Peer instruction improves comprehension and transfer of physiological concepts: a randomized comparison with self-explanation

Learning with and from peers.

IntroductionPeer-assisted study sessions (P.A.S.S.) are medical student–facilitated small-group sessions that aim to improve students’ knowledge and performance in preclinical courses. Peer teaching has been shown to have a positive impact on academic performance of both learners and peer teachers. For peer teaching to be more effective, there is a need for training of peer teachers. We developed a facilitator training workshop to help to improve medical students’ confidence in serving as P.A.S.S. facilitators.MethodsParticipants were first-year medical students who were approved to become P.A.S.S. facilitators. We recruited facilitators to attend a training workshop and provided them with a training manual to use during the training session and as a resource after the session. We recruited five standardized students to participate in an objective standardized teaching exercise (OSTE). We asked facilitators to complete pre/post surveys before and after the workshop to indicate their level of confidence in facilitating the sessions and provide feedback on the workshop.ResultsNine P.A.S.S. facilitators participated in the training session. Analysis of pre- and postworkshop survey data showed a statistically significant increase in student confidence (p ≤ .02).DiscussionDeveloping and implementing a formalized P.A.S.S. facilitator training manual and workshop with an OSTE helped improve students’ confidence in facilitating an organized, effective, and interactive peer teaching session. Students’ positive feedback on the OSTE suggests that OSTEs can be useful tools to help peer teachers learn skills to cope with challenging situations with students.

In order to manage the demands of university studies, research suggests that university students should possess efficient self-regulated learning (SRL) skills. The use of mobile learning is believed to enhance SRL skills. Yet, despite the potential benefits of mobile learning, many first-year students encounter challenges in using mobile devices to foster self-regulated learning skills. It is against this backdrop that this study aimed to examine how first-year medical students utilisee mobile learning to foster self-regulated learning. This study employed a Explanatory Sequential Study Design , combining both quantitative and qualitative data. It used the interpretativist and pragmatic paradigms to understand how students perceive and use mobile devices for self-regulated learning. The interpretivist paradigm focused on understanding students’ perspectives, while the pragmatic paradigm aimed to identify effective ways of using mobile devices to promote self-regulated learning. Participants to this study were first-year medical students. The mixed-methods approach aimed to provide a comprehensive understanding of the research problem by collecting data through various methods. Questionnaires gathered quantitative data, while participatory observation, reflective workshops, and focus group discussions provided qualitative data. The theoretical frameworks that guide the study include the Unified Theory of Acceptance and Use of Technology model (UTAUT) (Venkatesh et al., 2003) and Vygotsky's (1978) socio-cultural theory (SCT). The study findings revealed that mobile devices were used by first year medical students to manage and control their learning, both inside and outside the classroom. Notably, significant improvements were observed in cognitive learning strategies, metacognitive self-regulation strategies and resource management learning strategies, including time management. Additionally, the study found that first-year medical students had a positive perception of mobile learning. Furthermore, mobile devices were generally perceived as enablers of self-regulated learning (SRL), providing flexibility, convenience, and access to diverse learning resources. However, distractions and interruptions posed challenges to focus and attention. To mitigate these challenges, strategies such as device management and setting boundaries were suggested. Moreover, first-year medical students expressed the need for support in developing SRL through mobile learning. Guidance in selecting effective mobile applications, opportunities for collaborative learning, and technological skill training were identified as essential forms of support. The study thus recommends integrating mobile learning into curricula to enhance self-regulated learning skills in higher education students, especially among first-year students. Higher education institutions should establish deliberate policies and initiatives for mobile learning programs, especially for first-year students. Educators should offer guidance and training on using mobile learning tools effectively, including information searching skill. However, students should be cautious about distractions from the use of mobile devices.

