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A Novel Approach to Medical Student Peer-assisted Learning Through Case-based Simulations.

ABSTRACT: Peer-assisted learning (PAL) is the development of new knowledge and skills through active learning support from peers. Benefits of PAL include introduction of teaching skills for students, creation of a safe learning environment, and efficient use of faculty time. We present a novel approach to PAL in an emergency medicine (EM) clerkship curriculum using an inexpensive, tablet-based app for students to cooperatively present and perform low-fidelity, case-based simulations that promotes accountability for student learning, fosters teaching skills, and economizes faculty presence.We developed five clinical cases in the style of EM oral boards. Fourth-year medical students were each assigned a unique case one week in advance. Students also received an instructional document and a video example detailing how to lead a case. During the 90-minute session, students were placed in small groups of 3-5 students and rotated between facilitating their assigned cases and participating as a team for the cases presented by their fellow students. Cases were supplemented with a half-mannequin that can be intubated, airway supplies, and a tablet-based app (SimMon, $22.99) to remotely display and update vital signs. One faculty member rotated among groups to provide additional assistance and clarification. Three EM faculty members iteratively developed a survey, based on the literature and pilot tested it with fourth-year medical students, to evaluate the course.135 medical students completed the course and course evaluation survey. Learner satisfaction was high with an overall score of 4.6 on a 5-point Likert scale. In written comments, students reported that small groups with minimal faculty involvement provided a safe learning environment and a unique opportunity to lead a group of peers. They felt that PAL was more effective than traditional simulations for learning. Faculty reported that students remained engaged and required minimal oversight.Unlike other simulations, our combination of brief, student-assisted cases using low-fidelity simulation provides a cost-, resource- and time-effective way to implement a medical student clerkship educational experience.

SUBMITTER: Jauregui J

PROVIDER: S-EPMC5785193 | biostudies-other | 2018 Jan

REPOSITORIES: biostudies-other

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A Novel Approach to Medical Student Peer-assisted Learning Through Case-based Simulations.

Jauregui Joshua J Bright Steven S Strote Jared J Shandro Jamie J

The western journal of emergency medicine 20171218 1

<h4>Introduction</h4>Peer-assisted learning (PAL) is the development of new knowledge and skills through active learning support from peers. Benefits of PAL include introduction of teaching skills for students, creation of a safe learning environment, and efficient use of faculty time. We present a novel approach to PAL in an emergency medicine (EM) clerkship curriculum using an inexpensive, tablet-based app for students to cooperatively present and perform low-fidelity, case-based simulations t ...[more]

PMID: 29383080

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Project description:BACKGROUND:Including content on Indigenous health in medical school curricula has become a widely-acknowledged prerequisite to reducing the health disparities experienced by Indigenous peoples in Canada. However, little is known about what levels of awareness and interest medical students have about Indigenous peoples when they enter medical school. Additionally, it is unclear whether current Indigenous health curricula ultimately improve students' beliefs and behaviours. METHODS:A total of 129 students completed a 43-item questionnaire that was sent to three cohorts of first-year medical students (in 2013, 2014, 2015) at one undergraduate medical school in Canada. This survey included items to evaluate students' sociopolitical attitudes towards Indigenous people, knowledge of colonization and its links to Indigenous health inequities, knowledge of Indigenous health inequities, and self-rated educational preparedness to work with Indigenous patients. The survey also assessed students' perceived importance of learning about Indigenous peoples in medical school, and their interest in working in an Indigenous community, which were examined as outcomes. Using principal component analysis, survey items were grouped into five independent factors and outcomes were modelled using staged multivariate regression analyses. RESULTS:Generally, students reported strong interest in Indigenous health but did not believe themselves adequately educated or prepared to work in an Indigenous community. When controlling for age and gender, the strongest predictors of perceived importance of learning about Indigenous health were positive sociopolitical attitudes about Indigenous peoples and knowledge about colonization and its links to Indigenous health inequities. Significant predictors for interest in working in an Indigenous community were positive sociopolitical attitudes about Indigenous peoples. Knowledge about Indigenous health inequities was negatively associated with interest in working in an Indigenous community. CONCLUSIONS:Students' positive sociopolitical attitudes about Indigenous peoples is the strongest predictor of both perceived importance of learning about Indigenous health and interest in working in Indigenous communities. In addition to teaching students about the links between colonization, health inequities and other knowledge-based concepts, medical educators must consider the importance of attitude change in designing Indigenous health curricula and include opportunities for experiential learning to shape students' future behaviours and ultimately improve physician relationships with Indigenous patients.

Project description:ProblemMedical school can be a socially isolating experience, particularly for students underrepresented in medicine. Social isolation and perceptions of not belonging can negatively impact students' academic performance and well-being. Therefore, interventions are needed to support students and these efforts should be appealing, brief, and low-burden.InterventionGuided by evidence-based approaches, we developed the Build & Belong intervention for medical students as a brief peer-to-peer approach that consisted of four components. First, M3 and M4 students wrote reflections on belonging in medical school. Second, M3 and M4 students video recorded messages for M1 and M2 students using their written reflections. Third, M1 and M2 students watched and discussed the videos in small groups. Fourth, the M1 and M2 students wrote letters to future students. Our intervention differs from previous student belonging interventions in the peer delivery of messages.ContextThe Build & Belong intervention aimed to improve medical students' social belongingness. Using a longitudinal observational study design, the intervention was piloted at a medical school in the Mid-Atlantic United States in 2017-2018. Students completed surveys before and after the intervention. Paired samples tests (t-tests and Wilcoxon) assessed pre- to post-intervention changes in social isolation, social connectedness, and social assurance.ImpactAmong 63 medical students, with 25.9% from backgrounds underrepresented in medicine, we assessed follow-up outcomes in 38 students. Social isolation scores significantly decreased from baseline (M = 54.8, SD = 7.06) to follow-up (M = 51.3, SD = 6.67; p < .001). Social isolation changes were evident regardless of sex, although males reported a greater reduction (M Δ = -5.32, p < .001) than females (M Δ = -2.79, p = .014). Black/African American students had the largest reduction in social isolation (M Δ = -7.24, p = .010). Social assurance and connectedness scores did not change significantly between baseline and follow-up. Medical students appeared to resonate with messages delivered by more experienced peers (M3s and M4s), particularly messages that normalized feelings of not belonging and strategies to reduce those feelings.Lessons learnedThe Build & Belong intervention appears to reduce social isolation scores among medical students. This pilot test of the Build & Belong intervention provides initial evidence of the effectiveness of a brief, low-cost intervention. Build & Belong may provide a scalable strategy to reduce medical students' social isolation. Our peer-based approach is distinct from administrator-led strategies; peers were seen as trusted and reliable sources of information about belonging and ways to overcome the challenges experienced during medical school.

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A Novel Approach to Medical Student Peer-assisted Learning Through Case-based Simulations.

Publications

A Novel Approach to Medical Student Peer-assisted Learning Through Case-based Simulations.

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