Student-teacher education programme (STEP) by step: transforming medical students into competent, confident teachers

How to run successful tutor-training programs for radiographers: A systematic review and considerations for future perspectives

INTRODUCTION

Healthcare professions differ from each other, therefore need different approaches in teaching clinical practices. While teaching and learning designs for medical students are widely present on databases, few information is available for radiographers. The aim of this research is to define tools and knowledge needed to develop successful tutor-training programs that can be cross-cutting and inter-disciplinary for radiography profession, taking inspiration from other healthcare professions' programs since the paucity of evidence for radiographers.

METHODS

A systematic review (PubMed/Embase) was performed according to the PRISMA checklist. Original articles on learning environment related to healthcare practitioners were included. Inclusion criteria comprehended articles covering design and frameworks of peer-assisted-learning (PAL) programs and training-the-trainer (TTT) curricula, skills required to become tutors, tips to install successful tutor-training programs along with benefits for tutors involved. From 1618 retrieved articles, after two selection rounds, 15 articles met the inclusion criteria.

RESULTS

Out of the 15 articles, none is addressed to radiographers and only 7 % (1/15) to other healthcare professions, opposed to the 93 % (14/15) addressed to medical students. All articles discuss feedback providing, 66 % (10/15) debates which the best behaviour to maintain towards students is to maximize learning, and 46 % (7/15) inform about the importance of briefing and de-briefing activities. An identical percentage (46 %, 7/15) underlines the advantages of tutoring experiences. 11 articles (73 %) enhance that tutors aren't adequately trained to carry out tutoring activities.

DISCUSSION

Through curricula designed on TTT and PAL programs, radiographers are provided with necessary teachings and frameworks to set up effective training paths. Few institutes promote educational tutor-training courses, even though these are beneficial both for tutors and students, consolidating professionals' knowledge and maximizing students' practical skills.

CONCLUSION

Offering tutor-training curricula contributes to the development of radiographers as teachers, providing them with guiding principles to improve their formative skills towards future colleagues, therefore optimizing efficacy and effectiveness of programs.

Five Recommendations to Foster a Love of Teaching

How can educators foster a passion for teaching in a health sciences student who has never considered education as a career? The author recounts 5 experiences that were instrumental in shaping his own career as an educator. These experiences illustrate principles which may be used to encourage students to consider careers in education. Principles discussed include exposure to teaching opportunities while students are still studying the health sciences, recognition of students showing promise as teachers, role models, mentorship, and appropriate compensation for those in education careers.

Reflective Teaching Journals as an Effective Embedded Formative Assessment Process of Teaching Skill Development Confidence in a Longitudinal Medical Student-as-Teacher Elective

Background

This study focuses on the use of reflective teaching journals by fourth year US allopathic medical school students (MS4) during a longitudinal medical student-as-teacher (SaT) elective, and how MS4s self-assess their perceptions around teacher skill development and individual transitions into resident educators who teach junior learners.

Method

Between September 2020 and December 2020, twelve MS4s in a longitudinal SaT elective completed 21 hours in a clinical bedside student teaching placement with embedded structured reflective teaching journals. Sixty-nine individual reflective teaching journal entries were collected in two distinct stages and analyzed using a phenomenographical lens.

Conclusion

From these data, the author established three thematic categories where reflective teaching journals reveal (a) a framework for pedagogical skill building, (b) provided a sense-making tool to navigate the psychosocial environment, and (c) a framework for educator identity formation. Structured reflective teaching journals with educator feedback support self-reflection and awareness of growth through the SaT elective. Health professions educators can leverage the reflective teaching journal as a formative assessment process to help learners identify transitions and grapple with educator identity confidence and the formation of new teacher skill development to further advance the field of future health professions education.

How can peer teaching influence the development of medical students? a descriptive, longitudinal interview study

BACKGROUND

Peer-assisted learning (PAL) - where students take up a teaching role at an early stage of their training-is widely used in medical curricula. Many qualitative studies have investigated the perceptions and benefits of PAL, but no studies have longitudinally explored how peer teachers experienced their development. This could allow for a better understanding of PAL. In this study, we explored the perceived impact of being a peer teacher on the development of personal and professional competencies as a medical student.

