Optimal timing of faculty teaching when combined with near-peer teaching: A mixed methods analysis.

BACKGROUND: Near-peer teaching is increasingly used in medical education, supporting or replacing faculty teaching. It has positive aspects for learners and tutors, some of which are explained by higher social and cognitive congruence between learners and near-peer tutors (NPTs). This study investigates the optimal combination of faculty tutors (FTs) and NPTs in an abdominal ultrasound course. METHODS: Sixty-four third-year medical students underwent a basic ultrasound course, with 75% of lessons taught by NPTs and 25% by FTs. Each of four groups had a different faculty teaching timing. A mixed methods approach used a survey and semi-structured interviews at the course end to elicit learners' preferences, and end-of-course examination scores to look for differences in outcomes. RESULTS: Most learners preferred having faculty teaching in the second half of the course, saying it would be overwhelming to start with FTs. Learners preferred between a quarter and a third of the teaching to be from FTs, with NPTs rated better at teaching basics, and FTs contributing unique, helpful clinical knowledge. There was no significant between-group difference in examination scores. CONCLUSIONS: Medical students preferred most of their teaching to be from NPTs, with some faculty input in the second half of the course.

To teach is to learn twice, revisited: a qualitative study of how residents learn through teaching in clinical environments.

BACKGROUND: Teaching helps the teacher's own learning as a professional-as the saying goes, 'to teach is to learn twice'. Near-peer teaching in clinical practice has been shown to contribute to the development of both teaching skills and necessary competencies for doctors. Research on how near-peer teachers learn through their teaching roles has mainly focused on classroom learning. However, understanding how the phenomenon of 'teaching is learning twice' occurs in clinical settings and its influencing factors is important for the development of a quality workplace learning environment. Therefore, this study investigated how residents learn through teaching in clinical practice and the factors influencing this process. METHODS: This study's methodology is based on the constructivist grounded theory from a social constructivist perspective. Several teaching hospitals in Japan were included, and the study participants were post-graduate year 2 residents (PGY2s) from these hospitals. The interviews were recorded, transcribed into text, and analysed by the first author. RESULTS: From January 2016 to July 2022, 13 interviews were conducted with 11 PGY2s from nine educational hospitals. The PGY2s played diverse educational roles in clinical settings and learned competencies as physicians in almost all areas through such roles. We found that knowledge transfer and serving as role models stimulated PGY2s' intrinsic motivation, encouraged reflection on their own experiences, and promoted self-regulated learning. Further, educating about procedural skills and clinical reasoning prompted reflection on their own procedural skills and thought processes. Supporting post-graduate year 1 residents' reflections led to the refinement of PGY2s' knowledge and thought processes through the verbal expression of their learning experiences. Such processes required the formation of a community of practice. Thus, education promoted learning through reflection and clarified the expert images of themselves that PGY2s envisaged. CONCLUSIONS: The study found that residents acquire various physician competencies through multiple processes by teaching as near-peer teachers in clinical settings, that a community of practice must be formed for near-peer teaching to occur in a clinical setting, and that teaching brings learning to those who teach by promoting reflection and helping them envision the professionals they aim to be.

Tutors' perspective on the impact of their anatomy tutoring experience and ethics of body donation.

PURPOSE: To explore the future of former anatomy tutors, their perception of the impact that the anatomy near-peer teaching (NPT) program have had on them, in terms of academic performance, professional development, personal growth, long-term anatomical knowledge, and views on body donor ethics. Additionally, we compared their academic performance with non-tutor peers in terms of ranking at the National Qualifying Examination (NQE). METHODS: A voluntary survey was emailed to all anatomy tutors from 2005 to 2024, using an online Google Forms questionnaire including closed and open-ended questions across four themes. Quantitative data were analyzed descriptively, while qualitative responses underwent thematic analysis. A Wilcoxon signed-rank test was performed to compare former tutors' NQE rankings to their peers. RESULTS: Forty-seven out of 48 tutors responded. Tutors reported a positive program impact, including improvements in technical skills (100%), teamwork (97.9%), communication (89.4%), and organizational skills (76.6%), and good long-term anatomical knowledge retention (85.7%). Dissection on body donors was deemed essential for anatomy learning while shaping professional and ethical values. Of the 36 residents/specialists, 38.9% ranked in the top 10% at the NQE, with a statistically significant higher rank than their peers (p = 0.0011), and 100% obtained their desired specialty. CONCLUSION: This results suggest that the anatomy NPT program significantly enhanced tutors' academic performance, technical skills, personal and professional development, and was useful to foster a positive perception of dissection on body donors and reinforced the importance of anatomical knowledge in clinical practice.

