Teaching Medical Students to Teach: A Narrative Review and Literature-Informed Recommendations for Student-as-Teacher Curricula.

PURPOSE: Medical students play an important role as teachers. This narrative review synthesizes the student-as-teacher (SaT) literature that incorporates formal teaching skills training, with the goal of proposing literature-informed recommendations for SaT curriculum development within the context of competency-based medical education. METHOD: In January and August 2020, the authors searched Medline and Embase and conducted forward citation searches in Scopus to identify articles from 1985 to 2020 related to teaching medical students to teach. Search terms included "student(s) as teacher(s)," "near-peer teaching," and "teaching to teach." The findings from selected articles were summarized and synthesized. RESULTS: Forty-three articles met the inclusion criteria: 33 papers describing specific SaT curricula, 3 literature reviews, 6 stakeholder surveys, and 1 Delphi study. While students often engage in teaching roles, formal teaching skills training is not always provided. Existing curricula are usually optional, delivered as short courses, and offered to senior students. Course content commonly includes topics related to planning and delivering learning activities and providing feedback. Of the numerous teaching modalities employed, students indicate a preference for interactive and experiential learning. Methods used to assess students' teaching skills vary; however, direct observation and feedback are valued assessment methods. Program evaluations have shown positive outcomes, including high student satisfaction and enhanced self-confidence as teachers. CONCLUSIONS: Informed by these findings and outcome-based educational frameworks, the authors suggest 4 guiding principles for SaT curricula: (1) teaching skills training should be formally implemented in undergraduate medical education and should, whenever possible, be compulsory; (2) teaching skills should be taught longitudinally and progressively along the undergraduate to postgraduate continuum; (3) curriculum content should be aligned with a school's preexisting curriculum and local context; and (4) authentic opportunities for students to engage in teaching roles should be included. They also propose recommendations for curriculum content, teaching modalities, and assessment methods.

Reverse Educational Distance: Exploring a novel concept to enhance Resident-As-Teacher curricula.

Purpose: The learning benefits associated with residents teaching peers and junior trainees are well documented. However, the concept of Reverse Educational Distance (RED), when residents teach an academically senior audience, is poorly described. Methods: We explored Pediatric residents' and community health care providers' (cHCPs) perceptions of a RED teaching intervention, whereby residents would engage in teaching cHCPs. We explored the anticipated learning benefits, challenges, and ways to optimize its implementation in a residency program. We conducted a descriptive qualitative study with focus groups. We also compared RED with the traditional Resident-As-Teacher (RAT) approach from a theoretical framework perspective. Results: Benefits anticipated by residents included: (1) optimizing their incentive to learn; (2) focusing on the practical 'real-world application' of knowledge; and (3) a better understanding of community practice. Benefits anticipated by cHCPs included: (1) being updated on evidence-based practices; and (2) improving collaboration between cHCPs and future pediatricians. The major anticipated challenge was the residents' lack of clinical experience, for which key solutions were proposed. Conclusions: Engaging residents in teaching cHCPs could lead to enhanced and unique learning benefits compared to the traditional RAT approach. RED is a promising strategy for RAT curricula aiming at best preparing trainees for their future role as educators.

Draining Fluids through a Peritoneal Catheter in Newborns after Cardiac Surgery Helps to Control Fluid Balance.

Dialysis can be used in severe cases, but may not be well tolerated. In such patients, peritoneal drainage could be an alternative option for fluid removal. We report the case of a newborn with a truncus arteriosus who developed postoperatively a complicated clinical course with right ventricular dysfunction, prerenal condition as well as fluid overload despite diuretic therapy. Dialysis was indicated for fluid removal. Peritoneal dialysis was started using a surgically placed Tenckhoff catheter and stopped due to inefficacy and leaks and no other modalities of dialysis were used. However, the catheter was left in place over a period of two months for fluid drainage and removed because of unexplained fever. In order to determine the effect of peritoneal drainage, we selected a period of one week before and one week after the removal of the drain to compare daily clinical data, urine electrolytes and renal function and found a positive effect on fluid balance control. We conclude that the fluid removal by continuous peritoneal drainage is a simple and safe alternative that can be used to control fluid balance in infants after cardiac surgery.