Practice Report / Bericht aus der Praxis: An exploration of peer tutor roles and recruitment at German medical schools

Promoting medical competencies through a didactic tutor qualification programme - a qualitative study based on the CanMEDS Physician Competency Framework

BACKGROUND

In peer-led tutorial courses, qualified medical students ("tutors") provide their peers with opportunities to deepen their theoretical knowledge effectively and to practice clinical skills already in preclinical semesters. At the Medical Faculty of Heidelberg University, a structured medical didactic qualification programme prepares and trains future tutors for their responsibilities. This programme consists of four modules: 1. medical didactics and group leadership, 2. subject-specific training, 3. performance of tutorial courses as well as 4. collegial advice and reflection on the tutors' activities. The aim of this study is to systematically analyse and present the development of role competencies for medical tutors based on the CanMEDS Physician Competency Framework through the didactic qualification programme.

METHODS

We applied a qualitative research approach to detect CanMEDS role competencies acquisition within the tutor qualification programme. The CanMEDS framework describes key competencies, grouped thematically under seven professional roles. Two tutors and three training coordinators independently assigned the individual modules of the tutor qualification programme to the key competencies of the CanMEDS framework. Tutors and training coordinators compared and discussed the allocations within the groups in a consensus finding process. All authors analysed the findings in order to find out the so-called "hidden curriculum". The views of both groups are presented separately.

RESULTS

The training programme promotes the acquisition of competencies in all seven CanMEDS roles. The roles of the scholar and the leader are promoted in all modules. In addition, the first and fourth module focus predominately on the role of the collaborator, the second on the role of the medical expert and communicator, and the fourth on the role of the professional.

CONCLUSIONS

The systematic analysis through assignment of the CanMEDS roles to the individual modules of the tutor qualification programme documents the comprehensive acquisition of competencies, not only with regard to the tutor activity, but generally with regard to the later role of the physician. The reflection on one's own competency acquisition can support the promotion of corresponding competencies in the qualification programme and their transfer into the professional practice later.

Stress and stressors of medical student near-peer tutors during courses: a psychophysiological mixed methods study

BACKGROUND

Structured peer-led tutorial courses are widespread and indispensable teaching methods that relieve teaching staff and contribute to the development of students' competencies. Nevertheless, despite high general stress levels in medical students and associated increases in psychopathology, specific knowledge of peer tutors' additional burdens is very limited.

METHODS

Sixty student near-peer tutors from two structured peer-teaching programmes volunteered to participate. On multiple occasions in three different course sessions, we assessed tutors' subjective stress, affective state, heart rate variability, and salivary cortisol. Additionally, tutors named everyday and course-specific stressors, which were evaluated by means of content analyses.

RESULTS

The study participation rate was high (63% of all active tutors). The participating tutors are socially well adapted and resilient individuals. They report a variety of stressors such as time pressure, participant characteristics, teacher role demands, and study requirements, but nevertheless display only moderate psychological and physiological stress that decreases over sessions. Tutors' negative affect in sessions is low; their positive affect is consistently high for senior as well as novice tutors. Tutors rate their courses' quality as high and quickly recover after sessions.

CONCLUSIONS

Tutors successfully cope with teaching-associated and everyday life demands. The results corroborate the viability and success of current peer-teaching programmes from the tutors' perspective. This study is the first to comprehensively quantify tutors' stress and describe frequent stressors, thus contributing to the development of better peer teaching programmes and tutor qualification training.

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.