Near-peer teaching in a psychomotor skills course: Benefits, challenges and solutions.

INTRODUCTION: This study evaluates the perceptions and experiences of students in the role of near-peer teachers in a psychomotor skills course. MATERIALS AND METHODS: Final year BDS students were invited to participate as near-peer teachers in a 4th-year conventional bridges course. Near-peer teachers attended eight sessions (3 h) of simulation laboratory teaching relating to conventional bridge tooth preparations and provided feedback on near-peer tooth preparations and answered their questions. Interviews were conducted with all near-peer teachers to evaluate their perceptions of this novel teaching and learning experience and a thematic analysis was performed to analyse the data. RESULTS: Near-peer teachers reported this to be a rewarding, enjoyable and challenging experience. They benefited from learning and revising content-related materials as well as gained insights and teaching skills through the peer teaching process. Students felt supported and learned from peers and teaching staff and some used dyad teaching as a strategy to overcome perceived challenges. Students also reported the benefits of social and cognitive congruence in interacting with junior peers. However, students reported the feeling of inadequacy or lack of confidence and suggested the need for a training to prepare them better for the course. CONCLUSION: This paper reports on the benefits as well as challenges perceived by near-peer teachers during simulation laboratory teaching experience. We provide solutions into how to better prepare students for such teaching experience.

Evaluating the impact of a teaching course for GP speciality trainees.

INTRODUCTION: Near-peer teaching offers mutual benefits for clinical trainees and the students they teach. However, General Practice Speciality Trainees (GPSTs) are typically less involved in community-based teaching than their hospital-based peers and often do so without formal pedagogical training. This study details the immediate and longer-term evaluation of a teaching skills course delivered to final year GPSTs. It addresses a gap within existing near-peer literature which, although extensive, is predominantly hospital-based and limited to short-term outcomes. METHODS: The course was designed and delivered to all local final year GPST schemes. Pre- and post-course questionnaires scoring confidence, comfort, and understanding of teaching roles were analysed across two years' delivery. Furthermore, individual interviews of participants 4-6 months after attendance were thematically analysed to explore how GPSTs translated course content into practice. RESULTS: GPSTs reported a decline in their teaching activities as they embarked on their final year of GP teaching. Immediate post-course teaching-related confidence and knowledge scores increased. However, follow-up interviews revealed that GPSTs' initial enthusiasm was short-lived and outweighed by competing demands within an intensive short-duration training scheme. They expressed concerns about their own learner status as they themselves developed competency in a vast and varied speciality, and cited a lack of support from their trainers. CONCLUSIONS: Teaching skill courses alone are insufficient to address the ongoing challenges of enhancing the teaching role of GPSTs. Further work is now needed to explore multi-level interventions to promote the role of GPSTs as near-peer teachers to harness the mutual benefits to all involved.

A Hands-On Surgical Event to Improve Medical Student Operating Room Confidence.

INTRODUCTION: The negative perceptions and lack of exposure to surgery and the operating room (OR) have been known to divert students away from surgical specialties. This study describes the impact of a surgical subspecialty exposure event (OR Essentials), combined with surgical faculty and M4 mentorship on preclinical medical students' confidence at an academic medical center. METHODS: OR essentials event teaches surgical skills to preclinical medical students through hands-on skill-based workshops in a simulated OR setting. Pre and postevaluations were administered to measure program impact. RESULTS: One hundred four preclinical medical students participated. Following OR essentials, students reported a significant increase in confidence in the OR (P < 0.0001) and in basic surgical skills (P < 0.0001). CONCLUSIONS: Early surgical exposure events like OR essentials provide opportunities to improve medical student confidence in the OR, which will hopefully support recruitment of future surgeons.

