist, Division of General Internal Medicine, Cedars Sinai Medical Center
| | - Elizabeth K. Asfaw
- Elizabeth K. Asfaw, MD, is Clinical Instructor, Department of Medicine, David Geffen School of Medicine, UCLA
| | - Myung Shin Sim
- Myung Shin Sim, DrPH, MS, is Associate Professor, Department of Medicine, David Geffen School of Medicine, UCLA
| | - Gifty-Maria J. Ntim
- Gifty-Maria J. Ntim, MD, MPH, is Assistant Clinical Professor, Department of Medicine, David Geffen School of Medicine, UCLA
| | - Mina W. Ma
- Mina W. Ma, MD, is Clinical Professor, Department of Medicine, David Geffen School of Medicine, UCLA; and
| | - Antonio M. Pessegueiro
- Antonio M. Pessegueiro, MD, is Associate Clinical Professor, Department of Medicine, David Geffen School of Medicine, UCLA
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Rong K, Lee G, Herbst MK. Effectiveness of Near-Peer Versus Faculty Point-of-Care Ultrasound Instruction to Third-Year Medical Students. POCUS JOURNAL 2022; 7:239-244. [PMID: 36896384 PMCID: PMC9983727 DOI: 10.24908/pocus.v7i2.15746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Incorporation of point-of-care ultrasound (POCUS) in undergraduate medical education (UME) is expanding; however, its effective implementation is impeded by a lack of trained faculty. Recruitment of near-peer (NP) instructors is a potential solution, but there are concerns surrounding NP teaching effectiveness compared to faculty instruction. While some institutions have assessed supplemental NP instruction, or NP-taught sessions with strict faculty supervision, few if any have compared effectiveness of NP POCUS instruction alone to faculty instruction through a multi-dimensional assessment. The aim of this study was to compare the effectiveness of near-peer (NP) instruction to faculty instruction at an undergraduate medical education clinical POCUS session for third-year medical students. Methods: This was a randomized controlled trial where third-year medical students were assigned to one of two groups for a 90-minute POCUS session: NP instruction or faculty instruction. A pre- and post-session multiple-choice test and a post-session objective structured clinical examination (OSCE) were administered to assess conceptual and hands-on clinical POCUS knowledge gained. Students' perceptions of the instructors and session were evaluated using a Likert scale. Results: Seventy-three students (66% of the class) participated; 36 taught by faculty and 37 by NP instructors. Both groups showed a significant score increase from pre-test to post-test (p =0.002); however, there was no significant difference between groups in post-test (p=0.27) nor OSCE scores (p=0.20). Student perceptions of instructor competency were not statistically significant. Conclusions: NP instructors were as effective at teaching clinical POCUS to third-year medical students as faculty instructors at our institution.
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Affiliation(s)
- Katie Rong
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center Boston, MA United States
| | - Grace Lee
- University of Connecticut School of Medicine Farmington, CT United States
| | - Meghan Kelly Herbst
- Department of Emergency Medicine, University of Connecticut School of Medicine Farmington, CT United States
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Langer AL, Block BL, Schwartzstein RM, Richards JB. Building upon the foundational science curriculum with physiology-based grand rounds: a multi-institutional program evaluation. MEDICAL EDUCATION ONLINE 2021; 26:1937908. [PMID: 34114945 PMCID: PMC8204959 DOI: 10.1080/10872981.2021.1937908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/20/2021] [Accepted: 05/30/2021] [Indexed: 06/12/2023]
Abstract
Introduction: Vertically integrating physiology into patient care has the potential to improve clinical reasoning. Clinical Physiology Grand Rounds (CPGR) is a case-based teaching method that brings together students from all years of medical school to focus on linking clinical presentations to core basic science concepts including anatomy, physiology, and pathophysiology. In this study, we describe the implementation of CPGR at two different institutions in the United States and assess student-reported outcomes.Methods: We survey students who participated in CPGR at Columbia University College of Physicians & Surgeons (P&S) and Medical University of South Carolina (MUSC). Subjects were queried across three domains: the benefits of attending, the impact of concept maps, and the impact of the mixed-learner environment.Results: Despite differences in session leadership and the underlying medical school curricula, conference attendees reported similar benefits at the two schools included in this study. Students overwhelmingly (92.9%) reported that remembering clinical presentations was easier when they understood the underlying physiology. They also reported gaining a true understanding of concepts that were previously memorized (87.5%). Both clinical (92.5%) and preclinical students (93.1%) valued the mixed-learner environment as a component of the conference.Discussion: By assuring a mixed-learner environment with near-peer interactions, using concept maps as a teaching tool, and rigorously linking clinical presentation and management to physiological concepts, we found that the key benefits of CPGR were replicable across different institutions, despite several local differences in how CPGR was implemented, led, and conducted.
