Medical Students' Professional Development as Educators Revealed Through Reflections on Their Teaching Following a Students-as-Teachers Course.

Phenomenon: Teaching is an important part of the tri-partite mission of every medical center. Although teaching often is given lower priority and recognition as opposed to patient care and/or research, this activity for many physicians in academic medicine ranks second to their patient care responsibilities. Medical teacher training has traditionally been aimed at faculty and residents through faculty development initiatives, continuing education for physicians at professional conferences, formalized degree or certificate programs in education, and residents as teachers programs. More recently medical schools have developed medical-students-as-teachers programs, often offered as 4th-year electives, to introduce learners to the theory of teaching and learning with appropriate application in the clinical setting. Data on learner outcomes and students' perceptions and experiences in these programs consist mostly of their satisfaction after completing such a program. In this article we explore 4th-year medical student trainees' experiences and emerging self-concepts as educators during a teaching elective. APPROACH: The purpose of this project was to explore students' reflections on their experiences in a 4th-year medical students-as-teachers course in their own words through their written self-assessment narratives. We used qualitative content analysis to examine 96 trainees' self-reported, written reflective narratives of how they translated their students-as-teachers course experience into application by applying newly learned educational theories, instructional strategies, and feedback skills while teaching novice peers physical diagnosis skills. FINDINGS: Narratives revealed candid self-assessments and detailed descriptions of their experiences and what they valued most from the course. Content analysis revealed nine key themes: using teaching strategies for adult learning, preparing for class, modeling professionalism, incorporating clinical correlations, exceeding course requirements, giving and receiving feedback, providing mentoring, creating a positive learning climate, and growing as educators. Insights: This study's results reveal how learners perceive and translate their experiences in a teaching course, in terms of incorporating particular knowledge or skills, valuing or displaying certain professional behaviors, and gaining self-awareness and satisfaction from teaching experiences. The findings of this study, specifically major themes from self-assessment narratives, provide us with a better understanding of medical students' developing identities and emerging professional self-concept as educators, specifically as experienced through a combination of formal teaching, and applying education theories and strategies. Findings may be informative from a program evaluation lens but also for faculty development initiatives related to training medical teachers and the larger landscape of the emerging field of Health Professions Education.

Evaluating oral case presentations using a checklist: how do senior student-evaluators compare with faculty?

PURPOSE: Previous studies have shown student-evaluators to be reliable assessors of some clinical skills, but this model has not been studied for oral case presentations (OCPs). The purpose of this study was to examine the validity of student-evaluators in assessing OCP by comparing them with faculty. METHOD: In 2010, the authors developed a dichotomous checklist. They trained 30 fourth-year medical students (student-evaluators) to use it to assess 170 second-year medical students' OCPs in real time during a year-end objective structured clinical examination. Ten faculty physicians then scored videos of a random sample of these OCPs. After discarding items with poor faculty reliability, the authors assessed agreement between faculty and student-evaluators on 18 individual items, total scores, and pass/fail decisions. RESULTS: The total score correlation between student-evaluators and faculty was 0.84 (P < .001) and was somewhat better than the faculty-faculty intraclass correlation (r = 0.71). Using a 70% pass/fail cutoff, faculty and student-evaluator agreement was 74% (Kappa = 0.46; 95% CI, 0.20-0.72). Overall, student-evaluator scores were more lenient than faculty scores (72% versus 56% pass rates; P = .03). CONCLUSIONS: Senior student-evaluators were able to reliably assess second-year medical students' OCP skills. The results support the use of student-evaluators for peer assessment of OCPs in low-stakes settings, but evidence of leniency compared with faculty assessment suggests caution in using student-evaluators in high-stakes settings. Extending peer assessment to OCPs provides a practical approach for low-resource evaluation of this essential skill.