METHODS

We longitudinally conducted semi-structured interviews with peer teachers, during their 2-year teaching period in the skills lab at the University of Antwerp and applied descriptive thematic analysis.

RESULTS

In total we gathered 47 interviews in 13 peer teachers (9 female, 4 male,. 1-7 interviews each). Peer teachers reported an increase in self-confidence, which gradually transformed into self-efficacy in clinical and teaching skills., Participants told us to be inspired by the previous generation of peer teachers. Their motivation shifted from personal benefits to benefiting others while becoming a role model themselves. The peer teachers illustrated how they developed maturity by integrating different CanMEDS roles. They grew in reflection, changed/transformed an initial mark-driven study drive into more patient-centered ambitions, and started developing a personal style.

CONCLUSIONS

Our study suggests that being a peer teacher leads to more self-efficacy, in clinical and teaching skills, to become a role model with as motivation to benefit others and to grow towards a good doctor maturity. Although the task is to teach peers, this opportunity nurtures the practice and integration of various CanMEDS roles, not only that of scholar but also communicator, collaborator and leader, thereby positively influencing their personal and professional development and their identity as a doctor (professional role).

A Primer for Developing Chalk Talks

Chalk talks are a ubiquitous teaching strategy in both pulmonary, critical care, and sleep medicine and medicine in general; yet, trainees and early career faculty are rarely taught how to design, prepare, and present a chalk talk. Skills necessary to deliver a chalk talk are transferable to other settings, such as the bedside, wards during rounds, and virtual classrooms. As a teaching strategy, the chalk talk can involve learners at multiple levels, foster practical knowledge, stimulate self-assessment, encourage the generation of broad differential diagnoses, and promote an interactive learning environment. Suited for both formal and informal learning, the chalk talk can be prepared well in advance or, after some practice, can be presented "on the fly." Furthermore, often on the wards or in the intensive care unit, team members are asked to "teach the rest of the team" at some point during rounds. There is little guidance in medical education for students and trainees to prepare for how to do this, and the chalk talk can serve as an excellent format and teaching strategy to "teach the team" when tasked to do so. To highlight our perspectives on best practices in using the chalk talk format effectively, we first briefly review the literature surrounding this very common yet understudied teaching strategy. We then provide a primer on how to design, develop, and deliver a chalk talk as a resource for how we teach residents, fellows, and early career attendings to deliver their own chalk talks.

Developing Clinician-Educators: a Qualitative Analysis of Structured Reflections from Participatory Teaching in the Final Year in an Integrated Medical School Program

Objective

This study aimed to describe fourth-year medical students' experiences, recorded and tracked in structured reflective teaching logs (RTLs), as participants in a year-long longitudinal medical student-as-teacher elective.

Methods

Thirteen (13) participants from two medical student-as-teacher elective cohorts completed 20 contact hours of self-selected teaching. Participants chose three different learning environments spanning the first 3 years of the medical school curriculum. Reflections were entered into an online spreadsheet with guided prompts (RTL). Open-ended text in the RTLs was analyzed using an inductive qualitative research approach. Open coding was applied across all meaningful segments of text, identifying themes that were validated internally with three co-authors and one methodology expert without formal program involvement.

Results

Narratives revealed detailed descriptions and reflections of participant experiences. Analysis revealed eight themes: (1) Joy of Teaching; (2) Teaching Effectiveness; (3) Feedback; (4) Effective Patient-Physician Communication; (5) Assessment; (6) Differential Diagnosis Development; (7) Standardized Case Development; and (8) Training for Teaching in Residency.

Conclusion

Fourth-year medical student participants in a longitudinal medical student-as-teacher elective effectively used RTLs from participatory teaching to help facilitate their own development as clinician-educators. Themes identified in RTLs reflect students' awareness of teaching skill requirements and readiness for the next workplace, residency. Informed by situativity theory, formal teaching opportunities in authentic learning environments bestow students with critical formative teaching experience and awareness of the roles as clinician-educators during their undergraduate years.

