The "Near-Peer" Approach to Teaching Musculoskeletal Physical Examination Skills Benefits Residents and Medical Students.

BACKGROUND

The musculoskeletal physical examination (MSK PE) is an essential part of medical student training, and it is best taught in a hands-on, longitudinal fashion. A barrier to this approach is faculty instructor availability. "Near-peer" teaching refers to physicians-in-training teaching their junior colleagues. It is unknown whether near-peer teaching is effective in teaching this important physical examination skill.

OBJECTIVE

To investigate attitudes of medical students and physical medicine and rehabilitation (PM&R) residents regarding near-peer teaching in an MSK PE curriculum.

DESIGN

Qualitative, anonymous paper and online surveys.

SETTING

Tertiary academic center with a medical school and PM&R training program.

PARTICIPANTS

Ninety-nine second- and third-year medical students and 13 PM&R residents in their third or fourth postgraduate year.

METHODS

Attitudes of second- and third-year medical students were measured immediately after their MSK PE course. Resident attitudes were measured in a single cross-sectional sample.

MAIN OUTCOME MEASUREMENTS

Student attitudes were assessed via a questionnaire with 5-point Likert scales and a free-text comment section. The resident questionnaire included a combination of multiple-choice questions, rankings, free-text responses, and Likert scales.

RESULTS

All 99 students completed the questionnaire. The majority of students (n = 79 [80%]) reported that resident involvement as hands-on instructors of examination skills was "very useful," and 87 (88%) indicated that resident-led small discussion groups were "very helpful" or "somewhat helpful." Fifty-seven of 99 students (58%) reported that the resident-facilitated course was "much better" than courses without resident involvement. Twelve of 13 eligible residents completed the survey, and of those, 8 found teaching "very helpful" to their MSK knowledge, and 11 became "somewhat" or "much more confident" in clinical examination skills.

CONCLUSIONS

Our study supports educational benefits to medical students and resident instructors in our MSK PE program. We recommend including near-peer teaching in medical student education, particularly for hands-on skills; we also recommend providing opportunities for PM&R residents to participate in formal near-peer education.

LEVEL OF EVIDENCE

Not applicable.