Determining the effectiveness of peer-assisted learning in medical education: A systematic review and meta-analysis

The Daily Fact Pile: Exploring Mutual Microlearning in Neurology Resident Education

Problem: A significant proportion of learning during residency takes place through informal channels. Spontaneous collaboration among medical learners significantly contributes to this informal learning and is increasingly recognized as a component of the hidden curriculum in medical education. Yet historically, a disproportionate emphasis in medical education has been placed on didactic, structured, and faculty-initiated methods, leaving an important force in medical education understudied and underutilized. We hypothesize that there is significant educational potential in studying and deploying targeted tools to facilitate collaboration among medical learners. Intervention: At our institution, neurology residents implemented the "Daily Fact Pile" (DFP), a resident-led, email-based collaboration that served as a platform to share clinical pearls in an informal, digital way. Participation was voluntary and participants were encouraged to share facts that were new to them and thought to be clinically relevant. Motivated by the positive collective experience, we conducted a retrospective examination of this phenomenon. In this context, we developed the concept of "mutual microlearning" to characterize this efficient, multidirectional exchange of information. Context: Thirty-six residents in a single neurology residency program utilized the DFP at a large university hospital in the USA between 2018 and 2019. After 21 months of spontaneous and voluntary participation, we assessed the feasibility of the DFP, its impact on the education and morale of neurology residents, and compared its mutual microlearning approach to traditional lectures. This was done through a survey of the DFP participants with a response rate of 80.7%, and analysis of the statistics of participation and interaction with the DFP. Impact: Most participants felt that the DFP was beneficial to their education and thought they often or always learned something new from reading the DFP. The impact of the DFP extended beyond education by improving interest in neurology, morale, and sense of teamwork. The DFP was feasible during neurology residency and participation was high, though participants were more likely to read facts than share them. Lessons learned: Mutual microlearning represents an opportunity to augment residents' education, and well-designed mutual microlearning tools hold promise for complementing traditional teaching methods. We learned that efficiency, ease of use, and a supportive, non-judgmental environment are all essential to the success of such tools. Future research should delve deeper into the underlying mechanisms of mutual microlearning to establish its position within the theoretical frameworks of medical education.

Peer-Assisted Learning in Undergraduate Midwifery Clinical Education: A Qualitative Study on Experiences of Nursing Students From Three Namibian Training Institutions

Introduction

Peer-assisted learning is widely used in nursing education and is reported to have a positive impact on the students' learning process. However, students' experiences of peer-assisted learning from midwifery clinical education in resource-constrained, overcrowded, and small maternity sections are not documented.

Objective

This study was undertaken to explore undergraduate nursing students' experiences of peer-assisted learning in midwifery clinical education context in Namibia.

Methods

The study was approached from a social constructivism, with explorative, descriptive, and contextual qualitative as a methodological approach. The sample consisted of 32 nursing students from three training institutions, who were conveniently sampled. Data collection was via five focus group discussions, which used a focus group discussion guide, audio recorder, and field notes as research instruments. Data were analyzed using thematic analysis.

Results

Main themes that emerged from thematic analysis are students' conceptions of peer-assisted learning, benefits, challenges, and suggestions made to improve peer-assisted learning in midwifery clinical education. In thematic area of students' conceptions of peer-assisted learning, peer teaching tools, engagement, care, and support of peers were recorded as subthemes. The benefits of peer-assisted learning included teamwork, professional identity, a deep approach to learning, communication, coping mechanisms, and socialization. Challenges experienced by students while using peer-assisted learning are learning wrong practices from peers, personality influence, discrimination, labeling, and name calling. Suggestions made by students were formalization and training of students on peer-assisted learning.

Conclusions

Students' experiences of peer-assisted learning relate to how they understand it as a concept, their interaction with peers, and learning materials. In addition, students made suggestions to improve peer-assisted learning in midwifery clinical practice. These results may be useful in developing peer-assisted frameworks and guiding documents for use in its implementation in midwifery clinical education.

Peer-led versus instructor-led structured debriefing in high-fidelity simulation: a mixed-methods study on teaching effectiveness

BACKGROUND

Debriefing is the essential element of simulation teaching. Peer-led structured debriefing simulations could be a suitable approach because of the peers' similarity in age and experience to the students. The purpose of this study was to compare the teaching effectiveness of peer-led debriefing versus instructor-led debriefing in high-fidelity simulation scenarios.

METHODS

The study used a mixed-method approach, integrating quasi-experimental and qualitative components. A total of 88 third-year nursing students were randomly distributed into the instructor-led or peer-led group, with equal sample sizes in both cohorts. The study compared knowledge acquisition, simulation performance, student satisfaction and self-confidence in learning, and debriefing experience between the two groups. In addition, interviews were conducted with students in the peer-led group after the course.

RESULTS

The scores of students' simulation performance scale were higher in the peer-led group than in the instructor-led group, and both groups made significant gains in knowledge. The peer-led group and instructor-led group demonstrated similar performance in terms of knowledge, simulated performance, reporting experience, student satisfaction, and learning confidence. The semi-structured interview results indicated that students in the peer-led group expressed approval of peer facilitators.

