Pre-COVID and COVID experience of objective structured clinical examination (OSCE) as a learning tool for post-graduate residents in Obstetrics & Gynecology - a quality improvement study.

Objective: Due to its comprehensive, reliable, and valid format, the objective structured clinical examination (OSCE) is the gold standard for assessing the clinical competency of medical students. In the present study, we evaluated the importance of the OSCE as a learning tool for postgraduate (PG) residents assessing their junior undergraduate students. We further aimed to analyze quality improvement during the pre-coronavirus disease (COVID) and COVID periods. Methods: This quality-improvement interventional study was conducted at the Department of Obstetrics and Gynecology. The PG residents were trained to conduct the OSCE. A formal feedback form was distributed to 22 participants, and their responses were analyzed using a five-point Likert scale. Fishbone analysis was performed, and the 'plan-do-study-act' (PDSA) cycle was implemented to improve the OSCE. Results: Most of the residents (95%) believed that this examination system was extremely fair and covered a wide range of clinical skills and knowledge. Further, 4.5% believed it was more labor- and resource intensive and time-consuming. Eighteen (81.8%) residents stated that they had learned all three domains: communication skills, time management skills, and a stepwise approach to clinical scenarios. The PDSA cycle was run eight times, resulting in a dramatic improvement (from 30% to 70%) in the knowledge and clinical skills of PGs and the standard of OSCE. Conclusion: The OSCE can be used as a learning tool for young assessors who are receptive to novel tools. The involvement of PGs in the OSCE improved their communication skills and helped overcome human resource limitations while manning various OSCE stations.

Near-Peer-Teaching Revision Series During the COVID-19 Recovery Phase: An Experience From a UK Medical School.

Background The COVID-19 pandemic led to a significant disruption in clinical attachments for final-year medical students which can result in gaps in clinical knowledge and lower confidence levels. We developed a targeted near-peer-teaching (NPT) revision series to bridge this gap. Method A one-week virtual revision series was developed by the postgraduate doctors (PD and AT) and supervised by the final year written paper lead (NS) as per curriculum requirements. The series focused on eight key common clinical presentations. It was delivered via Leicester Medical School's virtual platform by PD and AT a week before the finals. Multiple-choice surveys were sent out prior to the commencement of the series to gauge participation and baseline confidence. Surveys were also sent out before and after each session evaluating teaching, confidence levels, and improvement points. Results This NPT experience was the first comprehensive revision series during the COVID-19 recovery phase. Between 30 and 120 students attended each session. From the pre-series survey (n=63), almost all students indicated that their clinical attachments had been affected by the pandemic and that they (100%) would be interested in participating in the NPT series. From the post-session surveys, 93% of students reported that the session enhanced their confidence in recognizing and managing the clinical presentation, and 100% considered the quality of teaching to be good to excellent. From the post-series survey, a significant improvement was seen in confidence based on the Likert scale (from a combined 35% to 83%, pre, and post-series, respectively). Conclusion The series evaluation demonstrates that students found it a valuable experience and benefited from the social and cognitive congruence afforded by near-peer teachers. Furthermore, the results support the continued use and development of a virtual pre-exam revision series within the medical school curriculum as an adjunct to normal teaching.

Peer teachers taking the lead in classroom instruction: program creation and challenges faced

Purpose: This paper discusses a program to train undergraduate students as near peer teachers delivering course-embedded information literacy instruction to undergraduate students. Design/methodology/approach: The approach involved the development and delivery of a curriculum combining information literacy concepts and teaching pedagogy. Significant student feedback was gathered which determined the final program structure. Findings: While the curriculum was successful in developing students' information literacy competencies and pedagogical skills, stakeholder buy-in and the COVID-19 pandemic hindered the program. Additionally, the goal of the program – solo student teaching, was not realized. Originality/value: Peer teaching is widely implemented in many disciplines;however, its application in academic libraries has focused more on peer reference, rather than peer teaching. This case study adds to the body of literature on this topic related to student peer teaching in academic libraries. © 2023, Emerald Publishing Limited.

