Abstract:

The proposed paper presents a peer teaching model that focuses on learning topics through answering higher order clinical scenario questions in a small group setting.

This method was aimed at increasing student’s abilities:
(1) to answer multiple choice standardized questions and
(2) think critically through difficult clinical and research situations
(3) connect concepts across areas of the first two years of the medical curriculum.

For this project, a new peer teaching model was applied to assist medical students preparing for licensing exams. The first step of medical school licensing is extremely difficult and is critical for obtaining a residency position following graduation. Scores on USMLE Step 1 can determine into what specialty a student can gain entry and eliminate careers for those that do not score high enough.

The initial peer teaching model for USMLE Step 1 was launched in 2003 as a way to bring up Step 1 board scores and passage rates. It was an integral part of the great success experienced by the University of Texas Medical Branch medical school in reaching its board passage goals. However, as different challenges presented themselves (the National Board of Medical Examiners raised passage score requirements, national averages increased, and exam content became more complex) we searched for new ways to better prepare our students. In personal interviews we learned that students who did not experience exam success in terms of successful passage or high scores were missing elements from their test taking and knowledge repertoire. Skills at taking a question apart, reconstructing it and determining pathways to correct answers were essential pieces that were absent. Examples of this process will be explored in this paper.

A modified peer teaching approach was adopted to introduce a Socratic questioning method that used clinical vignette question stems that closely mimicked the USMLE Step 1 format. Third and fourth year student teachers were trained in methodology by an experienced fourth year student who helped develop the teaching protocol and the question bank.

Each question painted a clinical or research scenario that reflected the difficulty seen on the actual exam, along with multiple choice answers that were higher order distractors that would be challenging to even the most advanced student. The questions were grouped by subject and presented in sessions lasting two to three hours. In the proposed session, a detailed description of the methodology for the sessions will be detailed along with example question scenarios. We will also discuss how the student teacher used the Socratic process to help the student process the information to correctly map out the material to the correct answer.

The proposed paper will present methodology and results from the first year of utilizing this process in tutoring students for their licensing exams. Initial results of USMLE Step 1 indicate a 99.99% passage rate and a school average above the national average. A survey of participants indicated that members in the student teaching for USMLE Step 1 found the Socratic Question tutoring method to help them feel more comfortable answering questions, helped them participate and speak up in group, helped them determine what kind of errors they were making when doing multiple choice questions, and helped them connect concepts and facts they had not yet made in their studies.

Keywords:

Peer teaching, tutoring, medical education, Socratic questioning, test taking.