CONCLUSIONS

Our study demonstrated that students in the peer-led group showed better performance in the simulation, and both groups demonstrated improved knowledge. Thus, with the premise of peers receiving training, the peer-led simulation teaching method can be regarded as a supplementary strategy for simulation teaching to enrich the form of simulation teaching and improve the effectiveness of simulation teaching.

Becoming a physiotherapist - a qualitative study exploring students' perspectives on peer assisted learning in physiotherapy education

BACKGROUND

Peer assisted learning (PAL) has become increasingly popular in higher education, and a range of benefits have been reported for students. However, there is scant knowledge on PAL study groups in physiotherapy undergraduate training.

OBJECTIVES

This study aimed to generate in-depth knowledge about the experiences of PAL study groups from the perspective of physiotherapy students.

METHODS

We conducted focus group interviews with 15 first-semester students who had attended PAL study groups, and 8 third-semester students who had been PAL leaders. The interviews were analyzed using an inductive, thematic analysis.

RESULTS

Four main themes were generated: 1) An overwhelming transition - Eased by PAL study groups; 2) The significant role model - Creating safe learning environments; 3) Building a bridge between theory and practice through scaffolding; and 4) Time to mature and filtered knowledge.

CONCLUSION

Overall, we found that PAL study groups formed an important community of practice, and that the PAL leaders became important role models, providing academic, social, and emotional support. Students learning from students in PAL study groups seemed beneficial to bridge theory and practice. Our findings support the implementation of PAL study groups as a supplement to formal teaching and suggest that PAL aids students' transition to the university environment.

Empowering the future: improving community wellbeing and health literacy through outreach and service-learning

Institutions training future healthcare professionals in healthcare and community engagement play a crucial role beyond traditional classroom settings. Recognizing their potential to support under-represented groups and minorities, institutions increasingly encourage engagement with schools and community organizations. However, work remains to advance meaningful and impactful educational outreach and service-learning programs. This manuscript synthesizes the perspectives of a group of medical school educators to discuss developing sustainable programs to engage youth in Science, Technology, Engineering, Math, and Medicine (STEMM) education with a focus on biomedical science. Through near-peer education and service-learning, healthcare students can impart knowledge, provide mentorship, promote enthusiasm for STEMM fields, and nurture health-related self-efficacy within individuals and communities. Collaborative efforts through student-as-teacher approaches bridge health-related disparities and cultivate healthier, more empowered futures for all. We advocate for community outreach strategies that target future health professionals early in their education and support the scholarship of teaching and learning and program evaluation. Successful long-term programs must ensure that results are systematically assessed, measured, and perpetuated. This perspective aims to highlight the role of service learning and community outreach in increasing individual health literacy and fostering an enduring interest in STEMM careers, thereby empowering the next generation of elementary and secondary school students.

Peer review for handoff education in a transition to residency course: A prospective cohort study

Background and Aims

Association of American Medical Colleges (AAMC) and Accreditation Council for Graduate Medical Education (ACGME) mandate training in handoff delivery for students and residents. Communication errors, including errors during handoffs of patient care, account for over 2/3 of sentinel events. This study aims to assess the effectiveness of peer-assisted learning (PAL) in handoff education within a longitudinal framework.

Methods

This study involved the analysis of fourth-year medical students (n = 67) enrolled in a transition to residency program designed to reinforce skills essential for success in internal medicine residencies. We modified the I-PASS handoff rubric for a single-encounter evaluation. Before attending the transitions of care workshop, students submitted one written handoff report. During high-fidelity simulation sessions, peers evaluated the written document as well as verbal handoffs, while faculty evaluated a recorded verbal version. The primary outcome measured was improvement in handoff quality and accuracy over time and secondary outcomes compared peer- and self-evaluations to faculty assessments.

Results

Overall, students demonstrated a statistically significant improvement in handoff quality and accuracy across all scoring criteria after completing the peer evaluation process. Peer evaluations did not demonstrate statistically significant differences in scores for quality or accuracy questions as compared to faculty.

Conclusion

Peer evaluators effectively assessed handoff reports using the modified I-PASS checklist yielding outcomes similar to faculty while providing feedback. These findings provide exciting evidence that should prompt training programs to consider incorporating standardized peer review into handoff education for medical students and, potentially, residents. The detailed evaluation of individual handoff events fosters feedback skills essential for ongoing professional growth and clinical excellence.

The hidden curriculum of peer teaching in developing a professional identity: Perspectives of medical students and junior doctors

INTRODUCTION

Peer teaching has been utilised in the field of medical education to support learning of the curriculum in both pre-clinical and clinical contexts. The literature has shown that there is a hidden curriculum unique to peer teaching, but little is known about this from the peer learner perspective. This study explored the hidden curriculum of peer teaching and from the perspective of medical students and junior doctors.

METHODS

Data was collected via one-on-one interviews with 10 participants including junior doctors and medical students (n = 10). The interviews were transcribed, and thematic analysis was used to interpret the data.

