Effect of didactically qualified student tutors on their tutees’ academic performance and tutor evaluation in the gross anatomy course

Does regular attendance in supplemental virtual near-peer tutoring in anatomy laboratory content improve anatomy performance for medical students?

Near-peer tutoring (NPT) programs are popular vehicles to supplement traditional delivery of medical school curricula, including for anatomy laboratory (AL) content. While NPT programs can result in improved preclinical coursework performance for tutees, little to no data specifically show a benefit of NPT in AL course performance. In 2021, NYIT College of Osteopathic Medicine launched an NPT program where qualified second-year students led group tutoring sessions for first-year students. This study investigated whether participation and level of attendance in AL NPT sessions were associated with greater examination-to-examination improvement in AL performance. Student attendance at AL sessions in the NPT program was categorized as either regular (10 or more sessions), moderate (5-9 sessions), infrequent (1-4 sessions), or never during one semester. For the first 2 years of the NPT program, attendance frequency at AL tutoring sessions had a significant impact on average exam-to-exam improvement (p < 0.05). Overall, students who attended tutoring at any frequency had greater exam-to-exam improvement than students who never attended (p < 0.05). However, this trend was only significant in 1 of 2 years investigated. These data show that NPT programs can, though not uniformly, benefit student outcomes in AL coursework. With these data, this study provides additional details on the level of attendance necessary for expected improvements in AL coursework.

Attendance of Near-Peer Tutoring Sessions Improves Academic Performance of First-Year Medical Students

Introduction

Many medical schools have implemented near-peer tutoring (NPT) programs based on the substantial benefits of these programs to both tutors and tutees. This study correlated the frequency of attending weekly NPT sessions to students' academic performance, and also compared performance of high and low attending students.

Methods

Twenty-one weekly NPT sessions were delivered by fourth-year (M4) students to first-year (M1) students. Attendance was recorded, and accordingly students were divided into three groups, high (15-21 sessions), moderate (7-14 sessions), and low (0-6 sessions) attendance groups. Pearson product-moment correlation coefficient was computed to assess the relationship between students' frequency of attendance and their overall performance on overall basic medical sciences at the end of M1 year and M2 mid-year NBME® CBSE. Students' performance was also analyzed using ANCOVA and Bonferroni post hoc test to compare differences between the three attendance groups.

Results

An increase in number of attended NPT weekly sessions corresponds with an increase in students' performance on overall M1 basic sciences weighted average (r(196) = .240, p ≤ 0.001) and the M2 mid-year NBME® CBSE (r(196) = .325, p ≤ 0.001). High attending students performed significantly higher than low attending students on overall M1 weighted average of basic science courses (F(2, 192) = 8.518, p < .001) and M2 mid-year NBME® CBSE (F(2, 192) = 15.494, p < .001).

Conclusion

Attending NPT weekly sessions is a valuable experience that is associated with an improvement in M1 medical students' academic performance. However, low performing students tend to miss attending NPT weekly sessions.

Weekly near-peer tutoring sessions improve students' performance on basic medical sciences and USMLE Step1 examinations

PURPOSE

This study examined the relationship between attendance at weekly near-peer tutoring (NPT) sessions offered in the second year of medical school and academic performance on basic science and USMLE Step 1 examinations.

METHODS

Twenty-four weekly NPT sessions were delivered across all modules in the second year of medical school. Attendance of the sessions was recorded and students were divided into three groups: high (16-24 sessions), moderate (7-15 sessions), and low-no (0-6 sessions) attendance groups. Pearson product-moment correlation coefficient was computed to determine the relationship between students' frequency of attendance and their performance on overall basic sciences, two NBME CBSEs, and USMLE Step 1 examinations. Students' academic performance was also analyzed using ANOVA and Bonferroni post hoc test (p < 0.05) to compare differences between the three groups.

RESULTS

Pearson correlation analyses revealed that attending peer tutoring sessions was significantly correlated with students' performance in overall basic sciences, CBSE mid-year, CBSE final, and USMLE Step 1 examinations. The high attendance groups significantly outperformed the low-no attendance groups on overall basic sciences (p = 0.007), CBSE mid-year (p < 0.001), CBSE final (p < 0.018), and USMLE Step 1 (p = 0.048) examinations.