Teaching Medical Students How to Teach: A Scoping Review

PHENOMENON

Teaching medical students how to teach is a growing and essential focus of medical education, which has given rise to student teaching programs. Educating medical students on how to teach can improve their own learning and lay the foundation for a professional identity rooted in teaching. Still, medical student-as-teacher (MSAT) programs face numerous obstacles including time constraints, prioritizing curriculum, and determining effective evaluation techniques. The purpose of this scoping review is to map the current landscape of the literature on medical school initiatives designed to train students to teach to describe why medical student teaching programs are started; the benefits and barriers; who teaches them; what content is taught; and how content is delivered. With this new map, the authors aimed to facilitate the growth of new programs and provide a shared knowledge of practices derived from existing programs.

APPROACH

The authors conducted a scoping review, guided by Arksey and O'Malley's framework, to map the literature of MSAT training programs. Six databases were searched using combinations of keywords and controlled vocabulary terms. Data were charted in duplicate using a collaboratively designed data charting tool. This review builds on the Marton et al. review and includes articles published from 2014 to 2020.

FINDINGS

Of the 1,644 manuscripts identified, the full-text of 57 were reviewed, and ultimately 27 were included. Articles included empirical research, synthetic reviews, opinion pieces, and a descriptive study. Analysis focused on modalities for teaching medical students how to teach; content to teach medical students about teaching; benefits and barriers to starting teaching programs; and the value of teaching programs for medical students.

INSIGHTS

The rapid growth of MSAT programs suggests that this curricular offering is of great interest to the field. Literature shows an increase in evaluative efforts among programs, benefits for students beyond learning to teach, and evidence of effective engagement in medical students' designing and implementing programs.

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.

Exploring Student Experiences of an Undergraduate Certificate in Veterinary Medical Education

The ability to teach is recognized as a core skill for many professionals, including veterinarians, but undergraduate opportunities to develop this skill are not always available. A complementary teaching certificate offered during the clinical years of an undergraduate veterinary program was evaluated to investigate student experiences of the program and the perceived benefits and challenges of participating. The study used a mixed methods approach with questionnaires to provide an overview of the participant experience and semi-structured interviews to gain a deeper insight into students' experiences of the program. Two cohorts completed questionnaires comprising Likert-style and open-ended questions on the 3-year teaching certificate, the first cohort after 1 year of the program and the second cohort at completion. Interviews with participants from both cohorts were thematically analyzed to identify recurring themes. An average of 27% of students per academic year enrolled in the certificate program, most of whom completed it. Additionally, four to six students per cohort applied for Associate Fellow of the Higher Education Academy (AFHEA), and 19 students have achieved this recognition. Key themes from the data included that students felt the certificate built their confidence, increased their veterinary knowledge, and helped them become better teachers, with time management and reflection the biggest challenges. The Undergraduate Certificate of Veterinary Medical Education was seen as a good teaching foundation, while working toward the AFHEA provided some insight into higher education and academic careers. A structured teaching program offers students the opportunity to develop their learning and reflection both as students and future educators.

Evaluation of Teachers' Innovation and Entrepreneurship Ability in Universities Based on Artificial Neural Networks

Based on iceberg theory and the questionnaire of competency’s elements, hierarchical index system of evaluation of teachers' innovation and entrepreneurship competency in universities is established. Through researches, we think that analytic hierarchy process(AHP) is a more scientific and reasonable evaluation method whose rationality is checked by satisfactory consistency while the evaluation model of artificial neutral network doesn’t consider weighting. If the samples are more than 30, the evaluation of neural network model of teachers' innovation and entrepreneurship competency can achieve the accurate results and satisfactory requirements. Since the method of artificial neutral network has advantages of strong operability, simple rules and minor errors, it can greatly reduce the workload because it not only eliminates human subjectivity of evaluation and greatly simplifies the process of evaluation, but also improves working efficiency and provides a new way of thinking for evaluation of the teachers' innovation and entrepreneurship competency in universities

'Educator with a capital E': Comparing medical education experiences of student-as-teacher elective participants and peers

PURPOSE

Student-as-teacher electives are increasingly offered at medical schools, but little is known about how medical education experiences among enrolled students compare with those of their peers. The study's aim was to characterize medical students' education-related experiences, attitudes, knowledge, and skills based on their enrollment status in a student-as-teacher course.