Background Teaching is a vital skill for future doctors. Peer-assisted learning (PAL), where students teach others early in their training, is widely integrated into medical curricula. This study evaluated the impact of PAL on peer teachers' academic performance and their personal and professional development, as well as its long-term effects. Methods A retrospective cohort study assessed the effect of PAL on academic scores. Additionally, a modified Delphi survey with peer teachers and faculty members evaluated PAL outcomes. We conducted longitudinal semi-structured interviews with 13 peer teachers during their 2-year teaching period. Eleven former peer teachers were interviewed after completing the program to explore long-term impacts. Realist thematic analysis was used to identify recurring themes. Results Of 311 medical students across three cohorts, 78 participated in PAL. Although peer teachers demonstrated higher academic performance, this was partly due to self-selection by better-performing students. Beyond grades, PAL had clear benefits for participants' development in several CanMEDS roles: medical expert, collaborator, scholar, and professional. A total of 47 interviews were conducted with 13 peer teachers (9 female, 4 male), allowing us to track their evolving motivations. Initially driven by personal goals, participants developed a stronger focus on helping others. They developed self-efficacy in clinical and teaching skills, became role models, and developed a professional identity by integrating various CanMEDS roles. Former peer teachers reflected positively on their experience, identifying it as a catalyst for pursuing teaching in their medical careers. They highlighted how PAL helped them mature, facilitated their transition into internships, and strengthened their personal and professional growth. Conclusion PAL offers medical students more opportunities to practice clinical skills while providing significant additional benefits for student-teachers. Through PAL, peer teachers are challenged to grow holistically as medical students, integrating diverse CanMEDS roles and forming a robust professional identity. Interviews with current and former peer teachers revealed how PAL enhanced their maturity, eased their transition into clinical practice, and encouraged teaching as part of their careers. Given the benefits observed, we advocate for widespread implementation of PAL in medical schools, ensuring every student has the opportunity to experience its positive impact. PAL not only fosters skill development but also nurtures future doctors who are enthusiastic about teaching the next generation.

Innovative training approaches are needed to address the lack of capacity in primary care for undergraduate medical student clinical placements. Near peer teaching (NPT) by general practice specialty trainees (GPSTs) is one possible solution. To compare the attainment of intended learning outcomes (ILOs) for students taught by GPSTs and qualified GPs. Quantitative pilot study of medical students undertaking clinical training in general practice at the University of Nottingham. Year 3 GPSTs were trained to supervise first-year graduate-entry medical students undertaking 6 half-day GP visits (2022-2023). Using Likert-scale post-training questionnaires, self-reported attainment of ILOs was compared for supervision provided to students by GPSTs and GPs. Secondary outcomes included student, GPST, and GP views about NPT. Of 112 medical students, seven were supervised by GPSTs and 105 by GPs. In total, 101 students responded (seven [100%] from GPST supervision; 94 [90%] from GP supervision). There was no significant difference between groups in attainment of seven ILOs with significantly greater attainment for students supervised by GPSTs for receiving feedback (P = 0.018) and self-reflection (P = 0.015). GPSTs reported improved organisation, communication, feedback skills, and desire for future student supervision. Medical students and GPs reported enthusiasm for future NPT by GPSTs. Attainment of ILOs during undergraduate GP placements was at least equivalent when students were supervised by GPSTs compared with GPs. GPSTs are an important group for building supervisory capacity for undergraduate education and this study adds confidence in enabling GPST supervision of undergraduates.

Introduction: Medical students have long provided informal, structured academic support for their peers in parallel with the institution’s formal curriculum, demonstrating a high degree of motivation and engagement for peer teaching. This qualitative descriptive study aimed to examine the perspectives of participants in a pilot peer teaching programme on the effectiveness and feasibility of adapting existing student-initiated peer bedside teaching into formal bedside teaching. Methods: Study participants were senior medical students who were already providing self-initiated peer-led bedside clinical teaching, clinicians who co-taught bedside clinical skills teaching sessions with the peer teachers and junior students allocated to the bedside teaching sessions led by peer teachers. Qualitative data were gathered via evaluation form, peer teacher and clinician interviews, as well as the observational field notes made by the research assistant who attended the teaching sessions as an independent observer. Additionally, a single Likert-scale question on the evaluation form was used to rate teaching effectiveness. Results: All three peer teachers, three clinicians and 12 students completed the interviews and/or questionnaires. The main themes identified were teaching effectiveness, teaching competency and feasibility. Teaching effectiveness related to the creation of a positive learning environment and a tailored approach. Teaching competency reflected confidence or doubts about peer-teaching, and feasibility subthemes comprised barriers and facilitators. Conclusion: Students perceived peer teaching effectiveness to be comparable to clinicians’ teaching. Clinical peer teaching in the formal curriculum may be most feasible in a hybrid curriculum that includes both peer teaching and clinician-led teaching with structured training and coordinated timetabling. Keywords: Peer Teaching, Undergraduate Medical Education, Bedside Teaching, Medical Students