CONCLUSIONS

Attending NPT sessions are significantly correlated with students' performance on basic sciences and on USMLE Step1 examinations. Attendance of weekly NPT sessions is a valuable experience for M2 students.

What factors motivate male and female Generation Z students to become engaged as peer teachers? A mixed-method study among medical and dental students in the gross anatomy course

Peer-teaching is widely established in anatomy teaching and offers well-described advantages. Nevertheless, at Ulm University, Germany, a reduction in the number of peer teacher applicants for the dissection course was observed. This study examined factors related to the attractiveness of a position as a peer teacher for Generation Z students. Participants of the gross anatomy course were asked to evaluate factors influencing the attractiveness of a peer teacher position using a six-point Likert scale. Additionally, open-ended questions were analyzed qualitatively. Sex-specific subgroup analysis was performed comparing students of low and high motivation to apply for a tutorship. Of the 374 students who participated in this study (response rate 53%), 38% stated that they were intending to apply as peer teachers. Data indicated that students displayed intrinsic motivation to apply for a tutorship because of the opportunity to improve their anatomy knowledge and/or their pleasure in teaching. In contrast, extrinsic factors like remuneration of the tutorship and its relevance for their curriculum vitae were least important. Anatomy educators underestimated the demotivating factor of the workload associated with the tutorship and encouraged students less frequently to apply than peer teachers. Only minor sex-specific differences could be identified. Nevertheless, female students were encouraged less frequently to apply than their male peers. In summary, Generation Z students apply as peer teachers because they are enthusiastic about the task. To motivate students to commit to extracurricular activities like a tutorship, anatomy educators should actively encourage students-particularly females-more frequently to apply.

Teaching Medical Students to Teach: A Narrative Review and Literature-Informed Recommendations for Student-as-Teacher Curricula

PURPOSE

Medical students play an important role as teachers. This narrative review synthesizes the student-as-teacher (SaT) literature that incorporates formal teaching skills training, with the goal of proposing literature-informed recommendations for SaT curriculum development within the context of competency-based medical education.

METHOD

In January and August 2020, the authors searched Medline and Embase and conducted forward citation searches in Scopus to identify articles from 1985 to 2020 related to teaching medical students to teach. Search terms included "student(s) as teacher(s)," "near-peer teaching," and "teaching to teach." The findings from selected articles were summarized and synthesized.

RESULTS

Forty-three articles met the inclusion criteria: 33 papers describing specific SaT curricula, 3 literature reviews, 6 stakeholder surveys, and 1 Delphi study. While students often engage in teaching roles, formal teaching skills training is not always provided. Existing curricula are usually optional, delivered as short courses, and offered to senior students. Course content commonly includes topics related to planning and delivering learning activities and providing feedback. Of the numerous teaching modalities employed, students indicate a preference for interactive and experiential learning. Methods used to assess students' teaching skills vary; however, direct observation and feedback are valued assessment methods. Program evaluations have shown positive outcomes, including high student satisfaction and enhanced self-confidence as teachers.

CONCLUSIONS

Informed by these findings and outcome-based educational frameworks, the authors suggest 4 guiding principles for SaT curricula: (1) teaching skills training should be formally implemented in undergraduate medical education and should, whenever possible, be compulsory; (2) teaching skills should be taught longitudinally and progressively along the undergraduate to postgraduate continuum; (3) curriculum content should be aligned with a school's preexisting curriculum and local context; and (4) authentic opportunities for students to engage in teaching roles should be included. They also propose recommendations for curriculum content, teaching modalities, and assessment methods.

Characteristics and impacts of peer assisted learning in university studies in health science: A systematic review

OBJECTIVE

Systematically analyse the characteristics and impact of peer assisted learning programmes implemented in undergraduate health education.

METHODS

Following the PRISMA protocol, we searched the electronic indexed databases WoS and SCOPUS; original studies reporting peer assisted learning in health science careers were included in the systematic review. Among them, the studies between 2010 and January 2020 were selected, and information regarding programme structures and principal results was subsequently extracted.

RESULTS

A total of 47 studies were included in the review. The most frequent programme characteristics were the near-peer teaching modality, lecture classes, clinical laboratories and peer tutor training. The main findings identified were benefits in tutors' confidence and knowledge, better student comprehension and a more comfortable learning environment in comparison with that established by academic tutors.