MATERIALS/METHODS

We conducted four focus groups at a medical school in the United States: two with graduating students in a student-as-teacher elective (n = 11) and two with unenrolled peers (n = 11). Transcripts were analyzed using the Framework Method to identify themes.

RESULTS

Four themes emerged: interest in and attitudes towards medical education; medical education skills, knowledge, and frameworks; strategies for giving/receiving feedback; medical education training as part of medical school. Course participants demonstrated higher-level education-related knowledge and skills. Both groups endorsed teaching skills as important and identified opportunities to incorporate medical education training into medical school curricula.

CONCLUSIONS

Medical education knowledge and teaching skills are self-reported as important learning outcomes for medical students, independent of enrollment status in a student-as-teacher course. The structure of such courses, best understood through a deliberate practice-based model, supports students' achievement of key learning outcomes. Certain course elements may warrant inclusion in standard medical school curricula.

The 3-D Skills Model: a Randomised Controlled Pilot Study Comparing a Novel 1-1 Near-Peer Teaching Model to a Formative OSCE with Self-regulated Practice

INTRODUCTION

Near-peer teaching is a popular pedagogical teaching tool, with well-recognised benefits for students and tutors. There are multiple existing models to structure these interventions, but it is often unclear how they translate to academic attainment. We designed a novel near-peer teaching model that expands on previous research.

METHODS

Our model was piloted in a formative Objective Structured Clinical Examination (OSCE) setting, trialled on 22 pre-clinical medical students to establish feasibility, acceptability and descriptive outcomes that could inform the design of a larger study. Students were randomly assigned to intervention or control cohorts. Each cohort undertook 5 min formative OSCE assessments with either 3 additional minutes of structured teaching or 3 min of self-regulated practice before reattempting the first OSCE station. Checklist marking sheets for 1^st and 2^nd sittings were collected by independent external markers, in addition to a global assessment rating in which we used the Borderline Regression Method to establish the station pass mark.

RESULTS

A quantitative and qualitative result analysis was performed, demonstrating that students gained on average 3 additional marks after teaching with this model. Students and student-tutors reported increased confidence, high course satisfaction and evidence of reflective practice.

DISCUSSION

We established acceptability and feasibility outcomes. The descriptive outcomes will support the design of a larger, adequately powered study required to demonstrate translation to summative exam performance.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01369-w.

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.

Evaluating Effectiveness of Faculty and Near-Peer Delivered Teaching and Communication Skills Training

Medical students who are given opportunities to teach and communicate complex information in an understandable manner will be more effective in educating patients in the future. We provided faculty and near-peer training to medical student facilitators of a community outreach program for middle school students to assess which type of training resulted in better teaching preparedness and confidence. Near-peer-trained students were more confident in their teaching compared to faculty trained counterparts; therefore, there may be some added benefit to peer-delivered/faculty-supervised training for community outreach programs.

Curriculum Design and Scholarship for New Educators: A Professional Development Workshop for Medical Students

INTRODUCTION

Medical students' professional development includes their role as educators. Despite greater opportunities to join medical education curriculum development, medical students' engagement in these activities remains limited. A recent national study on student leadership in curricular change revealed a formal lack of leadership and training in medical education as significant barriers. Medical students' unawareness of how to disseminate curricula as educational scholarship and its value to their careers also restricts the fullness of their formation as educators.

METHODS

We designed a 3-hour, interactive, project-focused conference workshop for medical students without prior knowledge in curriculum development. Of participants, 64 worked in 10 groups creating medical curricula using Kern's six-step approach in student-facilitated breakout sessions. Completed group projects were presented, including brief action plans for transforming their work into scholarship. The workshop was evaluated using a mixed-methods approach.

RESULTS

Of survey respondents, 44 mostly medical students, faculty, and administrators from different institutions rated the workshop as a very positive experience, and the pacing of the breakout groups as effective. A notable increase in self-reported mastery, as measured by learning objectives aligned with Kern's six-step model, was recorded from student respondents as compared to faculty. A sense of readiness to participate in curricular decisions either at the home institution or in individual career paths was evident from narrative comments.