Can Synchronous Online Near-Peer Teaching Offer the Same Benefits as the Face-to-Face Version When Used in Clinical Neuroanatomy Education?

COVID-19 sparked massive educational change and dictated that traditional courses rapidly transitioned online. This presented a unique challenge for anatomy, a visually orientated subject that has conventionally relied heavily on face-to-face teaching. Near-peer teaching (NPT) is one method with the potential to address this challenge. When given more responsibility, student-teachers are more likely to deliver effective teaching sessions and include the most appropriate resources for the learners. Current literature surrounding the use of NPT in both frontline and supplementary settings have already demonstrated its potential, however, its efficacy in an online environment is still largely unknown. The Faculty of Medicine at the University of Southampton has a well-established NPT programme as part of its 5 year undergraduate course (BM5). A quasi-experimental cohort study was conducted to determine whether the benefits associated with NPT are preserved when delivered online. Two cohorts of second year BM5 students received cranial nerve NPT as part of their formal clinical neuroanatomy module, one face to face (N = 150) and the other online (N = 168). Knowledge tests were undertaken by participants to assess knowledge gain and retention, and an established Likert style survey instrument was administered to assess student perceptions. Both online and face-to-face NPT sessions resulted in significant increases in student knowledge gain (p < 0.0001), yet the difference between the two was insignificant (p = 0.2432). Subsequent knowledge retention tests were also shown to be similar (p = 0.7732). Students perceived both methods of NPT delivery positively but found online NPT less enjoyable (p < 0.0001) and considered it to be a more inefficient use of time (p = 0.0035). This research suggests that online NPT can be deployed without a detrimental risk to learning when compared to traditional NPT applications in pre-clinical neuroanatomy teaching.

Twelve tips for teaching neuroanatomy, from the medical students' perspective.

Neuroanatomy is a complex and fascinating subject that is often a daunting prospect for medical students. In fact, the fear of learning neuroanatomy has gained its own name - "neurophobia." This widespread phenomenon among medical students poses a challenge to medical teachers and educators. To tackle "neurophobia" by summarising tips for dynamic and engaging neuroanatomy teaching formulated based on our experiences as medical students and evidence-based techniques.Focusing on the anatomical, physiological, and clinical aspects of neurology and their integration, here we present 12 tips which are [1] Teach the basic structure before fine details, [2] Supplement teaching with annotated diagrams, [3] Use dissections for haptic learning, [4] Teach form and function together, [5] Group anatomy into systems, [6] Familiarise students with neuroimaging, [7] Teach from clinical cases, [8] Let the patient become the teacher, [9] Build from first principles, [10] Try working in reverse, [11] Let the student become the teacher, [12] Let the student become the examiner. These 12 tips can be used by teachers and students alike to provide a high-yield learning experience.

Near-peer teaching for learning clinical photography skills: Perceptions of students.

AIM: This paper evaluates the perceptions and experience of students, in the role of both near-peer teacher and learner who participated in the clinical dental photography course, using a mixed-method analysis with focus group interviews of student tutors and a questionnaire of learner perceptions. METHODS: A student-led course on Digital Clinical Photography took place with BDS 5 and 6 students as near-peer teachers (NPTs) and BDS 2 and 3 students as learners. Interviews were conducted with near-peer teachers, and a questionnaire was distributed to learners to evaluate students' perceptions of this novel teaching and learning experience. RESULTS: Near-peer teaching has proven to be a beneficial alternative teaching pedagogy which was well-received by NPTs and student learners. The content creation and teaching experience deepened NPTs' understanding on the subject matter and were motivated given the autonomous nature of the project. NPTs enjoyed and benefited from the collaborative nature of the project and the relevance of the subject matter and improved their clinical skills. The student learners enjoyed the learning experience and benefits of learning from NPTs which is supported by social and cognitive congruence. The positive perception of teaching and learning in pairs were also described. CONCLUSION: This project demonstrates the perceived benefits of near-peer teaching for clinical photography skills for student experiential learning and highlights key elements on how to structure such an activity to engage and support students to participate in such future activities.

"We know what they're struggling with": student peer mentors' embodied perceptions of teaching in a health professional education mentorship program.