RESULTS

Five themes were identified in relation to the hidden curriculum of peer teaching-specifically, learning how to be a professional; be a better learner; to care for self and others; to navigate career pathways; and to become a future teacher.

CONCLUSION

Peer teaching is a powerful resource for professional identity development in medicine and can be better leveraged to deliver on this potential.

Comparison of peer-assisted learning with expert-led learning in medical school ultrasound education: a systematic review and meta-analysis

INTRODUCTION

Teaching point-of-care ultrasonography (PoCUS) to medical students is resource intensive. Peer-assisted learning, where the teacher can be a medical student, may be a feasible alternative to expert-led learning. The objective of this systematic review and meta-analysis was to compare the PoCUS performance assessments of medical students receiving peer-assisted vs expert-led learning.

METHODS

This study was submitted to PROSPERO (CRD42023383915) and reported with PRISMA guidelines. MEDLINE, Embase, ERIC, Education Source, Scopus, and Web of Science were searched from inception to November 2022. Inclusion criteria were studies comparing peer-assisted vs expert-led PoCUS teaching for undergraduate medical students. The primary outcome was performance assessment of PoCUS skills. Two reviewers independently screened citations and extracted data. The Cochrane risk-of-bias tool for randomized trials was used to assess study quality. Studies were included in the meta-analysis if mean performance assessment scores with standard deviations and sample sizes were available. A random-effects meta-analysis was conducted to estimate the accuracy score of practical knowledge test for each group. A meta-regression evaluated difference in mean scores.

RESULTS

The search yielded 2890 citations; 1417 unique citations remained after removing duplicates. Nine randomized-controlled studies conducted in Germany, USA, and Israel, with 593 participants, were included in the meta-analysis. The included studies assessed teaching of abdominal, cardiac, thoracic, musculoskeletal, and ocular PoCUS skills. Most studies had some risk-of-bias concerns. The estimate accuracy score after weighting is 0.56 (95% CI [0.47, 0.65]) for peer-assisted learning and 0.59 (95% CI [0.49, 0.69]) for expert-led learning. The regression coefficient estimate is 0.0281 (95% CI [- 0.1121, 0.1683]); P value is 0.69.

CONCLUSION

This meta-analysis found that peer-assisted learning was a reasonable alternative to expert-led learning for teaching PoCUS skills to medical students.

Role Modeling in Medical Education: A Twenty-First Century Learner's Perspective

Traditional role modeling is a complex process of observation and emulation delivered by experienced senior physicians with an unknown outcome. Role modeling through organized modalities has been utilized as an educational tool in medical school for years. However, effects of parenting, near peers, gender, race, and social media on role modeling in medical education have not been well characterized yet play a significant role in the development of modern clinicians. The aim of this paper is to encourage students as future medical and clinical educators through an in-depth analysis of role modeling, with the goal of improving their "role modeling consciousness."

Teaching Basic Surgical Skills Using a More Frugal, Near-Peer, and Environmentally Sustainable Way: Mixed Methods Study

BACKGROUND

The Royal College of Surgeons Basic Surgical Skills (BSS) course is ubiquitous among UK surgical trainees but is geographically limited and costly. The COVID-19 pandemic has reduced training quality. Surveys illustrate reduced logbook completion and increased trainee attrition. Local, peer-led teaching has been shown to be effective at increasing confidence in surgical skills in a cost-effective manner. Qualitative data on trainee well-being, recruitment, and retention are lacking.

OBJECTIVE

This study aims to evaluate the impact of a novel program of weekly, lunchtime BSS sessions on both quantitative and qualitative factors.

METHODS

A weekly, lunchtime BSS course was designed to achieve the outcomes of the Royal College of Surgeons BSS course over a 16-week period overlapping with 1 foundation doctor rotation. All health care workers at the study center were eligible to participate. The study was advertised via the weekly, trust-wide information email. Course sessions included knot tying, suturing, abscess incision and drainage, fracture fixation with application of plaster of Paris, joint aspirations and reductions, abdominal wall closure, and basic laparoscopic skills. The hospital canteen sourced unwanted pig skin from the local butcher for suturing sessions and pork belly for abscess and abdominal wall closure sessions. Out-of-date surgical equipment was used. This concurrent, nested, mixed methods study involved descriptive analysis of perceived improvement scores in each surgical skill before and after each session, over 4 iterations of the course (May 2021 to August 2022). After the sessions, students completed a voluntary web-based feedback form scoring presession and postsession confidence levels on a 5-point Likert scale. Qualitative thematic analysis of voluntary semistructured student interview transcripts was also performed to understand the impact of a free-to-attend, local, weekly, near-peer teaching course on perceived well-being, quality of training, and interest in a surgical career. Students consented to the use of feedback and interview data for this study. Ethics approval was requested but deemed not necessary by the study center's ethics committee.

RESULTS

There were 64 responses. Confidence was significantly improved from 47% to 73% (95% CI 15%-27%; P<.001; t13=5.3117) across all surgical skills over 4 iterations. Among the 7 semistructured interviews, 100% (7/7) of the participants reported improved perceived well-being, value added to training, and positivity toward near-peer teaching and 71% (5/7) preferred local weekly teaching. Interest in a surgical career was unchanged.

