The Impact of Near-Peer Teaching on Medical Students’ Transition to Clerkships

Abstract

Background and Objectives: The transition to clerkships is one of the most challenging times during medical school. To help students better cope, many schools have established transition-to-clerkship curricula. Such curricula may optimally prepare students through increasing their self-efficacy and response efficacy. We hypothesized that a small-group, near-peer-led format would be ideally suited to help students achieve these outcomes. Methods: During process improvement for a transition-to-clerkship curriculum, we conducted an informal focus group and subsequent survey of postclerkship students to guide curricular innovation, including incorporation of third- and fourth-year students as near-peer instructors in a seminar format. Seminars included three sequential small-group discussions focused on discrete topic areas and concluded with a large-group session highlighting salient discussion points. To evaluate the impact of this educational strategy, near-peer learners were surveyed before and after the seminars. Results: Junior student participants reported feeling more prepared to integrate into the health care team, develop a clerkship study plan, and access applicable, valuable study materials, both immediately following the seminars and 6 months later, demonstrating increased self-efficacy. These students placed equal or greater value on these topics as compared to students in previous year groups, demonstrating similar response efficacy. Conclusions: This study demonstrated an increase in student self-efficacy that persisted 6 months postintervention, in addition to similar response efficacy. Future research could be directed toward: (1) investigating whether improvements in self-efficacy among students transitioning to clerkships are associated with improved clerkship performance and (2) studying outcomes for near-peer teachers.

Beyond the struggles: a scoping review on the transition to undergraduate clinical training

“…Researchers thought it was important to make explicit ‘the hidden knowledge that students need to become effective team members’ and to create strategies that would ‘describe the roles and expectations … routines and logistics’ relevant to the clinical environment . It therefore was important to facilitate meaningful interactions and relationship building with others . Examples of these social strategies included initiating peer groups, near‐peer teaching sessions, facilitating students sharing experiences, and creating peer learning communities .…”

“…Additionally, to promote student–staff relationships in the clinical environment, some researchers reported on the use of multidisciplinary approaches to educational inductions and including residents in these orientations . Regarding measuring outcomes, increased social support was likely to reduce stress and, in one study, increased students’ perceptions of preparedness as it related to integrating into the clinical team …”

“…Included studies were from the USA (n = 21), Europe (n = 11), UK (n = 8), Canada (n = 3) and Australia (n = 2). There were 12 qualitative studies, 10,11,14,[19][20][21][22][23][24][25][26][27] 11 cross-sectional surveys, [6][7][8]13,[28][29][30][31][32][33][34] eight descriptive case studies 5,[35][36][37][38][39][40][41] (two of which were related, using the same participants and intervention), 36,37 seven longitudinal studies, [42][43][44][45][46][47][48] three descriptive comparative studies, 12,49,50 three review papers 1,3,9 and one concept paper. 51…”

“…12 It therefore was important to facilitate meaningful interactions and relationship building with others. 25,43,48 Examples of these social strategies included initiating peer groups, 25 nearpeer teaching sessions, 48 facilitating students sharing experiences, 43 and creating peer learning communities. 45 Additionally, to promote studentstaff relationships in the clinical environment, some researchers reported on the use of multidisciplinary approaches to educational inductions and including residents in these orientations.…”

“…12,39 Regarding measuring outcomes, increased social support was likely to reduce stress 19 and, in one study, increased students' perceptions of preparedness as it related to integrating into the clinical team. 48 Literature on the transition to clinical training conducted from a social perspective still sees the transition as a struggle as a result of students trying to fit into the new environment and not being familiar with existing cultural norms and how to build relationships. The approach was therefore to develop activities that familiarise students with others (professionals and peers) in the clinical environment.…”