Learning through Teaching: Peer Teaching and Mentoring Experiences among Third-Year Medical Students

Unpacking the perceptions and experiences of student facilitators in interprofessional education: a qualitative study

Enhancing health professional students' effective learning and collaborative practice requires a deep understanding of strategies for facilitating interprofessional learning. While faculty members and clinical preceptors are recognized as facilitators in interprofessional education (IPE), there is limited knowledge about the impact of student facilitators' engagement in IPE. Accordingly, this study aims to explore the perceptions and experiences of student facilitators in IPE. Thirteen student facilitators were recruited to lead an interprofessional learning program, and they were subsequently invited to participate in one-on-one interviews. An interview guide was developed to explore their motivations, expectations, engagement, effectiveness, and achievements in IPE facilitation. Thematic analysis was conducted using MAXQDA software to analyze the student facilitators' experiences and perceptions. Eight interviewees from various disciplines, including Medicine, Nursing, Pharmacy, Speech and Hearing Sciences, and Social Work, took part in the study. The findings revealed that student facilitators highly valued their IPE facilitation experience, which aligned with their expectations and led to the creation of social networks, increased confidence, improved understanding of other professions, and the development of lifelong skills. Furthermore, the student facilitators demonstrated cognitive and social congruence by establishing a relaxed learning environment, displaying empathetic and supportive behaviors, and using inclusive language to engage IPE learners in group discussions. This study provides a comprehensive understanding of the role of student facilitators in IPE, contributing to the evolving literature on IPE. A conceptual framework was developed to explore the entire facilitation experience, encompassing the motivations and expectations of student facilitators, their engagement and effectiveness, and the observed achievements. These findings can inform the development of peer teaching training in IPE and stimulate further research in identifying relevant facilitator competencies for optimal delivery of IPE.

Optimal timing of faculty teaching when combined with near-peer teaching: A mixed methods analysis

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.

Near-Peer Paradigms in Medical School: Integrating Student Teaching Assistants Into a Core Radiology Clerkship

RATIONALE AND OBJECTIVES: Near-peer paradigms have been demonstrated effective in supporting how students navigate novel clinical environments. In this study, we describe an innovative model of incorporating teaching assistants (TAs) into a core radiology clerkship and investigate both its perceived educational value by clinical-year learners and its perceived impact on professional growth by TAs. MATERIALS AND METHODS: At one U.S. medical school, the core clinical year includes a clerkship in radiology incorporating both reading room exposure and a didactic curriculum. Radiology faculty deliver a variety of traditional and interactive, "dynamic" lectures, while medical student TAs deliver additional dynamic sessions, including a final TA-created review session. The educational value of each didactic session by clerkship students was assessed using a five-point scale survey, and the professional value of the experience by TAs was assessed using a five-point Likert survey. RESULTS: Spanning from 2020 to 2023, 268 (74.4%) clinical-year students submitted the post-clerkship survey, with the didactic review sessions created and led by TAs receiving the highest ratings of any didactic session. Of 16 former TAs, 12 (75%) completed the post-service survey, with all respondents agreeing or strongly agreeing that they enjoyed and would recommend their experience, and that it enhanced their interest in radiology and in academic medicine. CONCLUSION: Near-peer education in a core radiology clerkship enhances the experience of the learner through peer guidance and the experience of the teacher through professional development. These findings may increase student interest in pursuing academic radiology as a career and invite opportunities for broadening medical school education in radiology.

Mentoring as a complex adaptive system - a systematic scoping review of prevailing mentoring theories in medical education

BACKGROUND

Effective mentorship is an important component of medical education with benefits to all stakeholders. In recent years, conceptualization of mentorship has gone beyond the traditional dyadic experienced mentor-novice mentee relationship to include group and peer mentoring. Existing theories of mentorship do not recognize mentoring's personalized, evolving, goal-driven, and context-specific nature. Evidencing the limitations of traditional cause-and-effect concepts, the purpose of this review was to systematically search the literature to determine if mentoring can be viewed as a complex adaptive system (CAS).

METHODS

A systematic scoping review using Krishna's Systematic Evidence-Based Approach was employed to study medical student and resident accounts of mentoring and CAS in general internal medicine and related subspecialties in articles published between 1 January 2000 and 31 December 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles underwent thematic and content analysis, with the themes identified and combined to create domains, which framed the discussion.

RESULTS

Of 5,704 abstracts reviewed, 134 full-text articles were evaluated, and 216 articles were included. The domains described how mentoring relationships and mentoring approaches embody characteristics of CAS and that mentorship often behaves as a community of practice (CoP). Mentoring's CAS-like features are displayed through CoPs, with distinct boundaries, a spiral mentoring trajectory, and longitudinal mentoring support and assessment processes.