Drawing upon Bloom’s taxonomy of educational objectives as a theoretical framework, this study examines attitudes toward communication skills training, knowledge of appropriate provider-patient communication, and confidence communicating with patients between first-year and fourth-year medical students at a large medical school in the southern United States. The study findings indicate that fourth-year medical students do not differ from first-year medical students in terms of attitudes towards communication skills training or knowledge of appropriate provider-patient communication, but they have significantly higher confidence scores about communicating with patients. In addition, positive attitudes towards communication skills training are significantly related to perceived importance of communication skills and confidence when communicating with patients. Finally, female medical students have more positive attitudes towards communication skills training than male medical students. The implications of the study findings and directions for future research are also discussed.

The primary objectives of this study were to implement a novel near-peer-facilitated case-based medical ethics curriculum intended for the audience of a large cohort of first-year medical students (n = 193) and to objectively evaluate the immediate efficacy of the curriculum based on pre- and post-session survey responses to ethical quandaries. Two near-peer-facilitated medical ethics case discussion sessions were included in the first-year curriculum during the 2017-2018 academic year. The sessions were designed and led by second-year medical student facilitators under the direction of a faculty mentor and were presented as a year-long curricular thread. First-year students were asked to complete pre- and post-session surveys with ethical questions relevant to each case and session. Students were additionally asked to measure the contribution of discussion sessions to their development as a future physician. Post-session survey results showed that students had a better understanding of specific ethical issues immediately following discussion sessions (p<0.0001). Over three-quarters of students indicated that the near-peer-led medical ethics case discussions contributed somewhat or very much to their development as a future physician. Anecdotal feedback from second-year medical students also suggested that their involvement as facilitators was beneficial to their educational development. Near-peer-facilitated case discussions were an effective strategy for teaching medical ethics to first-year medical students with demonstrated objective improvements in ethical decision-making. Additionally, near-peer discussions of ethical cases and principles with first-year medical students aided in subjective measures of professional development.

Introduction As a medical student's first encounter with human anatomy, cadaveric dissection facilitates a comprehensive, three-dimensional (3D) understanding of the human body. We believe that this interaction is vital for future clinicians' ability to interpret medical imaging, specifically when the anatomy may be viewed in different planes, such as in Magnetic Resonance Imaging (MRI). In this study, we evaluated how learning anatomy through cadaveric vs. virtual dissection software programs affected medical students' ability to interpret medical imaging, as well as the impact it had on student satisfaction with their anatomical education. Methods Twenty first year medical students and 8 senior-level pre-medical students were recruited for this study, each of them having no prior experience with cadaveric dissection. The first year medical students learned anatomy via virtual dissection software, while the pre-medical students performed in-person dissections. After both groups completed the musculoskeletal system in their respective program, each student was given a 16-question agree/neutral/disagree survey with questions regarding their confidence and satisfaction with their anatomical education, as well as questions about respecting human dignity and empathizing with future patients. Following the survey, each student was asked to complete a 30-question open-answer assessment which asked them to identify various musculoskeletal structures on MRI scans. Both cohorts received identical assessments and were given the same time restrictions. Two months later, each student was asked to complete a second, identical 30-question assessment in order to evaluate anatomical knowledge retention. Results The pre-medical students who were enrolled in a human anatomy dissection course scored higher than the first year medical students learning anatomy virtually on both assessments in this study. The pre-medical students had average scores of 43.3% (SD 9.4) and 41.7% (SD 10.8) for the initial and 2-month assessments, respectively. The first-year medical students had average scores of 37.5% (SD 12.6) and 32.2% (SD 13.4) for the initial and 2-month assessments, respectively. Additionally, the survey results demonstrated that the majority of first-year medical students (90%) felt that the virtual software was inadequate compared to in-person dissection. The survey also revealed that those who participated in cadaveric dissection developed more respect for the dignity of human beings and empathy for future patients (87.5% and 100%, respectively) compared to those who did not (25% and 5%, respectively). Conclusion This study demonstrates that cadaveric dissection provides several benefits to future physicians. In-person dissection facilitates a deeper understanding of the anatomy, and provides a 3D awareness of the human body that enables future physicians to comprehend anatomy on multiple planes. Additionally, this study demonstrates that cadaveric dissection not only improves student satisfaction, but it develops intangible characteristics in future physicians such as respect and empathy for human beings.