This paper reports on a study of student peer mentorship in the context of nursing education in a higher education program in Canada. The study used an embodied hermeneutic phenomenological methodology to investigate student peer mentors' perceptions of teaching during peer mentorship. The data were collected over one calendar year (2019) and involved analysis of 10 participants' interview data and their 'body maps,' produced in response to guided questions. Through the data analysis a core theme of 'commitment to mentee growth' was identified, along with seven interrelated themes: sharing responsibility for learning, moderating stress, mediating power relations, navigating unknown processes, valuing creative approaches, offering generous acceptance, and facilitating confidence. Student peer mentorship has the potential to contribute to health professions education in a number of unique ways including through embodied attunement, trusting intersubjective relations, and dialogic education. This study is innovative in its purposeful design and aim to investigate both cognitive and embodied perceptions of student peer mentors. The findings point to the promise of student peer mentorship for advancing health sciences education. Implications for peer mentorship program development in health professions education are discussed.

Describing Ultrasound Skills Teaching by Near-Peer and Faculty Tutors Using Cognitive Apprenticeship.

Phenomenon: Ultrasound skills are becoming increasingly important in clinical practice but are resource-intensive to teach. Near-peer tutors often alleviate faculty teaching burden, but little is known about what teaching methods near-peer and faculty tutors use. Using the lens of cognitive apprenticeship, this study describes how much time faculty and near-peer tutors spend on different teaching methods during abdominal ultrasound skills training. Approach: Sixteen near-peer and 16 faculty tutors were videotaped during one 55-min practical ultrasound lesson with randomly assigned students. Videos were directly coded using Cognitive Apprenticeship teaching methods and activities. Segment durations were summed up and compared quantitatively. Findings: All 32 tutors spent most of the time on observing and helping students (Coaching, Median 29:14 minutes), followed by asking open and stimulating questions (Articulation, 12:04 minutes and demonstrating and giving explanations (Modeling, 04:50 minutes). Overall, distributions of teaching methods used were similar between faculty and near-peer tutors. However, faculty tutors spent more time on helping students manually, whereas near-peer tutors spent more time on exploring students' learning gaps and establishing a safe learning climate. Cognitive Apprenticeship was well suited as observational framework to describe ultrasound skills. Insights: Ultrasound train-the-tutor programs should particularly focus on coaching and articulation. Near-peers' similar use of teaching methods adds to the evidence that supports the use of near-peer teaching in ultrasound skills education.

'Educator with a capital E': Comparing medical education experiences of student-as-teacher elective participants and peers.

PURPOSE: Student-as-teacher electives are increasingly offered at medical schools, but little is known about how medical education experiences among enrolled students compare with those of their peers. The study's aim was to characterize medical students' education-related experiences, attitudes, knowledge, and skills based on their enrollment status in a student-as-teacher course. MATERIALS/METHODS: We conducted four focus groups at a medical school in the United States: two with graduating students in a student-as-teacher elective (n = 11) and two with unenrolled peers (n = 11). Transcripts were analyzed using the Framework Method to identify themes. RESULTS: Four themes emerged: interest in and attitudes towards medical education; medical education skills, knowledge, and frameworks; strategies for giving/receiving feedback; medical education training as part of medical school. Course participants demonstrated higher-level education-related knowledge and skills. Both groups endorsed teaching skills as important and identified opportunities to incorporate medical education training into medical school curricula. CONCLUSIONS: Medical education knowledge and teaching skills are self-reported as important learning outcomes for medical students, independent of enrollment status in a student-as-teacher course. The structure of such courses, best understood through a deliberate practice-based model, supports students' achievement of key learning outcomes. Certain course elements may warrant inclusion in standard medical school curricula.

Analysis of a Near Peer Tutoring Program to Improve Medical Students' Note Writing Skills.