DISCUSSION

Our workshop provided medical students with a foundation in curriculum development and educational scholarship. Session design provided flexibility in the pace of breakout sessions and allowed in-depth discussion of educational topics.

Medical students as simulation educators: students’ experience of a 7-week simulation-based education rotation

Medical students will have future roles as clinician educators, and need to develop knowledge and skills for that role. Specific skills in simulation-based education (SBE) may be valuable in many educational settings. We aimed to understand the impact of a 7-week placement in SBE on the development of medical students’ knowledge, skills and perspectives as educators. We reviewed the experience of three graduated students (also coauthors of this article) who participated in the rotation in 2018. This case study includes analysis of the students’ electronic portfolios, rotation reports and subsequent reflections of the student coauthors. Five themes were identified:—‘Development as a professional’, ‘Active participation in an educator team’, ‘Diverse experience in simulation skills and techniques’, ‘Role models and mentoring’ and ‘Rethinking feedback’. Students describe the development of practical knowledge and skills, and more fundamental reflections on the nature of learning, feedback and their personal professional development. We suggest that integration of a simulation education elective within a medical school curriculum helps build capacity for effective SBE delivery, and has positive impacts on students for their future roles as doctors, educators and lifelong learners.

Perception of medical students about courses based on peer-assisted learning in five Peruvian universities

Objectives

Peer-assisted learning (PAL) is a supportive strategy in medical education. In Peru, this method has been implemented by few universities. However, there are no consistent studies evaluating their acceptability by medical students. The objective of this study was to evaluate the perception of medical students about PAL in five Peruvian universities.

Results

A total of 79 medical students were included in the study. The mean age was 20.1 ± 1.9 years, 54% were female, and 87% were in the first 4 years of study. Most of the students were satisfied with classes and peer teachers. Similarly, most of the students agreed with the interest in developing teaching skills. It was also observed that 97% of students approved to implement PAL in medical education programs.

Teaching, reflecting, and learning: The value of an intercalated medical education programme

Objectives: Teaching programmes within medicine focus primarily on pathways of a shorter length with little regard to teaching lasting longer than a month. This study is different from other studies as it examines the benefits of a nine month-long medical education degree programme and its impact beyond graduation. This study set out to explore the impact of a medical education intercalated degree programme for its graduates and their careers.Methods: A small scale, exploratory qualitative case study was conducted with 10 graduates of an intercalated degree programme.Results: The findings highlight the longer term value of an intercalated degree programme with particular emphasis on academic and personal skills; research and teaching skills; independence and confidence; its impact on future practice and the notion that 'student as teacher' programmes are a valuable asset to medical education as a whole. Participants advocated more teaching opportunities as a core longitudinal teaching component in preparation for the teaching responsibilities in their working lives.Conclusions: The programme enables the development of a range of academic and personal skills, with particular emphasis on research and teaching skills, independence and confidence.

Peer teacher training for health professional students: a systematic review of formal programs

BACKGROUND

Skills in peer teaching, assessment and feedback are documented internationally as required graduate attributes for health professional students, placing emphasis on universities to prepare health professional graduates with teaching skills. The aim of this systematic review was to determine the rational, design, content and evaluation of student peer teacher training skills programs across the health professions.

METHODS

In October 2017, a search was conducted of five databases (Pubmed, Embase, CINAHL, ERIC and Cochrane Collection) using combinations of key search terms: 'Student as teacher', 'near-peer teaching', 'student teacher', 'peer teacher', 'peer-to-peer', 'undergraduate', 'medical education', 'curriculum', 'program', 'training', 'allied health', 'health science', 'pharmacy', 'nurse', and 'medicine', with results restricted to articles published in English within the decade. Articles were excluded if they were not original research, focused on a teaching approach other than peer assisted learning or teaching, did not adequately describe a student teacher training component of at least 3 hrs duration, or addressed only clinical skills training and not teaching skills training.

