Evaluation of the peer teaching program at the University Children´s Hospital Essen - a single center experience

Near-Peer Teaching in Conjunction with Flipped Classroom to Teach First-Year Medical Students Basic Surgical Skills

BACKGROUND

There is increasing evidence that students are completing medical school with insufficient surgical education. Near-peer tutoring and flipped classroom formatting may be used to enhance learning while simultaneously relieving faculty burden of teaching. Here, we qualitatively evaluate a 3-month course that integrates the use of near-peer teaching and flipped classroom formatting, with the goal of increasing first-year medical students' self-perceived confidence in performing basic sutures and knot-ties as well as interest in surgery.

METHODS

Twenty-one first-year medical students participated in a suturing and knot-tying course led by senior medical students. The course consisted of 2-h sessions held every 2 weeks for a total of five sessions. Students were sent publicly available videos prior to each session by which to learn the upcoming techniques and received live feedback from instructors during sessions. Questionnaires were completed pre-course and post-course.

RESULTS

Compared to pre-course ratings, post-course ratings of self-perceived confidence to perform various knot-ties and sutures all increased significantly (p < 0.05). All students stated that the course strengthened their desire to pursue a career in surgery. Student feedback of the course was overall positive.

CONCLUSIONS

Near-peer teaching can be used in conjunction with flipped classroom to increase first-year medical students' self-perceived confidence in surgical suturing and knot-tying as well as interest in surgery. This curriculum may serve as an outline for student-led courses at other institutions.

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.

Near-Peer Tutor: A Solution For Quality Medical Education in Faculty Constraint Setting

Near-peer mentoring is a formal relationship in which more qualified students guide immediate junior students. It is an innovative approach to increase students' engagement from varied backgrounds and cultures in the health profession. This systematic review and meta-analysis aimed to investigate and compare the effectiveness of near-peer tutoring and faculty/expert teaching in health science undergraduates on knowledge and skill outcome. The review question considered was "how effective is near-peer tutor compare to faculty/expert teaching for undergraduate health science students?" A comprehensive systematic search was undertaken in PubMed, Embase, Scopus, and Cochrane and screened initially in Rayyan software (Qatar Computing Research Institute, Qatar). Identified articles were screened independently for eligibility by two reviewers and extracted the data. Data were analyzed using standardized mean difference with Review manager version 5.5 (Cochrane Campbell Collaboration).  Sixteen studies were analyzed. Heterogeneity (I2) among studies was high in knowledge and skill scores. Heterogeneity was reduced by 30-40% after sensitivity analysis. No difference in knowledge and skill score was found among the near-peer and expert teaching groups. Students had a satisfactory learning experience with near-peer tutors except for some issues related to teaching proficiency in near-peers. Near-peer teaching was found to be as effective as faculty/expert teaching. Students were more comfortable with near-peers. As mentioned by students, some challenges were differences in teaching skills and level of knowledge among near-peers.

Peer teaching beyond the formal medical curriculum

Peer-assisted learning (PAL) is nowadays commonly implemented in medical education. Mostly PAL is utilized to specifically support teaching within one subject or a specific curricular situation. Here, we present a large-scale peer teaching program that aims to address the individual student's learning needs. In addition, it provides a platform for students to participate in academic teaching. A retrospective data analysis was performed to reveal the program's development and acceptance. The program was implemented in 2008/09 with three tutorials conducted by 24 student tutors to support students preparing for reexaminations. Since then, the program has continuously grown. In 2015/16, 140 tutors conducted 52 tutorials, consisting of 2,750 lessons for 1,938 tutees. New tutorial categories were continuously introduced. In 2015/16, these encompassed tutorials that were held concomitantly to the formal curriculum, tutorials that exceeded the contents of the formal curriculum, tutorials for preparation for the state examination, and electives. Evaluations among the tutees revealed that 93.5% of the respondents rated the courses overall as "good" or "excellent" ( n = 13,489) in 2015/16. All elements of the peer teaching program are managed by one academic group. This encompasses the organization of tutorials, the quality management, and the qualification of tutors, including content-related supervision and didactic training. We conclude that the implementation of a large-scale peer teaching program can complement the formal curriculum. This might be beneficial for both tutors who can actively train their didactic and content-related competencies, and tutees who can autonomously consolidate and expand their knowledge.

An integrated 2-year clinical skills peer tutoring scheme in a UK-based medical school: perceptions of tutees and peer tutors

BACKGROUND

Several benefits of peer tutoring in medical school teaching have been described. However, there is a lack of research on the perceptions of peer tutoring, particularly from tutees who partake in a long-term clinical skills scheme integrated into the medical school curriculum. This study evaluates the opinions of preclinical tutees at the end of a 2-year peer-tutored clinical skills program and peer tutors themselves.