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Affiliation(s)
- Arielle L. Langer
- Division of Hematology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Brian L. Block
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Richard M. Schwartzstein
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jeremy B. Richards
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Weidenbusch M, Lenzer B, Sailer M, Strobel C, Kunisch R, Kiesewetter J, Fischer MR, Zottmann JM. Can clinical case discussions foster clinical reasoning skills in undergraduate medical education? A randomised controlled trial. BMJ Open 2019; 9:e025973. [PMID: 31494596 PMCID: PMC6731854 DOI: 10.1136/bmjopen-2018-025973] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Fostering clinical reasoning is a mainstay of medical education. Based on the clinicopathological conferences, we propose a case-based peer teaching approach called clinical case discussions (CCDs) to promote the respective skills in medical students. This study compares the effectiveness of different CCD formats with varying degrees of social interaction in fostering clinical reasoning. DESIGN, SETTING, PARTICIPANTS A single-centre randomised controlled trial with a parallel design was conducted at a German university. Study participants (N=106) were stratified and tested regarding their clinical reasoning skills right after CCD participation and 2 weeks later. INTERVENTION Participants worked within a live discussion group (Live-CCD), a group watching recordings of the live discussions (Video-CCD) or a group working with printed cases (Paper-Cases). The presentation of case information followed an admission-discussion-summary sequence. PRIMARY AND SECONDARY OUTCOME MEASURES Clinical reasoning skills were measured with a knowledge application test addressing the students' conceptual, strategic and conditional knowledge. Additionally, subjective learning outcomes were assessed. RESULTS With respect to learning outcomes, the Live-CCD group displayed the best results, followed by Video-CCD and Paper-Cases, F(2,87)=27.07, p<0.001, partial η2=0.384. No difference was found between Live-CCD and Video-CCD groups in the delayed post-test; however, both outperformed the Paper-Cases group, F(2,87)=30.91, p<0.001, partial η2=0.415. Regarding subjective learning outcomes, the Live-CCD received significantly better ratings than the other formats, F(2,85)=13.16, p<0.001, partial η2=0.236. CONCLUSIONS This study demonstrates that the CCD approach is an effective and sustainable clinical reasoning teaching resource for medical students. Subjective learning outcomes underline the importance of learner (inter)activity in the acquisition of clinical reasoning skills in the context of case-based learning. Higher efficacy of more interactive formats can be attributed to positive effects of collaborative learning. Future research should investigate how the Live-CCD format can further be improved and how video-based CCDs can be enhanced through instructional support.
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Affiliation(s)
- Marc Weidenbusch
- Institute for Medical Education, University Hospital of LMU Munich, Munich, Germany
- Department of Internal Medicine IV, University Hospital of LMU Munich, Munich, Germany
| | - Benedikt Lenzer
- Institute for Medical Education, University Hospital of LMU Munich, Munich, Germany
| | | | - Christian Strobel
- Institute for Medical Education, University Hospital of LMU Munich, Munich, Germany
| | - Raphael Kunisch
- Department of Internal Medicine IV, University Hospital of LMU Munich, Munich, Germany
| | - Jan Kiesewetter
- Institute for Medical Education, University Hospital of LMU Munich, Munich, Germany
| | - Martin R Fischer
- Institute for Medical Education, University Hospital of LMU Munich, Munich, Germany
| | - Jan M Zottmann
- Institute for Medical Education, University Hospital of LMU Munich, Munich, Germany
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Dick ML, Henderson M, Wei Y, King D, Anderson K, Thistlethwaite J. A systematic review of the approaches to multi-level learning in the general practice context, using a realist synthesis approach: BEME Guide No. 55. MEDICAL TEACHER 2019; 41:862-876. [PMID: 31012386 DOI: 10.1080/0142159x.2019.1595554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background: Recent global increases in medical student numbers and shifts in medical education from teaching hospitals to community settings call for effective strategies to meet the demand for general practice teaching placements. It has been proposed that "multi-level learning" (MLL), in which learning and teaching are shared across different levels of learners, may provide teaching efficiencies and valuable experiences for learners and teachers. Aims: To identify, evaluate and synthesize the evidence related to the types, benefits, challenges, and facilitators of MLL in community-based general practice, and the underlying mechanisms and associated contexts to explain the reported outcomes. Method: A realist synthesis approach guided the systematic review. Results: Fifteen papers were identified, providing primary evaluation data predominantly from interviews with or surveys of key stakeholders. Generally, all levels of learners reported overall satisfaction with their MLL experiences. Medical students appreciated learning from prevocational doctors and registrars due to social and cognitive congruence. Mechanisms and contexts that supported our hypotheses regarding successful MLL outcomes were identified, with "a strong teaching culture" being a major mechanism. Conclusions: The findings can help inform practices considering the implementation or enhancement of MLL initiatives in general practice. Further research should include measuring defined learning outcomes.