CONCLUSIONS

This course was feasible around clinical workloads, resourced locally at next to no cost, environmentally sustainable, and free to attend. The course offered junior doctors not only a weekly opportunity to learn but also to teach. Peer-led, decentralized surgical education increases confidence and has a positive effect on perceptions about well-being and training. We hope to disseminate this course, leading to reproduction in other centers, refinement, and wide implementation.

Special care dentistry education during the COVID-19 pandemic: The impact of online peer-assisted learning

OBJECTIVES

This study aims to analyze the impact and students' perceptions of online peer-assisted learning (OPL), developed as an alternative and innovative approach to Special Care Dentistry (SCD) training during the COVID-19 pandemic. Online peer-assisted learning (OPL) is an alternative pedagogical approach that combines online education and peer-assisted teaching.

METHODS

The OPL session was conducted by two postgraduate students in SCD (as teachers), to final year undergraduate dental students (as learners) (n = 90), supervised by two specialists in SCD-related areas (as supervisors). Vetted online pre- and post-intervention quizzes were conducted before and after the session, respectively, followed by an online validated feedback survey of the students' learning experiences. Meanwhile, a reflective session was conducted between the postgraduate students and supervisors to explore their perceptions of OPL. Quantitative data was analyzed via paired t-test (significance level, P < .05). Qualitative data was analyzed via thematic analysis.

RESULTS

Overall, 68 (response rate = 75.6%) and 81 (response rate = 90.0%) undergraduate students completed the quiz and feedback survey, respectively. There was a significant difference in total mean scores, and mean scores of 7 (out of 10) individual items on the quizzes. Most students offered positive reviews of multiple aspects of OPL. They acknowledged the benefit of OPL for its content and preparation process, technology utilized, and experts' roles. Postgraduate students perceived that OPL encourages knowledge-recall and utilization of technology-based educational tools, while improving their teaching skills.

CONCLUSION

Students provided positive responses toward the implementation of OPL as an innovative approach to the teaching and learning of SCD during the COVID-19 pandemic.

Alfaisal University's Academic Success Center: An Individualized Peer-Assisted Learning Program for Mutual Tutor-Student Advancement

INTRODUCTION

Peer-assisted learning (PAL) is an educational strategy whereby students teach other students. PAL presents many advantages to the institution, tutors, and tutees. It can benefit the university by presenting a cost-effective approach where the efforts and time of faculty are reduced. We describe a retrospective analysis detailing the structure, function, and effectiveness of the Academic Success Center (ASC) at Alfaisal University, Riyadh, Saudi Arabia, since 2020. The ASC encompasses various types of PAL methods. It is the only PAL program in Saudi Arabia whereby its tutors, referred to as student consultants, are compensated financially.

METHODS

We retrospectively analyzed the total number of appointments, the total number of students who accessed the center, as well as the breakdown between different colleges and academic years, and their satisfaction level with the PAL mode of teaching.

RESULTS

Our results indicate a high level of appointments for these PAL sessions increasing on a yearly basis and a high level of satisfaction from both the tutors and the tutees.

CONCLUSION

PAL is an effective teaching and mentoring modality with high retention rates that has contributed to an increased sense of well-being among students who have utilized these services.

Tutors´ and Students' Agreement on Social and Cognitive Congruence in a Sonography Peer-assisted-learning Scenario

Purpose

Peer-assisted learning has become an integral part within medical education and has been proven to be effective in teaching medical skills. Cognitive and social congruence are important factors that explain the effectiveness of peer-assisted learning. However, although theory suggests this, there is no study to date that demonstrates that students and tutors agree upon the level of cognitive and social congruence. Thus, we compared tutors' and students' perception of cognitive and social congruence and their agreement on the causes of congruence.

Methods

36 students and 9 tutors from 9 courses were asked to answer questionnaires for their perception of cognitive and social congruence in a peer-assisted learning sonography scenario.

Results

Students and tutors experienced cognitive congruence (t = 0.8277, df = 8, p = .4318, 95% CI = [-0.232; 0.491]) and social congruence (t = 0.962, df = 8, p = .364, 95% CI = [-0.145; 0.354]) similarly. In contrast, students and tutors disagreed on causes of cognitive congruence (agreement = 53.90%) and social congruence (agreement = 58.49%). Tutors rated their empathy and interest toward students as the main cause. Students rated the helpfulness, effectiveness, and approachableness of the tutor as the main cause.

Conclusions

Our study filled the gap in previous research on cognitive and social congruence. Consistent with theoretical considerations, it was shown that students and tutors do indeed experience cognitive and social congruence similarly. Nevertheless, differences also emerged that may carry more or less weight depending on the research question. Future studies should therefore carefully examine whether the assessment of cognitive and social congruence of students and tutors is necessary.