Peer instruction has been used extensively in lecture courses; however, there is little evidence of its use in laboratory courses. The purpose of the present study was to describe the implementation of the peer instruction method in a physiology laboratory course in China. Second-year medical students attended a 6-wk physiology laboratory course in the fall semester of the 2016-2017 school year. In the six new physiology laboratory classes, peer instruction strategies were used to substitute for the traditional short, didactic lectures. The effects of peer instruction were measured by in-class quizzes and confidence levels. The students' evaluations of peer instruction were measured by a Likert scale questionnaire. Peer instruction significantly improved the mean score on quizzes (0.53 ± 0.50 vs. 0.68 ± 0.47, P < 0.001) and confidence levels (2.36 ± 0.66 vs. 2.80 ± 0.45, P < 0.001). Furthermore, for individual incorrect answers, 39.07% changed to correct answers after peer instruction, whereas, for correct answers, 6.61% were changed to an incorrect response. Overall, significantly more students changed their answers from incorrect to correct than from correct to incorrect [χ2: 333.11; degrees of freedom (df): 1; P < 0.001]. Therefore, the positive effects of peer instruction were higher than the negative effects (χ2: 244.55; df: 1; P < 0.001). Moreover, student evaluations of peer instruction were highly positive. In conclusion, the implementation of peer instruction to the physiology laboratory course is an effective strategy to enhance students' performance on in-class quizzes and confidence levels. In addition, the attitude of students toward peer instruction was favorable.

To evaluate the knowledge of basic life support (BLS) among students and health providers in Medicine, Pharmacy, Dentistry, and Allied Health Science Colleges at Qassim University. A cross sectional study was performed using an online BLS survey that was completed by 139 individuals. Ninety-three responders were medical students, 7 were medical interns, 6 were dental students, 7 were pharmacy students, 11 were medical science students and 15 were clinical practitioners. No responder scored 100% on the BLS survey. Only two out of the 139 responders (1.4%) scored 90-99%. Both of these individuals were fifth year medical students. Six responders (4.3%) scored 80-89%. Of these, 5 were fifth year medical students, and one was fourth-year medical student. Eleven responders (7.9%) scored 70-79%. Of these, eight were fifth year medical students, two were medical interns and one was a pharmacist. Twenty-three responders (16.5%) scored 60-69%. Of these, 11 were fifth year medical students, 1 was a fourth-year medical student, 3 were medical interns, 2 were medical science students, 1 was a dentistry student, and 5 were pharmacists. Twenty-eight responders (20.1%) scored 50-59%. Of these, 11 were fifth year medical students, 3 were fourth-year medical students, 1 was a third-year medical student, 1 was a second-year medical student, 2 were first-year medical students, 1 was a pharmacy student, 3 were dental students, 1 was a allied health science student, 2 were doctors, and 3 were pharmacists. The remaining 69 responders (49.6%) scored less than 50%. Knowledge of BLS among medicine, pharmacy, dentistry, and allied health science students and health providers at Qassim University is poor and needs to be improved. We suggest that inclusion of a BLS course in the undergraduate curriculum with regular reassessment would increase awareness and application of this valuable life-saving skill set.