Problem: The ability to document a patient encounter is integral for any physician. Previous studies indicate that medical students' note writing skills are poor due to a lack of formal clinical documentation instruction. Barriers to formally teaching students how to write patient notes include the significant time burden and variability in faculty feedback. Implementing a near-peer teaching program to teach students how to write a patient note can overcome these barriers and fill this curricular gap. Intervention: Fourth year medical students who completed a Teaching in Medicine elective course were trained to provide individual feedback to 1st and 2nd year students on note writing as a part of their Introduction to Clinical Medicine course. In order to determine the effect of this two year, near-peer feedback program on note writing skills, we analyzed students' scores on the note writing portion of two Objective Structured Clinical Exams that took place at the end of the 2nd and 3rd years of medical school. Context: The near-peer feedback sessions were implemented in the Fall of 2013 during the preclinical years of the medical school curriculum. Data from students who received near-peer feedback (N = 112) were compared to a historical control group who did not receive near-peer feedback on their note writing (N = 110). Objective Structured Clinical Exam scores that were specific to note writing skills, including the history, physical exam, and differential diagnosis subscales were examined. Impact: The near-peer feedback had a positive impact on the quality of patient notes. On the end of the 2nd year Objective Structured Clinical Exam, the near-peer feedback intervention group outperformed the no feedback group on the history and physical exam subscale scores but not on the differential diagnosis subscale score. One year later, the near-peer feedback intervention group continued to outperform the no feedback group on the physical exam subscale score, but not the history or the differential diagnosis subscale scores. Lessons Learned: Near-peer teaching improves student documentation of the history and physical exam, however only the effects on the physical exam portion persist into the clinical years of training. Writing up a differential diagnosis is a skill that develops through the clerkship experience regardless of exposure to feedback in the preclinical years. Implementing near-peer teaching in the medical school setting is feasible and can provide students with valuable learning experiences without relying on clinical faculty.

On the job training in the dissection room: from physical therapy graduates to junior anatomy instructors.

BACKGROUND:  The training of near-peer (NP) teachers and junior faculty instructors received major attention as a possible solution for the shortage of experienced anatomy instructors in faculties of medicine and health professions. Several studies described the training of NP teachers and junior instructors (≤ 2 years of teaching experience) using various methods. However, few publications include On the Job Training (OJT), which enables reflection and performance evaluation and encourages professionals to cope with their blind spots. Previous publications describing OJT did not include formal observation of the NP teacher or junior instructor. Therefore, this study aimed to present a novel approach to OJT inclusion during prosection laboratories based on the Lewinian experiential model. METHODS:  Eight physical therapy (PT) graduates were recruited as junior anatomy instructors into the prosection laboratories. All participated in a unique training program during two consecutive academic years (2017, 2018) and received OJT during the teaching sessions. Two questionnaires were filled out to evaluate the educational impact of the training program. Eighty-three first-year PT students participated in prosection laboratories in anatomy taught by junior instructors, and filled out a questionnaire evaluating the performance of both junior and senior instructors. In addition, we compared the final grades in anatomy obtained by students taught by senior instructors to the grades of those taught by junior instructors. RESULTS:  Each junior anatomy instructor participated in four OJT sessions. Based on self-reported measures, all professional and didactic aspects of the training program received a median score of 4.5 or higher on a five-point Likert scale. Students obtained similar grades in anatomy when taught by junior instructors compared with senior ones, and were similarly satisfied from the teaching performance of both senior and junior anatomy instructors. CONCLUSIONS:  OJT is applicable in a small-sized PT program facing a shortage of anatomy instructors. Including junior anatomy instructors in prosection laboratories for PT students is a viable solution to the shortage of experienced anatomy instructors. Further study, involving a larger cohort with a longer follow up will strengthen the preliminary results presented here.

Near-Peer Teaching in Radiation Oncology: a Proof of Principle Study for Learning Treatment Planning.