Comparative study of accompaniment programs for undergraduate degree students in Spanish universities

Introduction

In the last decade, higher education has undergone a transformation in different areas. The most recent and impactful one may have been the need to keep it updated during the COVID-19 pandemic and to be able to teach remotely and affect university life as little as possible. Another significant change is the emergence of personal attention, accompaniment, or mentoring programs, which have become the prevalent leitmotif in many universities.

Methods

This study compares the different programs at 60 Spanish universities. The relevant information collected during this research is related to the existence of an accompaniment program, and in this program, which plays the role of mentor, or what year is it for. Other information collected from the search is related to the type of mentoring programs, whether they are regulated, have a formal program, or are linked to specific courses. Finally, the assessment procedures are also indicated in case any evaluation is used. After the analysis developed during this research, the mentor-mentee program implemented at the Francisco de Vitoria University is detailed, highlighting differences from other programs, its advantages, and students' benefits.

Results

The number of accompaniment and mentoring programs offered by Spanish universities continues to rise. In Spanish universities, some accompaniment and mentoring programs offer different and specific mentoring activities designed to enhance and further the kind of education and preparation institutions of higher learning should ideally provide. Accompaniment processes generally have a longer duration in private universities than in public universities, offering a wider range of programs for both current and incoming students and those with specific needs, such as international students.

Discussion

The authors found that not many studies have highlighted the value of the accompaniment, and even fewer have conducted comparative analyses of the diverse realities across various universities. Mentoring programs will have the potential to be part of a university's strategy to help students succeed when the shortcomings of mentoring programs. This study opens new avenues for research into the ideal profile of mentors to best accompany university students.

Evaluating the impact of COVID-19 pandemic on the physicians' psychological health: A systematic scoping review

Background

COVID-19 has endangered healthcare systems at multiple levels worldwide. Published data suggests that moral dilemmas faced during these unprecedented times have placed physicians at the intersections of ethical and unethical considerations. This phenomenon has questioned the physicians' morality and how that has affected their conduct. The purpose of our review is to tap into the spectrum of the transforming optics of patient care during the pandemic and its impact on psychological wellbeing of physicians.

Methods

We adopted the Arksey and O'Malley's framework, defining research questions, identifying relevant studies, selecting the studies using agreed inclusion and exclusion criteria, charting the data, and summarizing and reporting results. Databases of PubMed/Medline, Web of Science, Scopus, Science Direct, CINAHL, and PsycInfo were searched using a predefined search string. The retrieved titles and abstracts were reviewed. Later, a detailed full-text analysis of the studies which matched our inclusion criteria was performed.

Results

Our first search identified 875 titles and abstracts. After excluding duplicates, irrelevant, and incomplete titles, we selected 28 studies for further analysis. The sample size in 28 studies was 15,509 with an average size of 637 per study. Both quantitative and qualitative approaches were used, with cross-sectional surveys being utilized in all 16 quantitative studies. Using the data from semi-structured interviews, several discrete codes were generated, which led to the identification of five main themes; mental health, individual challenges, decision-making, change in patient care, and support services.

Conclusion

This scoping review reports an alarming rise in psychological distress, moral injury, cynicism, uncertainty, burnout, and grief among physicians during the pandemic. Decision-making and patient care were mostly regulated by rationing, triaging, age, gender, and life expectancy. Poor professional controls and institutional services potentially led to physicians' crumbling wellbeing. This research calls for the remediation of the deteriorating mental health and a restoration of medical profession's advocacy and equity.

Implementation of a Student-Teacher-Based Blended Curriculum for the Training of Medical Students for Nasopharyngeal Swab and Intramuscular Injection: Mixed Methods Pre-Post and Satisfaction Surveys

BACKGROUND

The COVID-19 pandemic caused a major disruption in the health care sector with increased workload and the need for new staff to assist with screening and vaccination tasks. Within this context, teaching medical students to perform intramuscular injections and nasal swabs could help address workforce needs. Although several recent studies discuss medical students' role and integration in clinical activities during the pandemic, knowledge gaps exist concerning their role and potential benefit in designing and leading teaching activities during this period.

OBJECTIVE

The aim of our study was to prospectively assess the impact in terms of confidence, cognitive knowledge, and perceived satisfaction of a student-teacher-designed educational activity consisting of nasopharyngeal swabs and intramuscular injections for the training of second-year medical students in the Faculty of Medicine, University of Geneva, Switzerland.

METHODS

This was a mixed methods pre-post surveys and satisfaction survey study. Activities were designed using evidence-based teaching methodologies based on the SMART (specific, measurable, achievable, realistic, and timely) criteria. All second-year medical students who did not participate in the activity's old format were recruited unless they explicitly stated that they wanted to opt out. Pre-post activity surveys were designed to assess perception of confidence and cognitive knowledge. An additional survey was designed to assess satisfaction in the mentioned activities. Instructional design was blended with a presession e-learning activity and a 2-hour practice session with simulators.