CONCLUSION

Recognizing mentorship as a CAS demands the rethinking of the design, support, assessment, and oversight of mentorship and the role of mentors. Further study is required to better assess the mentoring process and to provide optimal training and support to mentors.

Mechanisms of Near-Peer Learning in a Longitudinal Clerkship: A Grounded Theory Study

PURPOSE

Many medical schools incorporate longitudinal clerkships, which promote continuity and may offer early clinical exposure during the preclinical curriculum. However, the mechanisms of near-peer learning and how it contributes to the development of clinical skills in longitudinal clinical experiences are less clear. The authors explored how peer-to-peer interactions among medical students influenced their developmental trajectories from nascent clinicians to more seasoned practitioners capable of juggling dual roles of clinical care and clinical supervision within longitudinal clerkships.

METHOD

The Education-Centered Medical Home (ECMH) at Northwestern University Feinberg School of Medicine is a longitudinal clerkship that represents an ideal setting to explore peer learning. At ECMH, continuity is established across all 4 years of medical school among small groups of students from each year, a preceptor, and a panel of outpatients. The authors conducted 6 focus groups and 9 individual interviews between March 2021 and February 2023 with medical students from all years. Using constructivist grounded theory, the authors collected and analyzed data iteratively using constant comparison to identify themes and explore their relationships.

RESULTS

Within ECMH, peer relationships fostered an informal learning culture that enabled meaningful peer interactions while reinforcing the established culture. The authors identified 3 essential learning practices between senior and junior medical students: preparing for patient encounters, shifting roles dynamically during the joint encounter, and debriefing encounters afterward. These practices strengthened learning relationships and supported students' developmental trajectories.

CONCLUSIONS

Longitudinal peer learning relationships enabled meaningful peer interaction that influenced medical students' clinical development and capability for clinical supervision. Mutual trust, familiarity, and continuity facilitate targeted feedback practices and growth at the edge of junior students' capabilities. Optimizing this peer learning environment and seeking new opportunities to use longitudinal peer learning in clinical environments could promote psychological safety and professional identity formation for medical students.

Twelve tips for peer teaching by a medical education student society

University societies are student-led organisations which provide excellent opportunities for students to collaborate in a shared interest. Peer teaching is gaining recognition as an effective method of medical education. Peer teaching also provides student tutors with core educational skills and provides students with approachable peer mentors. This article offers practical guidance on organising, planning, executing and sustaining peer teaching via a medical education society at university and outlines the supporting literature.

The Student Grand Round: A Peer Teaching Initiative

Introduction Oral presentation and public speaking skills are poorly emphasised in the medical school curriculum. The student grand round was created to tackle this deficiency by changing the way in which students are taught, from traditional lecture-based learning to interactive small-group peer-to-peer teaching. This approach encourages students to become responsible for their own learning, develop their public speaking and teaching skills, as well as identify and address gaps in their knowledge. Aims The primary aims of this study were to determine the understanding of students before and after peer teaching, including retention of concepts via quiz scores and confidence of students in giving SBAR (Situation, Background, Assessment, Recommendation) handovers. The secondary aim is to determine the place of student-led grand round teaching in the medical curriculum as a means of developing teaching skills and encouraging active learning. Methods A cohort of 21 third-year medical students from Leicester University attended a weekly peer teaching programme where students presented a case they had encountered during their clinical attachment. Peer teachers were required to research some background and pathophysiology regarding the topic and teach in an interactive manner and create discussion regarding the topic. The students then summarised the case and practised the skill of concise handovers using the SBAR format. Knowledge and understanding were assessed with an interactive quiz, and feedback via a survey was gathered before and after sessions. Each student engaged in case discussion and received input from a specialty registrar regarding their presentation skills, case knowledge, and SBAR handover. Results Individual and combined session analysis demonstrated a significant improvement in scores across understanding the topic and confidence in SBAR. Student recommendation for the session cumulatively was significant (p=0.02); however, comparison of medical student recommendations of individual sessions did not yield statistically significant results. There was a significant improvement in the overall quiz score (p=0.045), and average scores improved from 51% to 70% (p=0.043). There was a significant increase in the mean quiz result after the first two sessions (28-55% (p=0.002) and 56-85% (p=0.0001), respectively). Summary The student grand round is a promising teaching initiative that capitalises on peer teaching, a valuable learning theory that centres around students taking on the role of teachers to instruct their peers. Results from this study have shown that this method of collaborative teaching is effective in improving the understanding of medical topics, increases confidence in public speaking and precise handover skills, and therefore better prepares medical students for their career as future clinicians.