Radiotherapy techniques are expanding in range and complexity; therefore, protecting learning environments where residents nurture treatment planning skills is critical. The evidence base for 'near-peer' teaching (NPT), where professionals at a similar career stage assist in each other's learning, is growing in hospital-based disciplines, but has not been reported in radiation oncology. The feasibility of a resident-led teaching programme for developing treatment planning skills was investigated herein with quality improvement (QI) methodology. Following consultation with attendings (n = 10) and all residents (n = 17) at the two cancer centres in the region, a regular NPT session focused on planning skills was initiated at the largest centre, with video-linking to the second centre. Tutorials were case-based and pitched at the level of qualifying examinations. Plan-Do-Study-Act (PDSA) cycles were designed based on primary and secondary improvement drivers derived by group consensus among residents, with tutorials adopted accordingly. Participation, content, and satisfaction were monitored for 20 months. Six PDSA cycles reformed the tutorial format, leading to logistical and pedagogical benefits including interprofessional contributions and enhanced interactivity. Tutorials occurred on 85% prescribed occasions (n = 45) during the subsequent 18-month follow-up, with 25 distinct tumour sites featured. Resident participation and satisfaction increased, independent of resident seniority. Tutorials were paused for the first 2 months of the SARS-CoV-2 pandemic only. A high-quality and cost-effective regional, trainee-led teaching programme on treatment planning was feasible and cost-effective in this study.

Evaluating the Efficacy and Optimisation of the Peer-Led Flipped Model Using TEL Resources Within Neuroanatomy.

The flipped classroom (where students prepare before and then develop understanding during class) and technology-enhanced learning (audio-visual learning tools) are increasingly used to supplement anatomy teaching. However, the supporting literature lacks robust methodology and is conflicting in demonstrating efficacy outcomes. Contrastingly, near-peer teaching (where senior students teach juniors on the same academic programme) is well researched and reported to be both effective and versatile. This provides an ideal vehicle in which to investigate and potentially optimise these approaches.This study aims to assess educational impact of the peer-led flipped model and student engagement and perceptions regarding traditional and TEL resources.A quasi-randomised, cross-sectional study was conducted with 281 second-year University of Southampton medical students. Students were randomly allocated to 3 groups: traditional lecture (control), flipped text resource, or flipped video resource. The first group received no pre-teaching material, but the flipped groups received a text or video pre-teaching resource. Objective outcomes measured were: Knowledge gain and retention via multiple-choice questionnaires and formative exams Student perceptions and engagement using questionnaires and 2 focus groups All groups demonstrated significant knowledge gain post-teaching (p < 0.0001). However, regardless of engagement with pre-teaching material, no significant difference was found in knowledge gain or retention between the groups. Students engaged 21.1% more with the text rather than video resource (p = 0.0019), but spent equal time using both (p = 0.0948). All resources and teaching approaches were perceived 'very useful' with no significant differences found between groups. A qualitative approach utilising thematic analysis of focus groups identified 4 themes, including 'Attitudes towards flipped classroom', which revealed mixed reviews and perceptions from participants.This study has found the peer-led flipped model is of no detriment to educational impact compared to peer-led traditional approaches in a well-established peer teaching programme in undergraduate medicine at the University of Southampton. Students value traditional and video resources but engage with them differently. Additionally, it was reported that in this experiment, NPT did not seem well suited to the flipped classroom, suggesting a rare limitation of the utility of NPT application within an anatomy curriculum.

Effectivity of near-peer teaching in training of basic surgical skills - a randomized controlled trial.

BACKGROUND: Near-peer teaching (NPT) is a special way of teaching where the tutor is one or more academic years ahead of the person being tutored. The literature agrees on the benefits of the method, but there are only a few publications examining its effectiveness using objective methods. The aim of our study was to examine the effectiveness of NPT in the training of basic surgical skills. METHODS: We included 60 volunteer students who participated in a 20 × 45 min long surgical skills course. Based on the results of a pre-course test, we randomly divided the students into six equal groups. All groups completed the same curriculum, with three groups being assisted by a NPT tutor. After the course, they completed the same test as at the beginning. The exams were recorded on anonymized videos and were blindly evaluated. The students' satisfaction was monitored using a self-administered online anonymous questionnaire. Statistical analysis was performed using the Mann-Whitney and Wilcoxon tests. RESULTS: Overall, student performance improved with completion of the course (from 119.86 to 153.55 points, p <  0.01). In groups where a NPT tutor assisted, students achieved a significantly better score (37.20 vs. 30.18 points improvement, p = 0.036). The difference was prominent in surgical knotting tasks (14.73 vs. 9.30 points improvement, p <  0.01). In cases of suturing (15.90 vs. 15.46 points) and laparoscopy (7.00 vs. 4.98 points), the presence of the NPT tutor did not significantly affect development. Based on student feedback, although students positively assessed the presence of NPT, it did not significantly improve students' overall satisfaction since it was already 4,82 on a scale of 5 in the control group. CONCLUSIONS: Overall, involving a NPT tutor had a positive impact on student development. An outstanding difference was observed in connection with knotting techniques.