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Affiliation(s)
- Marie-Louise Dick
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Margaret Henderson
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Yi Wei
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - David King
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Katrina Anderson
- Academic Unit of General Practice, Australian National University Medical School , Canberra , Australia
| | - Jill Thistlethwaite
- Faculty of Arts and Social Sciences, University of Technology Sydney , Australia
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Hoffman LA, Furman DT, Waterson Z, Henriksen B. A Novel Resident-as-Teacher Curriculum to Improve Residents' Integration Into the Clinic. PRIMER (LEAWOOD, KAN.) 2019; 3:9. [PMID: 32537580 PMCID: PMC7205102 DOI: 10.22454/primer.2019.394096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Graduate medical education depends on senior residents to facilitate peer education. Previous studies have described the benefits of resident-as-teacher (RaT) curricula; however, means of assessing these interventions have proven difficult. The purpose of this study was to provide meaningful evaluation of a novel RaT curriculum and scribing activity. METHODS Didactic sessions on teaching skills were presented in July, 2017. First- and third-year residents then alternated scribing for each other for 4 weeks within the outpatient clinic to allow for near-peer educational exchange. Residents' attitudes toward teaching and perceptions of teaching abilities were assessed using preand postintervention surveys. Independent reviewers reviewed charts completed by PGY-1 residents during the scribing activity, and compared them to charts from the previous academic year. RESULTS All first-year (n=12; 100%) and third-year (n=10; 100%) residents participated in the study. After participating in the RaT curriculum, residents were more comfortable giving feedback to other residents and felt better prepared to teach and assess the effectiveness of their teaching. Although there was no significant difference in ratings between the 2016 and 2017 charts, reviewers noted that the 2017 charts contained fewer obvious omissions, and third-year residents felt the charts were completed in a timelier manner. First-year residents saw 16% more patients in 2017 than they had in 2016, which expedited integration into the clinic. CONCLUSION This innovative RaT curriculum with scribing activity improved residents' teaching and communication skills and provided first-year residents with a more efficient and meaningful orientation into the outpatient clinic.
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Vanka A, Hovaguimian A. Teaching strategies for the clinical environment. CLINICAL TEACHER 2018; 16:570-574. [PMID: 30178546 DOI: 10.1111/tct.12928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Anita Vanka
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Alexandra Hovaguimian
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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Pierce JR, Rendón P, Rao D. Peer Observation of Rounds Leads to Collegial Discussion of Teaching. TEACHING AND LEARNING IN MEDICINE 2018; 30:233-238. [PMID: 29324048 DOI: 10.1080/10401334.2017.1360185] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/28/2017] [Accepted: 07/11/2017] [Indexed: 06/07/2023]
Abstract
PROBLEM Faculty in the Division of Hospital Medicine provide most of the clinical teaching for learners at our institution. The majority of these faculty are Assistant Professors with limited formal instruction in clinical teaching. Previous Divisional strategies to improve clinical teaching ability included discussion of effective teaching behaviors, developing written expectations for teaching faculty, and instituting seminars on effective clinical teaching. Heretofore, the Division had not utilized a direct observation exercise. INTERVENTION We developed a direct observation exercise to encourage discussion of teaching techniques and contemplation of change. Using a social learning model, we developed a peer-to-peer observation followed by a nonevaluative discussion. We created a tool for describing teaching behaviors in 5 domains that were similar to or different from the usual behavior of the observing peer: learner presentations, team leadership, bedside teaching, professionalism, and other. After the observation, the observing and observed faculty met to discuss observed teaching behaviors. Both faculty members discussed and then recorded any teaching behaviors that they planned to adopt or change. CONTEXT We implemented this intervention in a 22-member Academic Division of Hospital Medicine at a tertiary care medical center in the United States. A high proportion were junior faculty and graduates of our residency program. OUTCOME We reviewed records of 28 of 31 observations that were completed during the initial 9-month period of implementation and later surveyed faculty. The exercise resulted in planned changes in teaching behaviors that included instituting new methods to improve teaching team leadership, triaging of patients seen on rounds, faculty behaviors during oral presentations, giving real-time feedback, use of technology and humor, demonstrating physical examination findings, and modeling professional behaviors. Faculty later reported adoption of new teaching behaviors that were important to them. LESSONS LEARNED This exercise was easily implemented, resulted in planned changes by both observed and observing peers, and resulted in widespread adoption of some specific teaching behaviors. The most commonly planned change dealt with team leadership or organizational issues. When given the freedom to choose, junior faculty were more likely to observe senior faculty.