CONCLUSION

Peer assisted learning programmes have shown qualitative benefits in the learning environment, generation of support networks and confidence in knowledge acquired. Nonetheless, quantitative benefits measured as improvements in marks are inconclusive. Future studies are needed to standardise the methodologies used to determine which characteristics are the most positive in the learning process.

Curriculum Reform and New Technology to Fill the Void of Musculoskeletal Education in Medical School Curriculum

Musculoskeletal (MSK) disease comprises over 20% of all visits to healthcare providers each year, yet a disproportionately small percentage of medical school education focuses on MSK disease. Even among students applying into orthopaedic surgery, less than 50% demonstrate prerequisite anatomic knowledge before beginning their residency. Medical school curriculum reform is needed, given that only 15% have a required MSK curriculum. Inadequate education ultimately leads to poor patient care and forces clinicians to learn MSK medicine later in practice. Although this inadequacy in medical school MSK education has been recognized for decades, little has changed to address this critical deficiency. A successful curriculum development requires defining critical MSK topics, evaluative methods to assess knowledge acquisition, and ultimately assessment of applying that knowledge to the care of patients. Newer strategies for MSK education include "near-peer" learning from senior classmates and residents, clinical immersion within MSK care teams, peer interest groups, and standardize learning platforms and assessment tools. Technologies such as virtual reality simulation, adaptive video learning, and other technologies will inform the development of affordable, succinct, evidence-informed curriculums that can enhance medical student MSK education with universal implementation. As clinical practice evolves to optimize patient care, so should the education of physicians who deliver that care.

Peer Tutoring in Preclinical Medical Education: A Review of the Literature

Peer-assisted learning (PAL) is an educational method where students teach their peers. PAL has been increasingly integrated into medical education in various formats including near-peer tutoring (NPT), reciprocal-peer tutoring (RPT), and peer-to-peer tutoring. This review adds to current literature by focusing exclusively on outcomes from PAL peer tutoring programs implemented in conjunction with basic science courses in medical education. Although the programs differ in size, duration, course, resource availability, and method of evaluation and thus can be difficult to compare, PAL programs overall demonstrate benefits for both tutors and tutees and merit further investigation into optimal methods of implementation.

Peer-assisted learning versus didactic teaching in osteology for first-year Indian undergraduate medical students: a quasi-experimental study

PURPOSE

The utility of peer-assisted learning (PAL) in anatomy education has been recognized. In this study, PAL was incorporated into osteology teaching for the first-year medical students and compared to traditional didactic methods (TDM).

METHODS

This was a cross-over intervention study. The class of 60 students was divided into two equal groups. The first group underwent PAL for five upper limb osteology sessions and TDM for all lower limb osteology classes. The second group underwent TDM for five upper limb osteology classes and PAL for lower limb osteology classes. A pre-session test (PrST) and post-session test (PoST) were conducted for each session using multiple choice type questions. Perceptions of students about PAL were collected using a questionnaire. Between and within group differences were estimated using the independent sample T test and paired T test, respectively. The responses in the questionnaire were summarized and open-ended responses categorized into broad themes.

RESULTS

Greater group differences were noted in the PrST as compared to the PoST mean scores, with the PAL group showing higher mean scores for both upper and lower limb sessions. Significantly higher PoST scores compared to PrST scores for all the sessions were observed regardless of the method used. Significantly higher scores in the PrST or PoST scores were noted in the PAL group for five sessions. Most aspects of PAL were appreciated by the students.

CONCLUSIONS

This study provides evidence that PAL is at least as effective as TDM in learning osteology among the first-year medical students.

Professional and Personal Competency Development in Near-peer Tutors of Gross Anatomy: A Longitudinal Mixed-methods Study

There are many benefits to peer and near-peer tutoring. The current literature suggests that near-peer teaching within the domain of gross anatomy may lead to the development of numerous competencies for burgeoning medical professionals. The aim of this study was a quantitative and qualitative approach to explore which professional and personal competencies anatomy tutors developed as a result of their teaching activities in a gross anatomy course at a medical school in Germany. For a period of 18 months, 24 peer tutors were followed and queried multiple times via questionnaire and semi-structured interviews. It was found that most of the skills tutors developed or strengthened over one semester matched most of the core competencies described in various official competency frameworks used for physician education. In particular, tutors thought that tutoring gross anatomy had improved their knowledge of professional behavior as well as their communication skills. They also felt that they had learned to take on more responsibility and to use available resources more effectively. Overall, tutoring gross anatomy was perceived as very challenging, but also very rewarding, mainly because it provided the opportunity to develop and strengthen important skills such as self-confidence, self-awareness, positive thinking, self-insight, and stress management. Ultimately, these are all factors that contribute to resilience, an important attribute for physicians.