Informal near-peer teaching in medical education: A scoping review.

Background: Near-peer teaching (NPT) has a longstanding history within medical education. While it is becoming increasingly recognized within medical curricula, its beginnings can be traced back to informal teaching among medical students. Informal NPT such as this is still commonplace. However, it is often overlooked within the literature and has remained hidden from the scrutiny of evidence-based education. There has been minimal research conducted surrounding NPT outside of formal teaching sessions. Methods: A scoping PubMed search was conducted after identifying appropriate search terms. Directly relevant and high quality articles were included. Results/Synthesis: Within this scoping review, we discuss the potential benefits and shortfalls of such teaching. Results: Benefits include the opportunity for tutors to consolidate their own learning while contributing to the medical school community. Their learners benefit from the opportunity for small group learning focused on a relevant level of knowledge. However, shortfalls include the lack of prerequites, lack of content monitoring, and lack of resources. These should be considered when discussing the efficacy of this teaching. Conclusion: We also explore the wider culture of this informal NPT within medical education. We hope to promote further thought into this area, considering how guidance can be given to support both the near-peer teachers and their learners.

The role of residents in medical students' neurology education: current status and future perspectives.

BACKGROUND: Neurophobia, a well-described fear of neurology, affects medical students worldwide and may be one of the factors contributing to a shortage of neurologists in the United States. Residents spend a considerable amount of time with medical students; therefore, we sought to understand better the impact neurology residents have on medical students during their neurology clerkship and their subsequent interest in neurology. We aimed to identify and implement strategies to decrease neurophobia and increase the number of students pursuing neurology as a career. METHODS: Third-year medical students (n = 234) of UTHealth's McGovern Medical School rotating through their neurology core clerkship completed two surveys regarding their rotation experiences. Surveys were completed anonymously before and after the clerkship to measure their interest and confidence in neurology and the impact of their interactions with the neurology residents during the clerkship. In parallel, residents participated in a teaching workshop focused on small group teaching to improve their teaching effectiveness. Non-parametrical comparison and ordinal regression analyses were utilized for data analyses. RESULTS: Medical students reported a statistically significant increase in their confidence in managing neurological conditions and interest in pursuing a neurology residency after their clerkship. There was a significant association between the medical students' overall rotation experience and the residents' teaching effectiveness. The overall clerkship experience correlated with the medical students' interest and confidence in neurology. There was a trend towards an increase in residents' teaching effectiveness and students' rotation experience after a resident teaching workshop. Additionally, of note, students who rotated on both and outpatient and inpatient sites during their clerkship reported an increased interest in neurology. CONCLUSION: Our study supports that resident-led teaching efforts are important in improving medical students' neurologic education and their interest in neurology. Our data also supports that the interest in neurology increased for medical students after their neurology clerkship. We examined future strategies to implement "near-peer" teaching activities to enhance the medical students' neurologic educational experience. These strategies could potentially mitigate neurophobia and ultimately lead to a much-needed increase in future neurologists.

Key tips for teaching in the clinical setting.

Teaching with real patients in the clinical setting lies at the heart of health professional education, providing an essential component to clinical training. This is true of all the health disciplines - particularly medicine, nursing, dentistry, physiotherapy, and dietetics. Clinical tutorials orientate students to the culture and social aspects of the healthcare environment, and shape their professional values as they prepare for practice. These patient-based tutorials introduce students to the clinical environment in a supervised and structured manner, providing opportunities to participate in communication skills, history taking, physical examination, clinical reasoning, diagnosis and management. It is only through participation that new practices are learnt, and progressively, new tasks are undertaken. The aim of this paper is to provide health professional students and early career health professionals involved in peer and near peer teaching, with an overview of approaches and key tips for teaching in the clinical setting. Although there are many competencies developed by students in the clinical setting, our tips for teaching focus on the domains of medical knowledge, interpersonal and communication skills, and professionalism.