Can near-peer medical students effectively teach a new curriculum in physical examination?

Wolfgang A Blank, Hannes Blankenfeld, Roger Vogelmann, Klaus Linde, Antonius Schneider, Wolfgang A Blank, Hannes Blankenfeld, Roger Vogelmann, Klaus Linde, Antonius Schneider

Abstract

Background: Students in German medical schools frequently complain that the subject 'clinical examination' is not taught in a satisfying manner due to time constraints and lack of personnel resources. While the effectiveness and efficiency of practice-oriented teaching in small groups using near-peer teaching has been shown, it is rarely used in German medical schools. We investigated whether adding a new near-peer teaching course developed with student input plus patient examination under supervision in small groups improves basic clinical examination skills in third year medical students compared to a traditional clinical examination course alone.

Methods: Third year medical students registered for the mandatory curricular clinical examination course at the medical faculty of the Technische Universität München were invited to participate in a randomised trial with blinded outcome assessment. Students were randomised to the control group participating in the established curricular physical examination course or to the intervention group, which received additional near-peer teaching for the same content. The learning success was verified by a voluntary objective structured clinical examination (OSCE).

Results: A total of 84 students were randomised and 53 (63%) participated in the final OSCE. Students in the control group scored a median of 57% (25th percentile 47%, 75th percentile 61%) of the maximum possible total points of the OSCE compared to 77% (73%, 80%; p < 0.001) for students in the intervention group. Only two students in the intervention group received a lower score than the best student in the control group.

Conclusion: Adding a near-peer teaching course to the routine course significantly improved the clinical examination skills of medical students in an efficient manner in the context of a resource-constrained setting.

Figures

Figure 1
Figure 1
Trial flow chart.
Figure 2
Figure 2
Percentage of points scored in the five subjects of the OSCE and in total. Bold lines represent medians, boxes the interquartile ranges, the upper and the lower whiskers the 2.5th and the 97.5th percentile (circles and asterisks are outliers).
Figure 3
Figure 3
Percentage of participants receiving a given grade in the OSCE.

References

    1. Hofer M, Schiebel B, Hartwig HG, Garten A, Modder U. Innovative course concept for small group teaching in clinical methods. Results of a longitudinal, 2-cohort study in the setting of the medical didactic pilot project in Dusseldorf. Dtsch Med Wochenschr. 2000;125(23):717–723. doi: 10.1055/s-2007-1024468.
    1. Busari JO, Prince KJ, Scherpbier AJ, Van Der Vleuten CP, Essed GG. How residents perceive their teaching role in the clinical setting: a qualitative study. Med Teach. 2002;24(1):57–61. doi: 10.1080/00034980120103496.
    1. Konig S, Markus PM, Becker H. Teaching and learning in surgery-The Gottingen curriculum. Chirurg. 2001;72(5):613–620. doi: 10.1007/s001040170146.
    1. Tolsgaard MG, Gustafsson A, Rasmussen MB, Hoiby P, Muller CG, Ringsted C. Student teachers can be as good as associate professors in teaching clinical skills. Med Teach. 2007;29(6):553–557. doi: 10.1080/01421590701682550.
    1. Ten Cate O. A teaching rotation and a student teaching qualification for senior medical students. Med Teach. 2007;29(6):566–571. doi: 10.1080/01421590701468729.
    1. Ten Cate O, Durning S. Peer teaching in medical education: twelve reasons to move from theory to practice. Med Teach. 2007;29(6):591–599. doi: 10.1080/01421590701606799.
    1. Lawry GV 2nd, Schuldt SS, Kreiter CD, Densen P, Albanese MA. Teaching a screening musculoskeletal examination: a randomized, controlled trial of different instructional methods. Acad Med. 1999;74(2):199–201. doi: 10.1097/00001888-199902000-00020.
    1. Nikendei C, Andreesen S, Hoffmann K, Junger J. Cross-year peer tutoring on internal medicine wards: effects on self-assessed clinical competencies-a group control design study. Med Teach. 2009;31(2):e32–e35. doi: 10.1080/01421590802464452.
    1. Burke J, Fayaz S, Graham K, Matthew R, Field M. Peer-assisted learning in the acquisition of clinical skills: a supplementary approach to musculoskeletal system training. Med Teach. 2007;29(6):577–582. doi: 10.1080/01421590701469867.
    1. Rashid MS, Sobowale O, Gore D. A near-peer teaching program designed, developed and delivered exclusively by recent medical graduates for final year medical students sitting the final objective structured clinical examination (OSCE) BMC Med Educ. 2011;11:11. doi: 10.1186/1472-6920-11-11.
    1. Ten Cate O, Durning S. Dimensions and psychology of peer teaching in medical education. Med Teach. 2007;29(6):546–552. doi: 10.1080/01421590701583816.
    1. Ramani S. Twelve tips for excellent physical examination teaching. Med Teach. 2008;30(9–10):851–856.
    1. Harden RM, Stevenson M, Downie WW, Wilson GM. Assessment of clinical competence using objective structured examination. BMJ. 1975;1(5955):447–451. doi: 10.1136/bmj.1.5955.447.
    1. Pasquale SJ, Cukor J. Collaboration of junior students and residents in a teacher course for senior medical students. Med Teach. 2007;29(6):572–576. doi: 10.1080/01421590701468737.
    1. Dandavino M, Snell L, Wiseman J. Why medical students should learn how to teach. Med Teach. 2007;29(6):558–565. doi: 10.1080/01421590701477449.
    1. Bulte C, Betts A, Garner K, Durning S. Student teaching: views of student near-peer teachers and learners. Med Teach. 2007;29(6):583–590. doi: 10.1080/01421590701583824.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner