Development and Assessment of a New Course in Medical Education

Abstract

Purpose: Teaching is an essential skill to the practice of medicine. A growing body of literature underscores the value of teaching medical students to teach, leading to an increase in programs for “peer-assisted learning,” though undergraduate medical curricula rarely include teaching competencies. Models for student teaching programs vary widely with respect to structure and evaluation. Few are outpatient, a missed opportunity to increase primary care interest and competency. We sought to design a course that would allow students to explore a range of teaching venues and skills relevant to teaching about primary care. Methods: We designed a pilot elective in primary care and teaching for 8 students who had completed their core clerkships. The program includes didactics on medical education; placement as a junior preceptor to MS1s in a continuity clinic; the design and delivery of a Grand Rounds presentation; and the creation of a 3-5 minute educational “concept video” on a topic in primary care. Our planned evaluation includes 3 components: 1. Evaluation of students’ skills in teaching in each teaching venue, and in a 3-station Observed Structured Teaching Evaluation at course conclusion. 2. Assessment of students’ attitudes toward the course components and toward primary care and future teaching responsibilities. 3. Assessment of the attitudes of the first-year students and preceptors who work with the advanced student preceptors in the FCC course. Results: Due to the academic calendar, the pilot is ongoing. The only completed evaluation is advanced students’ attitudes toward the didactic sessions. Initial feedback from anonymous surveys done after each the 5 completed didactics is positive. Mean confidence in applying the newly-taught skills on a 5-point Likert scale was 4.44 (range 4.0-5.0), and mean effectiveness of the teaching format was rated at 4.72 (range 3.71-4.88). Post-course survey data will be necessary to determine impact on advanced students’ perceived teaching ability and interest in medical education and primary care. Formal evaluations of participants’ teaching skills will be essential to determining the efficacy of the course. Conclusions: Evaluations of peer-assisted learning have focused heavily on the efficacy of medical students-as-teachers compared to faculty in delivering discreet knowledge, such as physical examination or procedural skills, with few examples of advanced students participating in an outpatient practice. We describe a well-received program training and deploying advanced students as near-peer educators in an ambulatory, primary care setting, with a unique multimodal approach to evaluate students on teaching performance rather than participation alone.