RESULTS

Between December 13, 2021, and January 25, 2022, a total of 108 second-year medical students were recruited; 82 (75.9%) students participated in the preactivity survey and 73 (67.6%) in the postactivity survey. Students' confidence in performing intramuscular injections and nasal swabs significantly increased on a 5-point Likert scale for both procedures-from 3.31 (SD 1.23) and 3.59 (SD 1.13) before the activity to 4.45 (SD 0.62) and 4.32 (SD 0.76) after the activity (P<.001), respectively. Perceptions of cognitive knowledge acquisition also significantly increased for both activities. For the nasopharyngeal swab, knowledge acquisition concerning indications increased from 2.7 (SD 1.24) to 4.15 (SD 0.83), and for the intramuscular injection, knowledge acquisition concerning indications increased from 2.64 (SD 1.1) to 4.34 (SD 0.65) (P<.001). Knowledge of contraindications for both activities increased from 2.43 (SD 1.1) to 3.71 (SD 1.12) and from 2.49 (SD 1.13) to 4.19 (SD 0.63), respectively (P<.001). High satisfaction rates were reported for both activities.

CONCLUSIONS

Student-teacher-based blended activities for training novice medical students in commonly performed procedural skills seem effective for increasing their confidence and cognitive knowledge and should be further integrated within a medical school curriculum. Blended learning instructional design increases students' satisfaction about clinical competency activities. Future research should elucidate the impact of student-teacher-designed and student-teacher-led educational activities.

Student Team Achievement Division as a tool for peer assisted co-operative learning in neuroanatomy

Student Team Achievement Division (STAD) is a co-operative learning approach premised on a group learning activity that emphazises learning as a social exchange of knowledge between students, in which each student is accountable for his or her own learning and is also encouraged to assist others in achieving their goals. It promotes the cognitive, psychomotor, and emotional growth of students involved in the team. By random sequencing, 60 participants were allocated to interventional group (n=30) and control group (n=30). The participants of the interventional group were subjected to STAD strategy and participants of the control group were instructed to do a conventional self learning on the ventricles of brain. The outcomes were statistically analysed. It was found that the performance of the students is far better with STAD approach than conventional self learning. Our study has shown that Students team Achievement Division can be used as an effective tool for Peer assisted Co-operative Learning in Anatomy. Further studies can be done to investigate the contribution of STAD to teaching other disciplines of Anatomy and other basic medical sciences.

Is student mentoring career-defining in surgical disciplines? A comparative survey among medical schools and medical students for mentoring programs

Objective

Facing a shortage of young surgeons, this study aimed to examine the availability of mentoring programs and if this can counteract this lack.

Summary background data

Medical mentoring programs have proven to be decisive to influence students' later career decisions. Since their structure may depend on the medical school and the effort of single disciplines, the offers are often very heterogeneous.

Methods

Anonymous online-questionnaires were developed and distributed among medical students in Germany and the dean for teaching of the medical schools from July 2019 to January 2020 in Germany. Data of the availability of mentoring programs, their structure and the impact of surgery were collected.

Results

Forty three medical schools participated, with 65% offering mentoring programs. 18 of medical schools had no additional funding available for this. Surgical subjects participated in these programs in only 30%. Additionally, 1,516 medical students participated in the second survey. A total of 70% had already participated in a mentoring program with a significantly higher proportion of men. Of these, 94% stated that this was helpful and had an impact on their career planning, without any gender differences. 95% would participate in structured surgical mentoring programs and 95% agreed that this could have an impact on their career planning.

Conclusion

Mentoring programs may be able to influence career planning, nevertheless participation by surgical specialties has been low. Becoming more active in providing mentoring programs with a special focus on women and offering more surgical content can be a way to counteract the lack of surgical trainees.

Impact of Peer-Assisted Learning in Chest Tube Insertion Education on Surgical Residents

Objective

To investigate the impact of peer-assisted learning (PAL) in chest tube insertion education on surgical residents.

Methods

This study is a quasi-experimental study conducted on thirty general surgeon residents enrolled in the PAL program. They were divided into two learner groups (A and B) based on the period of residency start. Group A and B had six and one months of general surgery residency experience, respectively. All participants received adequate training for chest tube insertion by a recently graduated general surgeon. Chest tubes insertion skill was assessed using the tool for assessing chest tube insertion competency (TACTIC) test.

Results

Post-TACTIC test score was significantly higher (p=0.001) than Pre-TACTIC test score in both groups. However, a comparison of mean Pre-TACTIC test scores and mean Post-TACTIC test scores between group A and group B showed that PAL effectiveness in group A was significantly higher (p=0.001) than group B.

Conclusion

There was a positive relationship between the PAL program and the improvement of chest tube insertion technical skills in surgical residents. Based on our findings and similar studies, it can be concluded that the PAL program can increase the chest tube insertion skill of surgical residents.

Assessing the utility and efficacy of e-OSCE among undergraduate medical students during the COVID-19 pandemic

BACKGROUND

The outbreak of coronavirus disease 2019 (COVID-19) and its quick progression to a global pandemic has urged medical schools to shift from didactic to distance learning and assessment approaches. The quality of clinical training and assessment have been jeopardized due to the regulatory restrictions and potential hazards to human lives. The aim of this paper is to evaluate the utility and efficacy of an electronic Objective Structured Clinical Examination (e-OSCE), which attempted to transform the format of a face-to-face OSCE to an e-OSCE.