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Affiliation(s)
- J Rush Pierce
- a Department of Internal Medicine , University New Mexico School of Medicine , Albuquerque , New Mexico , USA
| | - Patrick Rendón
- a Department of Internal Medicine , University New Mexico School of Medicine , Albuquerque , New Mexico , USA
| | - Deepti Rao
- a Department of Internal Medicine , University New Mexico School of Medicine , Albuquerque , New Mexico , USA
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Simon LE, Eve EJ, Dolce MC, Allareddy V, Nalliah RP. Physician Assistant Student Perceptions of an Interprofessional, Peer-to-Peer Oral Health Curriculum Led by Dental Students. J Physician Assist Educ 2017; 28:210-213. [PMID: 29189652 DOI: 10.1097/jpa.0000000000000170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE Physician assistants (PA) are health care team members who often work in primary care. Providing oral health education to PAs during training could improve oral health for vulnerable patients who seek treatment in the primary care setting and who are less able to access dental care. The purpose of this study was to assess the effectiveness of a peer-to-peer oral health curriculum taught by dental students to their PA student colleagues. METHODS Dental students presented an interactive, case-based curriculum, followed by a hands-on oral examination training session. PA student feedback was obtained, and results were analyzed. RESULTS Students found the content to be highly relevant and well presented. Conveying oral health competencies to future primary care providers may reduce oral health disparities. CONCLUSIONS PA students reported improved understanding of oral health and indicated they would incorporate what they had learned into their future clinical practice.
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Affiliation(s)
- Lisa E Simon
- Lisa E. Simon, DMD, is a fellow in Oral Health and Medicine Integration, Harvard School of Dental Medicine, Cambridge, Massachusetts. Elizabeth J. Eve, DMD, is a postgraduate resident in orthodontics, University of California at San Francisco, San Francisco, California. Maria C. Dolce, PhD, RN, is an associate professor, School of Nursing, State University of New York at Stony Brook, Stony Brook, New York. Veerasathpurush Allareddy, PhD, BDS, MBA, MHA, MMSc, is an associate professor, Department of Orthodontics, University of Iowa College of Dentistry, Iowa City, Iowa. Romesh P. Nalliah, BDS, MS, is a clinical associate professor, School of Dentistry, University of Michigan, Ann Arbor, Michigan
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Moore F. Peer-led small groups: Are we on the right track? PERSPECTIVES ON MEDICAL EDUCATION 2017; 6:325-330. [PMID: 28822105 PMCID: PMC5630531 DOI: 10.1007/s40037-017-0370-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Peer tutor-led small group sessions are a valuable learning strategy but students may lack confidence in the absence of a content expert. This study examined whether faculty reinforcement of peer tutor-led small group content was beneficial. METHODS Two peer tutor-led small group sessions were compared with one faculty-led small group session using questionnaires sent to student participants and interviews with the peer tutors. One peer tutor-led session was followed by a lecture with revision of the small group content; after the second, students submitted a group report which was corrected and returned to them with comments. RESULTS Student participants and peer tutors identified increased discussion and opportunity for personal reflection as major benefits of the peer tutor-led small group sessions, but students did express uncertainty about gaps in their learning following these sessions. Both methods of subsequent faculty reinforcement were perceived as valuable by student participants and peer tutors. Knowing in advance that the group report would be corrected reduced discussion in some groups, potentially negating one of the major benefits of the peer tutor-led sessions. DISCUSSION Faculty reinforcement of peer-tutor led small group content benefits students but close attention should be paid to the method of reinforcement.