Off-line or on-line? – near-рeer assisted anatomy education in the time of Covid-19 рandemic – a single center randomized controlled study

The COVID-19 pandemic significantly changed the way anatomy classes were carried out, depriving students of practical learning using real anatomical specimens. Once COVID restrictions were lifted and students returned to a normal class setting a randomized study was carried out to elevate effectiveness of practical anatomy didactics. The aim of this study was to evaluate the impact of an anatomy workshop based on demonstrating anatomical structures delivered in a face-to-face format, and to compare it with a standard course based on online learning. The randomization involved 350 students from whom 80 participants were drawn to form both a study and control group. The study consisted of three parts: exam 1, workshop, exam 2. The study group participated in all parts of the project, while the control group participated only in the exam. The workshop was held by near peer teachers (NPT). Statistical analysis showed that participation in the workshop had an effect on the passing score of exam 2 (p=0.039). It was also shown that the difference in scores was significantly higher (p=0.049) in the study group compared to the control group. The study proved that the workshops which were based on demonstrating anatomical structures by NPT significantly affected the scores obtained by trainees. In conclusion, the project confirmed the importance of student interaction with anatomical specimens and that online teaching is not a substitute for teaching in a dissecting room. Additionally, this study confirmed the high usefulness of NPT as a support for the didactic process conducted by experts. Copyright: © 2022 Jurand Domański, Marta Wanat, Jacek Ciach, Angelika Osuch, Bożena Kurc-Darak, Sławomir Woźniak, Zygmunt Domagała.

Enhancing medical students` confidence and performance in integrated structured clinical examinations (ISCE) through a novel near-peer, mixed model approach during the COVID-19 pandemic.

BACKGROUND: Near-peer medical education serves as an important method of delivering education to junior students by senior students. Due to the reduced clinical exposure because of the COVID-19 pandemic, we developed a mentorship scheme to help medical students with their Integrated Structured Clinical Examinations (ISCEs) by providing a combination of near-peer mentorship together with lecture-based teaching on a weekly basis for a 12-week period. Students attended a specialty-focused lecture every Tuesday followed by a small group teaching session organised by their tutor. METHODS: A longitudinal evaluative interventional study was undertaken by the international student led medical education organisation, OSCEazy. The teaching programme was organised and conducted by third year medical students to a recruited cohort of second year medical students. Students' perceptions of ISCEs (confidence, anxiety, and overall performance) were evaluated using 5-point Likert scales while their knowledge of the specialty was assessed using 10 single best answer questions which were distributed via Google® forms at the start and end of each week. In addition, we assessed tutor perceptions of their teaching and learning experience. RESULTS: Seventy-two tutees were enrolled in the programme (mean age: 24.4, female: 77.8%). 88.9% of the participants had not attended any online ISCE teaching prior to this. They preferred in-person ISCE teaching as compared to virtual sessions [median 4.5 (IQR 4-5) vs 3 (IQR 3-4), p <  0.0001), respectively]. There was a significant overall increase in knowledge when comparing pre-session and post-session performance [mean 53.7% vs 70.7%, p <  0.0001)]. There was a significant increase in student confidence [Confidence: median 3 (IQR:3-4) vs 4 (IQR 3-4), p <  0.0001] while no change was seen in the anxiety and perception of their overall performance in an ISCE. [Anxiety: median 3 (IQR 2-4) vs 3 (IQR 3-4), p = 0.37, Performance: median 3 (IQR 3-4) vs median 3 (IQR 3-4), p <  0.0001]. The tutors reported an increase in their confidence in teaching ISCEs online [median 3 (IQR 2-3.25) vs median 4 (IQR 4-5), p <  0.0001)]. CONCLUSION: Online near-peer teaching increases the confidence of both tutees and tutors involved while enhancing the tutees' knowledge of the specialty. Thus, medical schools should incorporate near-peer teaching in their curriculum to enhance the student learning experience.

Lessons From a Near-Peer Junior Doctor Teaching Program in Trauma and Orthopedics.