An overview of peer tutor training strategies at German medical schools

BACKGROUND

An increased popularity of peer-assisted learning in medical schools all over the globe has caused a growing interest in taking a closer look into how student tutors are trained to handle the task. This article provides an overview of the tutor training strategies at five medical faculties in Germany.

METHODS

Nine German medical faculties with an evident tutor training strategy were contacted by phone or e-mail. Ultimately, five of the nine contacted faculties responded and provided a detailed overview of their individual tutor training.

RESULTS

In many cases, tutors receive a mandatory didactic training in preparation of the tutorials and also an additional technical or specialized training. Frequently, tutor training is provided within the framework of an organized, faculty-based tutor training program. There is a trend towards a needs-adapted training strategy.

CONCLUSION

There is a broad variety of peer teaching and tutor training strategies at the various faculties surveyed. Their individual characteristics are determined by factors such as the nature of tutorials and the number of students.

Dissecting the role of sessional anatomy teachers: A systematic literature review

Worldwide there is a growing reliance on sessional teachers in universities. This has impacted all disciplines in higher education including medical anatomy programs. The objective of this review was to define the role and support needs of sessional anatomy teachers by reporting on the (1) qualifications, (2) teaching role, (3) training, and (4) performance management of this group of educators. A systematic literature search was conducted on the 27 July 2017 in Scopus, Web of Science, and several databases on the Ovid, ProQuest and EBSCOhost platforms. The search retrieved 5,658 articles, with 39 deemed eligible for inclusion. The qualifications and educational distance between sessional anatomy teachers and their students varied widely. Reports of cross-level, near-peer and reciprocal-peer teaching were identified, with most institutes utilizing recent medical graduates or medical students as sessional teachers. Sessional anatomy teachers were engaged in the full spectrum of teaching-related duties from assisting students with cadaveric dissection, to marking student assessments and developing course materials. Fourteen institutes reported that training was provided to sessional anatomy teachers, but the specific content, objectives, methods and effectiveness of the training programs were rarely defined. Evaluations of sessional anatomy teacher performance primarily relied on subjective feedback measures such as student surveys (n = 18) or teacher self-assessment (n = 3). The results of this systematic review highlight the need for rigorous explorations of the use of sessional anatomy teachers in medical education, and the development of evidence-based policies and training programs that regulate and support the use of sessional teachers in higher education. Anat Sci Educ 11: 410-426. © 2017 American Association of Anatomists.

Quantitative and qualitative analysis of student tutors as near-peer teachers in the gross anatomy course

INTRODUCTION

Peer teaching is a well-established teaching method in medical education. During the 2012/13 winter term, the Institute of Anatomy and Cell Biology in Ulm, Germany, introduced a longitudinal didactics program ("Train the Tutor": TtT) to train student tutors as near-peer teachers (NPT) in the dissection course (DC). Twenty-three of 38 tutors participated in the programme. Our study describes the educational concept and the NPTs' activities in the dissection course.

METHODS

NPTs documented their activities on a daily basis in the form of semi-structured reports. A total of 575 reports were quantitatively and qualitatively analysed. Free-text analysis was performed using Grounded Theory followed by code quantification of all indications (n=1868).

RESULTS

NPTs spend 61% of their time dissecting by themselves or supervising the tutee's dissection process. Organisational tasks had a larger share at the beginning of the course. Just before examinations the proportion of time spent giving feedback rose. Of all positive indications, 45% described experiences working with the tutees. In contrast, 68% of all negative indications were characterized by a self-critical reflection on their own activities. NPTs included all learning domains in their teaching, substantially functioning as teachers and role models to convey particular attitudes.

CONCLUSION

TtT-Trained Tutors (NPT) clearly met the requirements of a practical course and adjusted their activities in response to the course's progress. NPTs were concerned about their tutees' attitudes and may need more professional support within the TtT program regarding this.