Abstract:

Final year medical students in the United Kingdom are expected to familiarise themselves with the General Medical Council’s (GMC) Good Medical Practice guidance and their Outcomes for Graduates document. Both define ongoing commitment to teaching others as a fundamental principle of the holistic doctor, an aspect that is further emphasised in postgraduate curricula for doctors in training.

Near-to-peer (NTP) teaching is one such way for medical students to become involved in clinical education. This is defined as a peer assisted learning technique where senior students act as tutors for junior peers, making them well placed to pass on their own recent experiences and knowledge. It is an educational tool that has gained popularity in medical education and there is evidence to suggest that NTP tutors can be comparable educators alongside senior doctors. Other benefits for tutors include enhanced leadership skills, communication and even improved clinical competence.

Though a number of NTP schemes related to medicine have been described in the literature, few offer any form of pre-encounter teacher training for participants. Moreover, programmes are often heterogeneous with respect to topics taught, seniority gap between students and location. Somewhat controversially, many are established to fill gaps that exist in the absence of a recognised teaching faculty.

Here we describe the ‘Medical Students As Teachers’ (MSAT) programme that was established at Leicester Royal Infirmary, a major tertiary NHS trust in the East Midlands. The scheme recruited final year medical students as tutors and 3rd year students as recipients, and was two-staged in approach. Firstly, our final year students participated in a teacher training workshop, aimed at bridging the gap in teaching experience. This was run by education faculty at the hospital and included topics such as delivering feedback, an overview of the curriculum and medical education theory. Secondly, our tutors were assigned to small groups of 3rd year students and encouraged to deliver four tutorials across their six week placement. Topics were flexible but centred on preparation for the upcoming OSCEs (objective structured clinical examination).

The responses of our senior and junior students were collected using Likert-style questionnaires before and after the programme, and a number also participated in a structured interview. Our pre-scheme survey found that 66% of 3rd year students were not confident about their upcoming OSCE examination but the same proportion felt that the final year students would be well placed to prepare them for these assessments. For tutors, the training workshop was well received, with our final years commenting on improved confidence with delivering teaching. Tutors also felt that the wider scheme helped them improve their own knowledge of clinical topics. Preliminary feedback has indicated that the near-peer tutorials were well received by the junior students.

We conclude that NTP teaching can have an important role to play in clinical attachments, both from a tutor and recipient perspective. Projects such as this ought to be more widely available for final year medical students so that they can gain experience of teaching before becoming qualified doctors. The addition of a teacher-training workshop is a particularly important intervention and should be included in order to maintain standards in undergraduate education.

Keywords:

Medical students as teachers, near-to-peer, medical education, OSCE.