INTRODUCTION:  A junior doctor teaching program delivered by near-peers can foster collaboration in a less-pressured and conducive learning environment. The aim of this study was to provide an analysis of an orthopedic teaching program in a high-resource environment utilizing readily available tools and resources that are potentially available in most hospitals globally.  Methods: This study involved the utilization of an outcome-based learning approach with regular formal feedback. An anonymized Google Forms survey using a 10-point Likert scale was conducted after a 30-week period. The survey tool was sent out to 28 doctors and two senior nurse practitioners who participated in the program either as tutors, learners, or both. A total of 19 out of 30 respondents completed the survey giving a 63% survey completion rate. The setting for this study was the trauma and orthopedics department in a United Kingdom district general hospital. RESULTS:  Learners' confidence in their orthopedic knowledge and skills pre-program had a median response of eight with a mode of seven whereas confidence following engagement on the program improved with a median response of nine and a mode of 10. At an alpha level of 0.05, this observed improvement was statistically significant using the Mann-Whitney U test (p=0.466). Tutors' perception of the usefulness of the teaching feedback had a median response of nine with a mode of 10. Relevance of the selected topics had a median response of nine and a mode of 10. Inclusion in the teaching program to cater to learner diversity had a median response of nine and a mode of 10. The effectiveness of a blended approach for learning had a median response of nine and a mode of 10.  Conclusion: This study has provided evidence of the benefits of a near-peer teaching program. This is especially important in the post-coronavirus disease (COVID) pandemic recovery period where easily accessible and well-grounded educational programs will be useful to complement the deanery teachings for trainees. This is important as this may be the main source of formal teaching for non-trainee junior doctors in many hospital settings. Additional research will be needed to further explore the pros and cons of such programs within a surgical specialty like orthopedics with an emphasis on the various pedagogical approaches to teaching and learning for junior doctors working in a busy clinical setting.

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.

Developing an Interest in Mathematics with Occupational Exemplars

This paper introduces four different ways for developing upper secondary school students’ interest in and motivation toward mathematics by connecting mathematics topics and contextualizing mathematical problems to working life scenarios in different occupations. They include materials for teachers, a self-study online course for students, a virtual reality environment with embedded mathematics problems, and the use of near-peer role models (university students) as math ambassadors that visit upper secondary schools. All four activities were created in project TyöMAA with the general objectives of informing upper secondary school students where and how mathematics is used in their future careers, enhancing students’ mathematical skills to enable them to progress in their post-graduate studies, and infusing the students with enthusiasm and self-confidence in mathematics. Although the COVID-19 pandemic has inevitably slowed the implementation and dissemination of the created tools, we have observed some encouraging indicators of the need for and effectiveness of the solutions. © 2022, Springer Nature Switzerland AG.

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.

Evaluation of Online Near-Peer Teaching for Penultimate-Year Objective Structured Clinical Examinations in the COVID-19 Era: Longitudinal Study.

BACKGROUND: The benefits of near-peer learning are well established in several aspects of undergraduate medical education including preparing students for Objective Structured Clinical Examinations (OSCEs). The COVID-19 pandemic has resulted in a paradigm shift to predominantly online teaching. OBJECTIVE: This study aims to demonstrate the feasibility and benefits of an exclusively online near-peer OSCE teaching program in a time of significant face-to-face and senior-led teaching shortage. METHODS: A teaching program was delivered to penultimate-year students by final-year students at Manchester Medical School. Program development involved compiling a list of salient topics and seeking senior faculty approval. Teachers and students were recruited on Facebook. In total, 22 sessions and 42 talks were attended by 72 students and taught by 13 teachers over a 3-month period. Data collection involved anonymous weekly questionnaires and 2 separate anonymous student and teacher postcourse questionnaires including both quantitative and qualitative components. RESULTS: On a scale of 1-10, students rated the quality of the program highly (mean 9.30, SD 1.15) and felt the sessions were highly useful in guiding their revision (mean 8.95, SD 0.94). There was a significant increase in perceived confidence ratings after delivery of the program (P<.001). Teachers felt the program helped them better understand and retain the subject material taught (mean 9.36, SD 0.81) and develop skills to become effective clinical teachers (mean 9.27, SD 0.79). CONCLUSIONS: This is the first study demonstrating the efficacy of a near-peer OSCE teaching program delivered exclusively online. This provides an exemplary framework for how similar programs should be encouraged given their efficacy and logistical viability in supplementing the undergraduate curriculum.