RESULTS

The two authors independently assessed 42 full-text articles for eligibility, with 19 articles satisfying criteria for inclusion. Dominating results were uni-disciplinary, faculty-led, non-mandated programs, targeting participants in senior years of training. Medicine was the dominant profession, with an obvious underrepresentation of the other health professions. Common program content included the foundations of education theory, teaching methods and techniques, and providing feedback. Summary and comparison of program design is restricted by gaps and inconsistencies in reporting, while the evaluation of programs remains largely subjective.

CONCLUSIONS

Teaching is increasingly recognised as a core professional skill across the health workforce, with expectations to teach peers and colleagues, within and across professional disciplines, as well as to educate patients. Students, faculty and institutes may benefit from training programs being designed for implementation in any health profession; and further to this, implemented within an interprofessionally context. Consistent reporting of teacher training programs, and objective methods of evaluation would enable more in-depth investigation.

Improving near-peer teaching quality in anatomy by educating teaching assistants: An example from Sweden

Peer-assisted learning has gained momentum in a variety of disciplines, including medical education. In Gothenburg, Sweden, medical students who have finished their compulsory anatomy courses have the option of working as teaching assistants (TAs). Teaching assistants provide small group teaching sessions as a complement to lectures given by faculty. Previously, TAs were left to handle the role as junior teachers by themselves, but since 2011, a continuation course in anatomy has been developed with the aim of providing the TAs better anatomy knowledge and guidance for teaching. The course was designed to comprise 7.5 ECTS credits (equivalent to 5 weeks of full-time studies), and today all TAs are required to take this course before undertaking their own teaching responsibilities. This study aims to compare course evaluations of TA teaching before and after the introduction of the anatomy continuation course, in order to understand how students perceived teaching performed by self-learned versus trained TAs. The results of this study demonstrate that there was a trend towards better teaching performed by trained TAs. The variability in rankings decreased significantly after the introduction of the continuation course. This was mainly due to an improvement among the TAs with the lowest levels of performance. In addition to comparing student rankings, TAs were interviewed regarding their experiences and perceptions within the continuation course. The course was generally positively regarded. The TAs described a sense of cohesion and appreciation since the institute invested in a course dedicated specifically for them. Anat Sci Educ 11: 403-409. © 2018 American Association of Anatomists.

Medical students can teach communication skills - a mixed methods study of cross-year peer tutoring

BACKGROUND

Cross-year peer tutoring (CYPT) of medical students is recognized as an effective learning tool. The aim of this study is to investigate the non-inferiority of the objective outcome of medical interview training with CYPT compared with the results of faculty-led training (FLT), and to explore qualitatively the educational benefits of CYPT.

METHODS

We conducted a convergent mixed methods study including a randomized controlled non-inferiority trial and two focus groups. For the CYPT group, teaching was led by six student tutors from year 5. In the FLT group, students were taught by six physicians. Focus groups for student learners (four tutees) and student teachers (six tutors) were conducted following the training session.

RESULTS

One hundred sixteen students agreed to participate. The OSCE scores of the CYPT group and FLT group were 91.4 and 91.2, respectively. The difference in the mean score was 0.2 with a 95% CI of -1.8 to 2.2 within the predetermined non-inferiority margin of 3.0. By analyzing the focus groups, we extracted 13 subordinate concepts and formed three categories including 'Benefits of CYPT', 'Reflections of tutees and tutors' and 'Comparison with faculty', which affected the interactions among tutees, tutors, and faculty.

CONCLUSIONS

CYPT is effective for teaching communication skills to medical students and for enhancing reflective learning among both tutors and tutees.

Peer teaching as a means of enhancing communication skills in anaesthesia training: trainee perspectives

PURPOSE

The purpose of this study is to introduce peer teaching of communication skills to first-year anaesthesia trainees in Ireland and to evaluate their perception of this teaching modality.

METHODS

Seventy-nine first-year anaesthesia trainees participated in a novel peer-led communication skills programme over a 2-year period (Y1, Y2). A Likert scaling questionnaire was developed to explore trainee perception of the peer teaching programme.