METHODS

We conducted three end of clerkship e-OSCEs for final year medical students in Surgery, Medicine and Family Medicine using the teleconferencing application of Microsoft Teams (MST). The e-OSCE blueprint included the assessment of all clinical skills except physical examination and procedural skills. Examiners supervised e-OSCE from the college campus, while all students were remotely assessed through the MST channels. During the exam, the students stayed in their specified MST channel and examiners rotated across all students. The utility and efficacy of e-OSCE was evaluated using a self-administered questionnaire for students, examiners and e-OSCE team.

RESULTS

The data analysis showed that 93.4% students and 92.2% examiners agreed with the quality and process of e-OSCE. Similarly, 83.6% students and 98% examiners agreed with the seamless organization of e-OSCE. As many as 45.9% students and 74.5% examiners agreed that e-OSCE was close to real life practice. Approximately one fifth of students and one third of examiners preferred e-OSCE over the face-to-face OSCE. The analysis of qualitative data generated the themes of e-OSCE structure and technology. While majority of participants were satisfied with e-OSCE, students were concerned about examiners' training and e-OSCE contents. Examiners and e-OSCE team recognized the paper-less, tech-savy, fast and reliable format of e-OSCE.

CONCLUSION

During and beyond COVID- 19 era, e-OSCE is a strong substitute to standard OSCE for assessing clinical competence except for physical examination and procedural skills. The planning and implementation of e-OSCE reflects an ingenuity in the assessment of clinical competencies of medical students.

A meta-analysis of peer-assisted learning on examination performance in clinical knowledge and skills education

BACKGROUND

Peer-assisted learning is a method of active learning that is gaining traction throughout higher education. In the medical curriculum, peer-assisted learning has been the subject of independent studies collecting various types of data. However, an overall analysis of those studies providing objective measurements of the influence of peer-assisted learning could be particularly useful for teachers and students alike in a knowledge-heavy curriculum such as medicine. In this study we set out to analyse the efficacy of peer-assisted learning on medical students' learning of clinical knowledge and skills that is assessed through some objective examination, and thereby define whether such approaches have a reproducible benefit for inclusion in the medical curriculum.

METHODS

Databases including Pubmed, Embase and Science Direct were searched for relevant studies containing randomized controlled trials (RCTs) of peer-assisted learning published before July 29th ,2020. A meta-analysis was performed by using RevMan 5.3 software.

RESULTS

Thirteen studies involving 2,003 medical students were analyzed for clinical knowledge and skills gains that included some objective measurement of learning. The results of this meta-analysis indicated that considering all these studies together, peer-assisted learning leads to improvements in clinical knowledge and skills learning for medical students compared with traditional teacher-led passive learning. One study was found likely to be a source of significant heterogeneity, and when this was removed from the meta-analysis, the pooled effect was no longer statistically significant.

CONCLUSIONS

Peer-assisted learning can be an effective method of learning applied to medical student education. Active learning through peer-assisted learning should be seen as complementary to teacher-led approaches. Two of the individual studies on peer-assisted learning show a statistically significant benefit on examination performance compared to the other studies considered, that either show negligible benefits or at worst no detriment in learning. This highlights the need for more high-quality and focused randomized control trials to identify those critical parameters that lead to improved student learning using such approaches.

Peer-Assisted Learning (PAL): Perceptions and Wellness of First-Year Medical Students

INTRODUCTION

Medical education is oftentimes stressful and has been documented to compromise student well-being, hinder performance, and contribute to burnout. Many medical schools aim to foster students' sense of well-being. This can be accomplished by peer-assisted learning (PAL), which has the potential to improve student wellness and performance in medical school.

METHODS

The PAL program at Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine provides first-year medical students with educational sessions related to their curriculum, led by second-year medical students. The goal of this study was to determine the efficacy of PAL in promoting wellness and enhancing knowledge. Pre- and post-program surveys were distributed to students prior to and after the completion of PAL. Data analysis included frequencies of responses, qualitative analysis, and chi-square analysis.

RESULTS

Thirty-eight out of 51 first-year medical students responded to the pre-program survey (response rate 75%) and 23 out of 51 responded to the post-program survey (response rate 45%). A majority of respondents from the pre-survey believed that PAL would provide them with tools necessary to be successful. These findings were similar in the post-program survey with a majority of attendees sharing that PAL enhanced their knowledge, reduced test-taking anxiety, and provided useful skills.

DISCUSSION

Results from the pre- and post-program surveys suggest that PAL can enhance student well-being while improving knowledge of the material taught in medical school.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01381-0.

Teaching to learn: Using peer-assisted learning to complement the undergraduate dental curriculum

INTRODUCTION

Peer-assisted learning (PAL) is a method of teaching in which students teach their often less-experienced peers. Whilst they gain more knowledge, peer tutors are able to convey information at a level that tutees can engage with. Whilst the use of PAL has increased in popularity within the healthcare faculty, there are fewer reports of its efficacy within dental education. Our aim is to explore the advantages and disadvantages of PAL, identifying factors that make it effective within undergraduate dental teaching.