Mentoring in palliative medicine in the time of covid-19: a systematic scoping review : Mentoring programs during COVID-19.

INTRODUCTION: The redeployment of mentors and restrictions on in-person face-to-face mentoring meetings during the COVID-19 pandemic has compromised mentoring efforts in Palliative Medicine (PM). Seeking to address these gaps, we evaluate the notion of a combined novice, peer-, near-peer and e-mentoring (CNEP) and interprofessional team-based mentoring (IPT) program. METHODS: A Systematic Evidence Based Approach (SEBA) guided systematic scoping review was carried out to study accounts of CNEP and IPT from articles published between 1st January 2000 and 28th February 2021. To enhance trustworthiness, concurrent thematic and content analysis of articles identified from structured database search using terms relating to interprofessional, virtual and peer or near-peer mentoring in medical education were employed to bring together the key elements within included articles. RESULTS: Fifteen thousand one hundred twenty one abstracts were reviewed, 557 full text articles were evaluated, and 92 articles were included. Four themes and categories were identified and combined using the SEBA's Jigsaw and Funnelling Process to reveal 4 domains - characteristics, mentoring stages, assessment methods, and host organizations. These domains suggest that CNEP's structured virtual and near-peer mentoring process complement IPT's accessible and non-hierarchical approach under the oversight of the host organizations to create a robust mentoring program. CONCLUSION: This systematic scoping review forwards an evidence-based framework to guide a CNEP-IPT program. At the same time, more research into the training and assessment methods of mentors, near peers and mentees, the dynamics of mentoring interactions and the longitudinal support of the mentoring relationships and programs should be carried out.

Filling in the Blanks: Senior Medical Student Supporting the Transition of Incoming First-Year UK Medical Students During COVID-19.

There is a lack of resources available to support transition into the first year of UK medical schools. Due to COVID-19 and the possibility that students have lost learning, it is argued that there is a demand for free, accessible curated materials. These can reinforce confidence in expected core topics, mitigate differences in student knowledge and provide a head start in new concepts prior to entry - particularly important in the transition to a virtual learning environment. During lockdowns, this may lessen the effect of lost learning and can be assembled by medical students pitching appropriate content and encouraging near-peer support.

Changing Student Perception of an Online Integrated Structured Clinical Examination During the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic has created a hiatus in in-person clinical assessments due to safety and logistical concerns. We aimed to evaluate student perception and utility of an online Integrated Structured Clinical Examinations (ISCEs) during the pandemic. METHODS: Final-year medical students from a single institution were offered an online mock ISCE through a student-to-student ("near-peer") teaching-programme. A questionnaire-based cross-sectional study was conducted pre- and post-online mock ISCE. RESULTS: Sixty-four students completed the study. Pre- and post-data showed an increase in confidence (p<0.0001), less worry regarding the online format (p<0.0001) and less anxiety about excelling in ISCEs (p<0.001). Students felt that having done the mock, an online format would more positively affect their overall performance (p=0.007). CONCLUSION: This study demonstrates a positive change in student perception and confidence in online ISCEs. Online ISCEs are thus feasible, though sole reliance on this format may provide an incomplete assessment of student's overall clinical competency.

Creation of a Student-Run Medical Education Podcast: Tutorial.