RESULTS

Of the 79 respondents (36 in Y1 and 43 in Y2), 99% either agreed or strongly agreed that the peer teachers were successful in their role. Ninety-two percent requested formal peer teaching in other areas of training. The trainees regarded a peer teacher as an appropriate information provider (92%), role model (88%), planner (88%) and facilitator (94%), but less so as an assessor (70%). The most consistently stated strength of peer teaching was the relatability of peer teachers with their lack of experience cited as the main weakness. Eighty percent of participants preferred peer teaching to regular expert teaching.

CONCLUSION

This study highlights the positive attitudes of first-year anaesthesia trainees towards a novel peer teaching programme in communication skills. This author recommends that peer teaching is further developed within postgraduate medical programmes to maximise learning for trainees in the student and teacher roles and to redistribute the teaching burden within clinical departments.

How are we assessing near-peer teaching in undergraduate health professional education? A systematic review

BACKGROUND

Near Peer teaching (NPT) is reported as an effective pedagogical approach to student learning and performance. Studies in medicine, nursing and health sciences have relied mainly on self-reports to describe its benefits, focusing on psychomotor and cognitive aspects of learning. Despite increasing research reports on peer teaching internationally, little is known about the various domains of learning used in assessment of performance and objective learning outcomes of NPT.

OBJECTIVE

To determine the domains of learning and assessment outcomes used in NPT in undergraduate health professional education.

METHODS

Quantitative systematic review was conducted in accord with the PRISMA protocol and the Joanna Briggs Institute processes. A wide literature search was conducted for the period 1990-November 2015 of fourteen databases. Grey literature was undertaken from all key research articles. Studies meeting the inclusion criteria were eligible for consideration, including measured learning outcomes of near-peer teaching in undergraduate education in nursing, medicine and health sciences. Set limitations included publications after 1990 (2015 inclusive), English language and objective learning outcomes. A quality appraisal process involving two independent reviewers was used to analyse the data.

RESULTS

Of 212 selected articles, 26 were included in the review. Terminology was confusing and found to be a barrier to the review process. Although some studies demonstrated effective learning outcomes resulting from near-peer teaching, others were inconclusive. Studies focused on cognitive and psychomotor abilities of learners with none assessing metacognition, affective behaviours or learning outcomes from quality of understanding.

CONCLUSION

The studies reviewed focused on cognitive and psychomotor abilities of learners. Even though evidence clearly indicates that metacognition and affective behaviours have direct influence on learning and performance, indicating more research around this topic is warranted. Methodological quality of the studies and lack of theoretical frameworks underpinned by educational psychology may have contributed to inconsistencies in learning outcomes reported.

MedTalks: developing teaching abilities and experience in undergraduate medical students

OBJECTIVES

According to the CanMEDS' Scholar competency, physicians are expected to facilitate the learning of colleagues, patients and other health professionals. However, most medical students are not provided with formal opportunities to gain teaching experience with objective feedback.

METHODS

To address this, the University's Medical Education Interest Group (MEIG) created a pilot teaching program in January 2015 entitled 'MedTalks'. Four 3-hour sessions were held at the University Faculty of Medicine, where first and second year medical students taught clinically oriented topics to undergraduate university students. Each extracurricular session included three 30-minute content lectures, and a 90-minute small group session on physical examination skills. Each medical student-teacher received formal feedback from undergraduate students and from faculty educators regarding teaching style, communication abilities, and professionalism. In addition, medical student-teachers self-evaluated their own teaching experience.

RESULTS

Over 50 medical students from the University participated as medical student-teachers. Based on quantitative and qualitative evaluation surveys, 100% of medical students agreed that MedTalks was a useful way to develop teaching skills and 92% gained a greater confidence in individual teaching capabilities, based largely on the opportunity to gain experience (with feedback) in teaching roles.

CONCLUSIONS

A program designed to give medical students multi-source teaching experience (lecture- and small group-based) and feedback on their teaching (from learners and Faculty observers, in addition to their own self-reflection) can improve medical student confidence and enthusiasm towards teaching. Future studies will clarify if medical student self-perceived enhancements in teaching ability can be corroborated by independent (Faculty, learner) observations of future teaching activity.