METHODS

A cross-sectional study was conducted in a UK-based medical school that primarily utilizes peer tutoring for clinical skills teaching. A questionnaire was designed to assess the views of preclinical tutees and peer tutors. Likert scales were used to grade responses and comment boxes to collect qualitative data.

RESULTS

Sixty-five questionnaires were collected (52 tutees, 13 peer tutors). Seventy-nine percent of students felt satisfied with their teaching, and 70% felt adequately prepared for clinical placements. Furthermore, 79% believed that peer tutoring is the most effective method for clinical skills teaching. When compared to faculty teaching, tutees preferred being taught by peer tutors (63%), felt more confident (73%), and were more willing to engage (77%). All peer tutors felt that teaching made them more confident in their Objective Structured Clinical Examination performance, and 91% agreed that being a tutor made them consider pursuing teaching in the future. Thematic analysis of qualitative data identified 3 themes regarding peer tutoring: a more comfortable environment (69%), a more personalized teaching approach (34%), and variation in content taught (14%).

CONCLUSION

Preclinical tutees prefer being taught clinical skills by peer tutors compared to faculty, with the peer tutors also benefitting. Studies such as this, looking at long-term schemes, further validate peer tutoring and may encourage more medical schools to adopt this method as an effective way of clinical skills teaching.

Evaluation of a combined approach of clinical skills training utilizing near-peers, in-campus faculty and clinicians: An innovative integrated model

INTRODUCTION

Training clinical skills is essential in medicine. Different models of clinical skills courses have been previously suggested. Here, we report an innovative approach adopted to train junior medical students in clinical skills in a multimodal fashion by near-peers, basic scientists with clinical background and senior clinicians.

METHODS

This quasi-experimental study was conducted at Alfaisal University College of Medicine at Riyadh. An electronic survey was conducted among year-2 and year-3 medical students seeking their perception about the (a) organization, (b) delivery, (c&d) self- and peer-assessment in clinical skills courses. Total 298 male and female medical students (91%), consisting of 164 from year 2 and 134 from year 3, participated by filling out a questionnaire (Cronbach's alpha 0.93).

RESULTS

Out of maximum five, the average ratings for the course were 3.81, 3.72, 3.67 and 3.73 in organization, delivery, self-evaluation and peer-assessment respectively, with no significant difference between both subgroups. The in-campus sessions rated higher than hospital sessions (p < 0.001). As tutors, interns were rated higher than clinicians (p < 0.001). The qualitative analysis suggested high satisfaction.

CONCLUSIONS

The clinical skills course that was conducted in a multimodal fashion utilizing diverse tutors showed a positive attitude of students toward the organization and delivery of the course.

Introducing a curricular program culminating in a certificate for training peer tutors in medical education

AIM

Student tutorials are now firmly anchored in medical education. However, to date there have only been isolated efforts to establish structured teacher training for peer tutors in medicine. To close this gap, a centralized tutor training program for students, culminating in an academic certificate, was implemented at Heidelberg University Medical School. The program also counts within the scope of the post-graduate Baden-Württemberg Certificate in Academic Teaching (Baden-Württemberg Zertifikat für Hochschuldidaktik).

METHOD

Based on a needs assessment, a modular program comprised of four modules and a total of 200 curricular units was developed in cooperation with the Department for Key Competencies and Higher Education at Heidelberg University and implemented during the 2010 summer semester. This program covers not only topic-specific training sessions, but also independent teaching and an integrated evaluation of the learning process that is communicated to the graduates in the form of structured feedback. In addition, to evaluate the overall concept, semi-structured interviews (N=18) were conducted with the program graduates.

RESULTS

To date, 495 tutors have been trained in the basic module on teaching medicine, which is rated with a mean overall grade of 1.7 (SW: 0.6) and has served as Module I of the program since 2010. A total of 17% (N=83) of these tutors have gone on to enroll in the subsequent training modules of the program; 27 of them (m=12, f=15) have already successfully completed them. Based on qualitative analyses, it is evident that the training program certificate and its applicability toward the advanced teacher training for university instructors pose a major incentive for the graduates. For successful program realization, central coordination, extensive coordination within the medical school, and the evaluation of the attained skills have proven to be of particular importance.

CONCLUSION

The training program contributes sustainably to both quality assurance and professionalism, as well as to solving the issue of resources in medical education. The introduction and continued development of similar programs is desirable.