BACKGROUND: Podcasting has become a popular medium for medical education content. Educators and trainees of all levels are turning to podcasts for high-quality, asynchronous content. Although numerous medical education podcasts have emerged in recent years, few student-run podcasts exist. Student-run podcasts are a novel approach to supporting medical students. Near-peer mentoring has been shown to promote medical students' personal and professional identity formation. Student-run podcasts offer a new medium for delivering near-peer advice to medical students in an enduring and accessible manner. OBJECTIVE: This paper describes the creation of the UnsCripted Medicine Podcast-a student-run medical education podcast produced at the University of Cincinnati College of Medicine. METHODS: The planning and preparatory phases spanned 6 months. Defining a target audience and establishing a podcast mission were key first steps. Efforts were directed toward securing funding; obtaining necessary equipment; and navigating the technical considerations of recording, editing, and publishing a podcast. In order to ensure that high professionalism standards were met, key partnerships were created with faculty from the College of Medicine. RESULTS: The UnsCripted Medicine Podcast published 53 episodes in its first 2 years. The number of episodes released per month ranges from 0 to 5, with a mean of 2.0 episodes. The podcast has a Twitter account with 217 followers. The number of listeners who subscribed to the podcast via Apple Podcasts grew to 86 in the first year and then to 218 in the second year. The show has an average rating of 4.8 (out of 5) on Apple Podcasts, which is based on 24 ratings. The podcast has hosted 70 unique guests, including medical students, resident physicians, attending physicians, nurses, physicians' family members, graduate medical education leadership, and educators. CONCLUSIONS: Medical student-run podcasts are a novel approach to supporting medical students and fostering professional identity formation. Podcasts are widely available and convenient for listeners. Additionally, podcast creators can publish content with lower barriers of entry compared to those of other forms of published content. Medical schools should consider supporting student podcast initiatives to allow for near-peer mentoring, augment the community, facilitate professional identity formation, and prepare the rising physician workforce for the technological frontier of medical education and practice.

Is remote near-peer anatomy teaching an effective teaching strategy? Lessons learned from the transition to online learning during the Covid-19 pandemic.

In response to the Covid-19 pandemic, medical educators have transformed pre-clerkship anatomy curricula into online formats. The purpose of this study was to evaluate the effectiveness and student perceptions of an online near-peer anatomy curriculum. The classes of 2022 and 2023 completed identical foundational anatomy curricula in-person, whereas the class of 2024 completed an adapted curriculum for remote online learning. Quantitative and qualitative responses were used to compare attitudes between instructional methods. Assessment scores and evaluation survey responses were collected from the classes of 2022 (n = 185), 2023 (n = 184), and 2024 (n = 183). Mean assessment scores (±SD) for the classes of 2022, 2023, and 2024 were 93.64% (±5.86), 93.75% (±4.09), and 92.04% (±4.83), respectively. Post hoc group comparisons showed the class of 2024 scored significantly lower than the two previous classes [2022: (H(1) = 18.58, P < 0.001), 2023: (H(1) = 18.65, P < 0.001)]. Mean survey results concerning curriculum quality were 4.06/5.00 for the class of 2023 and 3.57/5.0 for the class of 2024 (t(365) = 2.67, P = 0.008). Considering a small effect size (η2 = 0.034), there was no meaningful difference in student assessment scores. A potential drawback of online near-peer anatomy teaching remains in student perceptions of course quality; qualitative feedback suggested technological limitations and perceptions of online course instructors were partly responsible for lower student satisfaction. Following the Covid-19 pandemic, medical educators should incorporate the lessons learned from this unique educational inflection point to improve curricula moving forward.

Students engage in primary literature in molecular biology techniques using an online journal club format.

Campus closures in Spring 2020 required rapid transition to online course delivery. Fall 2020 has similar needs and expectations. The Advanced Topics in Molecular Biology Techniques course, designed for upper division undergraduate and graduate students, uses a "journal club" format. The journal club format includes practice-based learning and provides student choice. Examples from graduate students effectively model the expectations using near-peer instruction. Teaching in the time of COVID-19 requires openness to new ideas and modifications to previous approaches. We were able to move the course online with little interruption.

Surgery Clerkship Curriculum Changes at an Academic Institution during the COVID-19 Pandemic.

PROBLEM: The COVID-19 pandemic has suspended the surgery clinical clerkship for third-year medical students at numerous institutions across the world. As a result, educators and students have adapted rapidly. There is a paucity of precedents regarding urgent and brusque formal curricular changes for medical students enrolled in surgical clinical rotations. APPROACH: The University of California, San Francisco Department of Surgery created a surgically focused extended mastery learning rotation (EMLR). The surgery clerkship leadership designed a curriculum consisting of multiple learning strategies compatible with virtual learning environments. The primary aims of the newly developed EMLR were to help students consolidate their foundational science knowledge before their return to clinical medicine in an altered learning environment. The EMLR is currently underway, and further studies are necessary to evaluate its effectiveness.