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.

Describing Ultrasound Skills Teaching by Near-Peer and Faculty Tutors Using Cognitive Apprenticeship

Phenomenon: Ultrasound skills are becoming increasingly important in clinical practice but are resource-intensive to teach. Near-peer tutors often alleviate faculty teaching burden, but little is known about what teaching methods near-peer and faculty tutors use. Using the lens of cognitive apprenticeship, this study describes how much time faculty and near-peer tutors spend on different teaching methods during abdominal ultrasound skills training. Approach: Sixteen near-peer and 16 faculty tutors were videotaped during one 55-min practical ultrasound lesson with randomly assigned students. Videos were directly coded using Cognitive Apprenticeship teaching methods and activities. Segment durations were summed up and compared quantitatively. Findings: All 32 tutors spent most of the time on observing and helping students (Coaching, Median 29:14 minutes), followed by asking open and stimulating questions (Articulation, 12:04 minutes and demonstrating and giving explanations (Modeling, 04:50 minutes). Overall, distributions of teaching methods used were similar between faculty and near-peer tutors. However, faculty tutors spent more time on helping students manually, whereas near-peer tutors spent more time on exploring students' learning gaps and establishing a safe learning climate. Cognitive Apprenticeship was well suited as observational framework to describe ultrasound skills. Insights: Ultrasound train-the-tutor programs should particularly focus on coaching and articulation. Near-peers' similar use of teaching methods adds to the evidence that supports the use of near-peer teaching in ultrasound skills education.

Motivations and Experiences of Teaching Assistants in a First-Year Integrated Medical Course

Peer teaching is used in many medical schools and is recognized as beneficial to the student teacher and learner. We surveyed a cohort of teaching assistants (TAs) in a first-year course to determine their motivations to serve as TAs and the perceived benefits. TAs served because they wanted to help, solidify their knowledge, and have an opportunity to teach. They perceived that their experience helped them develop their communication skills and encouraged them to pursue future teaching opportunities. This information will help in recruiting students into teaching and also in developing a standardized student-as-teacher program to foster the next generation of physician educators.

Assessing the Merits and Effectiveness of Peer Teaching in Small Groups through the Employment of Different Learning Media

Background  Peer teaching is a well-acknowledged method to facilitate teaching and learning among medical students. The objective of the study was to assess the merits and effectiveness of peer teaching in small groups using a student-centered approach through the employment of different learning media. Methods  This was a cross-sectional descriptive study conducted among a group of 34 students from third professional year. Purposive sampling was used, wherein students were subdivided into five small groups. At the beginning, a pretest consisting of 10 multiple-choice questions was conducted on the topic "Epidemiology of Hypertension." This topic was further subdivided into five subtopics, and five separate learning media (viz., video, PowerPoint, white board, chalk-and-talk, and chart) were allocated using the lottery method. Each group discussed the allotted topic and then presented their findings in the large group using the assigned learning media, while other groups gave feedback, and the best group was decided through multivoting. Posttest was administered and the results were compared with the pretest. Data entry was done in Microsoft Excel and analysis was done using SPSS 16. Descriptive statistics and paired t -test was used to compare the results in pretest and posttest at p level < 0.05. Results  This innovative session of peer teaching featured 34 students, with a mean age of 22 ± 1.3 years. While carrying out the Kirkpatrick Level 1 evaluation, almost 90% students liked the role of the facilitator in stimulating interest in the topic. There was a mean average increase of 1.7 marks on comparing the scores of posttest with pretest (Kirkpatrick Level 2), and the reported difference was statistically significant. Joyful learning 24 (66.7%) and group discussion 23 (63.9%) emerged as the most liked aspects of the session. Conclusion  In conclusion, peer teaching through learning media is an effective method as it promotes active learning, improves communication skills, and improves the academic performance of students. Peer teaching using different learning media proved to be quite effective in improvement of knowledge about epidemiology of hypertension, the pros and cons of different learning media, and encouraged creativity among students.

Peer-Assisted Learning in a Longitudinal Hybrid Physical Exam Course

Peer-assisted learning (PAL) improves teaching skills and self-confidence for instructors and creates a supportive learning climate for learners. We developed a PAL hybrid teaching structure for our physical exam course by partnering upper-level peer instructors with faculty co-instructors and evaluated its impact on upper-level student peer instructors and first-year student learners using quantitative and qualitative methods. The PAL component of the hybrid teaching structure was perceived to have important benefits for all and salient limitations for student learners. The hybrid nature of the course provided a unique vantage point for evaluation of PAL and we theorize that faculty co-instructors may balance some of the perceived limitations of PAL.