METHOD

3rd-year dental students enrolled in supplementary PAL sessions taught by 4th-year dental student volunteers alongside their curriculum on an Integrated Human Disease course. Tutees participating in more than one PAL session were invited to a focus group to discuss the value of PAL within teaching, as were their tutors. Semi-structured focus groups in which they reflected on their learning experience and satisfaction were recorded, transcribed and analysed thematically.

RESULTS

The qualitative data gathered from the focus groups for peer tutees (n = 4) and peer tutors (n = 5) revealed that the sessions stimulated learning, built confidence, developed skills out with the core topics and were complementary to the course.

CONCLUSION

Our study confirms that PAL enhances the learning experience and is mutually advantageous to both tutees and tutors. Whilst further training, a larger sample size and higher quality research are required to confirm the more general use of PAL, the promise shown in this study would suggest that PAL is an extremely useful method, complementing the undergraduate dental curriculum.

Simulation-Based Peer-Assisted Learning: Perceptions of Health Science Students

OBJECTIVE

Since 2010, simulation-based learning has become increasingly popular as a well-recognized method of learning used by medical undergraduates in clinical settings. However, the relatively new concept of simulation-based peer-assisted learning has not yet been widely accepted, so it has not been well documented. Therefore, this study evaluated the perceived advantages of simulation-based peer-assisted learning among health professions students and interns and their acceptance of this new concept of learning from a student-instructor.

METHODS

This was a pilot study conducted with 11 students in various health profession fields at Princess Nourah bint Abdulrahman University (PNU). The students were given a comprehensive lecture on simulation scenario development and were assigned to four separate interdisciplinary teams for a practical session on simulation scenario writing. Then, they each completed a questionnaire seeking their opinion concerning their experience and concept understanding.

RESULTS

The results confirmed the advantages of interprofessional simulation-based peer-assisted learning as it helped in understanding the process as perceived by the study participants. All students expressed their willingness and enthusiasm to use simulation as a technique for peer-assisted learning.

CONCLUSION

The study affirms the importance of developing student teachers' teaching skills at an institutional level. The future implementation of simulation-based peer-assisted learning is dependent on the students' awareness of the concept. By exploring a new dimension of medical education, the student teachers could expand their horizon of exposure to holistic case management and interactive learning and equip themselves with practical communication skills to excel in a real-world setting.

The Implementation of Peer-Reflection to Improve Retakers' Achievement in National Medical Students Examination

INTRODUCTION

Faculty of medicine plays a role to support the students' success in passing national exit exam through mentorship. Peer-reflection evaluates the students' learning process. We aimed to analyze the impact of peer-reflection to change the students' learning attitude and improve national exam score.

METHODS

Nine test-retaker students participated in mentorship program for three months. They took two parts of faculty-level examination. After the 1st and the 2nd part of faculty exam, there were peer-reflections I and II that argued about the characters, strengths and weaknesses, suggestions. Then, they did self-reflection to conduct responses about the mentorship including the impact of peers' input and finally took national exam. The examination score before and after peer-reflection were compared. We analyzed the statement of reflection by documents and content analysis. The progress of examination score was analyzed descriptively.

RESULTS

The students objectively understood the strengths and weaknesses of their way of learning, and then implemented the peers' advices. Peer-reflection method provided a feeling of same purpose, then developed ways of learning that promoted them to be higher motivated. Finally, 6 of 9 students passed the exam.

DISCUSSION

Suggestions given by peers would be memorable and powerfully changed motivation. Peer-reflection explored non-academic problems that determined the pattern and the way of how students learned.

Preparing junior radiology residents for overnight call via peer-led, hands-on simulation

PURPOSE

The aim of this study was to assess the perceived value and impact of a hands-on mock call simulation program on resident confidence with interpretation of emergency department overnight call cases.

METHODS

A five-session course was implemented in June of 2018 for rising PGY-3/R2 residents to mimic the experience of overnight call with indirect supervision. Sessions were led by senior residents in the program and consisted of timed, independent interpretation of 15-20 high-yield cases per day which highlighted "do-not miss" critical findings and simulated workflow interruptions including phone calls, consultations, and questions from technologists. IRB-approved, and anonymous pre- and post-course surveys were administered to participants which assessed residents' degree of confidence in interpretation of on-call cases and comparison of the mock call experience with existing preparatory strategies. Survey responses were analyzed using McNemar's test and Mann-Whitney U test.

RESULTS

Our survey response rate was 91% (29/32). After completing the mock call simulation, there was a significant increase in the mean Likert score of resident confidence levels and feelings of preparedness from 4.59 to 7.38 (p < 0.01). The majority of respondents (72.4% [21/29]) felt that the mock call simulation was "extremely useful." One hundred percent of respondents indicated that the mock call simulation should be implemented for the following year.

CONCLUSION

Implementation of a hands-on mock call simulation significantly improves the confidence levels of radiology residents before assuming on-call responsibilities and may serve as an adjunct to existing preparatory strategies.