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Affiliation(s)
- Fraser Moore
- McGill University Centre for Medical Education, Montreal, Quebec, Canada.
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Lin JA, Farrow N, Lindeman BM, Lidor AO. Impact of near-peer teaching rounds on student satisfaction in the basic surgical clerkship. Am J Surg 2016; 213:1163-1165. [PMID: 28277232 DOI: 10.1016/j.amjsurg.2016.09.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 09/06/2016] [Accepted: 09/12/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Teaching rounds are rarely featured in the surgery clerkship. Senior students interested in surgery are suited to precept teaching rounds. Near-peer teaching can provide benefits to both learners and preceptors. METHODS Near-peer teaching rounds consisted of senior student-precetors leading groups of 3 clerkship students on teaching rounds once during the clerkship. We prospectively surveyed student satisfaction before and after instituting near-peer teaching rounds. We retrospectively gathered qualitative narratives from student-preceptors. RESULTS The survey response rate was 93% before near-peer teaching rounds were instituted and 85% after. Satisfaction with the learning environment and the quality and amount of small-group teaching were significantly higher after the institution of near-peer teaching rounds (P ≤ .001 for all 3). Satisfaction with the overall clerkship and baseline interest in surgery were not significantly different. Student-preceptors reported gaining valuable experience for future roles in academia as residents and attending surgeons. CONCLUSIONS Student satisfaction with small-group teaching and the learning environment increased after the institution of near-peer teaching rounds in the surgery clerkship. Student-preceptors gained early experience for careers in academic surgery.
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Affiliation(s)
- Joseph A Lin
- Department of Surgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA; Department of Surgery, University of California San Francisco, 513 Parnassus Ave, San Francisco, CA 94143, USA.
| | - Norma Farrow
- Department of Surgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA; Department of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Brenessa M Lindeman
- Department of Surgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anne O Lidor
- Department of Surgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA; Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Ramani S, Mann K, Taylor D, Thampy H. Residents as teachers: Near peer learning in clinical work settings: AMEE Guide No. 106. MEDICAL TEACHER 2016; 38:642-55. [PMID: 27071739 DOI: 10.3109/0142159x.2016.1147540] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This AMEE Guide provides a framework to guide medical educators engaged in the design and implementation of "Resident as Teacher" programs. The suggested approaches are based on established models of program development: the Program Logic model to guide program design, the Dundee three-circle model to inform a systematic approach to planning educational content and the Kirkpatrick pyramid, which forms the backbone of program evaluation. The Guide provides an overview of Resident as Teacher curricula, their benefits and impact, from existing literature supplemented by insights from the authors' own experiences, all of whom are engaged in teaching initiatives at their own institutions. A conceptual description of the Program Logic model is provided, a model that highlights an outcomes-based curricular design. Examples of activities under each step of this model are described, which would allow educational leaders to structure their own program based on the scope, context, institutional needs and resources available. Emphasis is placed on a modular curricular format to not only enhance the teaching skills of residents, but also enable development of future career educators, scholars and leaders. Application of the Dundee three-circle model is illustrated to allow for a flexible curricular design that can cater to varying levels of educational needs and interests. In addition, practical advice is provided on robust assessment of outcomes, both assessment of participants and program evaluation. Finally, the authors highlight the need for congruence between the formal and hidden curriculum through explicit recognition of the value of teaching by institutions, support for development of teaching programs, encouragement of evidence-based approach to education and rewards for all levels of teachers.
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Affiliation(s)
- Subha Ramani
- a Department of Medicine , Brigham and Women's Hospital , Harvard Medical School, Boston , MA , USA
| | - Karen Mann
- b Division of Medical Education, Faculty of Medicine , Dalhousie University , Halifax , Nova Scotia , Canada
| | - David Taylor
- c School of Medicine , University of Liverpool , Liverpool , UK
| | - Harish Thampy
- d Manchester Medical School, University of Manchester , Manchester , UK
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Blanchard DS. Peer-teaching: an important skill for all medical students and doctors? PERSPECTIVES ON MEDICAL EDUCATION 2015; 4:6-7. [PMID: 25605494 PMCID: PMC4348226 DOI: 10.1007/s40037-015-0157-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- David S Blanchard
- School of Medicine, Keele University, ST5 5BG, Keele, Staffordshire, UK,
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