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.

One-Year Progress in Ophthalmic Education: Annual Review

PURPOSE

The aim of this study was to update the practicing ophthalmologist on the English language literature about medical education from the prior year.

DESIGN

A search of English language literature was performed on PubMed from January 1, 2014, to December 31, 2014.

METHODS

Because the search using the main topic of the review "medical education" came up with 7394 citations, authors finally decided to narrow the search to 3 topics of their interest:1. Current state of competency-based education and teaching methods of competencies. This section included ophthalmic/ophthalmology education, core competencies, competency-based education, teaching strategies, tools and methods in medical education.2. E-learning. This section included e-learning, online learning, online teaching, Web-based teaching, Web-based learning, and flipped classroom.3.

ASSESSMENTS

This section included assessment of medical students, residents, fellows, faculty, attending physicians, and medical teachers, assessment of medical student ophthalmology programs, ophthalmology residency programs, residency programs, and fellowship programs.

RESULTS

The authors reviewed and summarized articles published in 2014 examining or describing the 3 main areas of the review described previously.

CONCLUSIONS

This review updates the comprehensive ophthalmologist on advances in ophthalmic medical education. Ophthalmic educators could apply the ideas presented in this review according to their possibilities in their own settings and programs.

Development of a competency-based formative progress test with student-generated MCQs: Results from a multi-centre pilot study

INTRODUCTION

Progress tests provide students feedback on their level of proficiency over the course of their medical studies. Peer-assisted learning and competency-based education have become increasingly important in medical education. Although progress tests have been proven to be useful as a longitudinal feedback instrument, there are currently no progress tests that have been created in cooperation with students or that focus on competency in medical education. In this study, we investigated the extent to which students can be included in the development of a progress test and demonstrated that aspects of knowledge related to competency can be represented on a competency-based progress test.

METHODS

A two-dimensional blueprint for 144 multiple-choice questions (MCQs) covering groups of medical subjects and groups of competency areas was generated by three expert groups for developing the competency-based progress test. A total of 31 students from seven medical schools in Germany actively participated in this exercise. After completing an intensive and comprehensive training programme, the students generated and reviewed the test questions for the competency-based progress test using a separate platform of the ItemManagementSystem (IMS). This test was administered as a formative test to 469 students in a pilot study in November 2013 at eight medical schools in Germany. The scores were analysed for the overall test and differentiated according to the subject groups and competency areas.

RESULTS

A pool of more than 200 MCQs was compiled by the students for pilot use, of which 118 student-generated MCQs were used in the progress test. University instructors supplemented this pool with 26 MCQs, which primarily addressed the area of scientific skills. The post-review showed that student-generated MCQs were of high quality with regard to test statistic criteria and content. Overall, the progress test displayed a very high reliability. When the academic years were compared, the progress test mapped out over the course of study not only by the overall test but also in terms of the subject groups and competency areas.

OUTLOOK

Further development in cooperation with students will be continued. Focus will be on compiling additional questions and test formats that can represent competency at a higher skill level, such as key feature questions, situational judgement test questions and OSCE. In addition, the feedback formats will be successively expanded. The intention is also to offer the formative competency-based progress test online.

Unveiling Cancer

This article narrates a multifaceted educational journey undertaken by a medical student through a weekly SCRAPS (surgery, clinical disciplines, radiology, anatomy, psychiatry and laboratory sciences) clinico-pathological meeting held in the College of Medicine & Health Sciences at Sultan Qaboos University in Muscat, Oman. Through a presentation titled 'Unveiling Cancer', the multidisciplinary and interprofessional audience witnessed a simulated interaction between a medical student, a technologist peer and tutors in medicine, pathology and radiology. The presentation was based on the complexities of presentation, diagnosis and management of a patient with anaplastic large cell lymphoma, a rare type of non-Hodgkin lymphoma, in the aftermath of a bone marrow transplantation. After describing the case, the student shared with the audience a spectrum of learning objectives, which included integration in the complex world of contemporary medicine, insight into the triumphs and travails of technology (immunohistochemistry) and peer collaboration, communication and mentorship.