The role of ultrasound and preparation in first-year medical students' learning lumbar spine anatomy and diagnostic skills

This research study sought to determine the formats (print or electronic) of articles and book chapters most-preferred by first-year medical students, third-year medical students entering clinical clerkships, and incoming residents and to determine if these preferences change during the course of the medical curriculum. These trends will enable academic health sciences libraries to make appropriate collection development decisions to best cater to their user populations. First-year medical students, third-year medical students, and incoming medical residents were asked to complete a paper survey from September 2014 to June 2015. The survey consisted of five multiple-choice questions, with two questions given space for optional short answers. Quantitative and qualitative responses were collected and calculated using Microsoft Excel. First-year students, third-year students, and incoming residents all preferred to read journal articles and book chapters in print, except in cases where the article or book chapter is under ten pages in length. Although print is preferred, demand for electronic articles and book chapters increases as students progress from undergraduate medical education into residency. The only category where a majority of incoming residents chose an electronic resource was which format they would give to a colleague, if the article or book chapter was critical to the care of an individual patient. The preference for print resources is strong across the medical curriculum, although residents show an increased preference for electronic materials when compared to first- and third-year students. Academic health sciences libraries should take these preferences into account when making decisions regarding collection development.

Emotional intelligence (EI) has a positive correlation with the academic performance of medical students. However, why there is a positive correlation needs further exploration. We hypothesized that the capability of answering higher-order knowledge questions (HOQs) is higher in students with higher EI. Hence, we assessed the correlation between EI and the capability of medical students to answer HOQs in physiology. First-year undergraduate medical students (n = 124) from an Indian medical college were recruited as a convenient sample. EI was assessed by the Schutte Self-Report Emotional Intelligence Test (SSEIT), a 33-item self-administered validated questionnaire. A specially designed objective examination with 15 lower-order and 15 higher-order multiple-choice questions was conducted. The correlation between the examination score and the EI score was tested by Pearson's correlation coefficient. Data from 92 students (33 females and 59 males) with a mean age of 20.14 ± 1.87 yr were analyzed. Overall, students got a percentage of 53.37 ± 14.07 in the examination, with 24.46 ± 9.1 in HOQs and 28.91 ± 6.58 in lower-order knowledge questions (LOQs). They had a mean score of 109.58 ± 46.2 in SSEIT. The correlation coefficient of SSEIT score with total marks was r = 0.29 (P = 0.0037), with HOQs was r = 0.41 (P < 0.0001), and with LOQs was r = 0.14 (P = 0.19). Hence, there is a positive correlation between EI and the capability of medical students to answer HOQs in physiology. This study may be the foundation for further exploration of the capability of answering HOQs in other subjects.NEW & NOTEWORTHY This study assessed the correlation between emotional intelligence (EI) and the capability of medical students to answer higher-order knowledge questions (HOQs) in the specific context of physiology. The finding reveals one of the multifaceted dimensions of the relationship between EI and academic performance. This novel perspective opens the door to further investigations to explore the relationship in other subjects and other dimensions to understand why students with higher EI have higher academic performance.

Various studies have revealed that there is a disproportionately low representation of skin of colour (SOC) in medical school dermatologic curriculum and board study resources. First-year and second-year medical students were emailed an 18-question survey regarding (1) identifying correct diagnoses of dermatologic conditions on either White skin or SOC and (2) their confidence in identifying dermatologic conditions on SOC. 15% of the images of dermatologic conditions included in the institutional preclinical curriculum show images of patients with SOC. Regarding overall scores for diagnosing dermatologic diseases, students performed similarly on both the White image survey (61.73%) and SOC image survey (66.20%) with no statistically significant differences between surveys (p=0.14). Second-year medical students performed better than first-year medical students overall (p=0.01) and on White skin image survey scores (p=0.02) but not on people of colour image survey scores (p=0.09). Students largely agreed that they were more comfortable identifying dermatologic diagnoses on White skin and that their school could benefit from increased SOC dermatological resources. The overall low scores for the diagnosis of common skin conditions on both the White image and SOC image survey by first- and second-year students are not surprising given the results of a prior study and support the need for re-exposure to dermatology presentations in all skin types during the preclinical curriculum. The low scores support the need for changes in the pre-clinical dermatology curriculum to improve diagnostic ability. Second-year students performed better at diagnosing dermatologic conditions overall and on White skin compared to SOC at the end of their didactic years, possibly due to an underrepresentation of SOC images in institutional and outside educational resources. Attitudes towards school-specific dermatologic SOC education demonstrated a clear desire amongst students for more exposure to dermatologic conditions in various skin colours throughout the curriculum.