a Department of Obstetrics and Gynecology , University of Toronto , Toronto , Ontario , Canada.
d Undergraduate Medical Education , Queen's University , Kingston , Ontario , Canada.
Teach Learn Med. 2019 Jun-Jul;31(3):307-318. doi: 10.1080/10401334.2018.1516555. Epub 2018 Dec 15.
Medical educators recognize that professionalism is difficult to teach to students in lecture-based or faculty-led settings. An underused but potentially valuable alternative is to enroll near-peers to teach professionalism. We describe a novel near-peer curriculum on professionalism developed at Queen's University School of Medicine. Senior medical students considered role models by their classmates were nominated to facilitate small-group seminars with junior students on topics in professionalism. Each session was preceded by brief pre-readings or prompts and engaged students in semistructured, open-ended discussion. Three 2-hour sessions have occurred annually. The near-peer sessions are a required component (6 hours; 20%) of the 1st-year professionalism course at Queen's University (30 hours), which otherwise includes faculty-led seminars, lectures, and online modules. Senior facilitators are selected through a peer nomination process during their 3rd year of medical school. This format was chosen to create a highly regarded position to which students could aspire by demonstrating positive professionalism. We performed a qualitative descriptive evaluation of the near-peer curriculum. Fifty-six medical students participated in 11 focus group interviews, which were coded and analyzed for themes inductively and deductively. Quantitative reviews of student feedback forms and a third-party thematic analysis were performed to triangulate results. Medical students preferred the near-peer-led discussion-based curriculum to faculty-led seminars and didactic or online formats. Junior students could describe specific examples of how the curriculum had influenced their behavior in academic, clinical, and personal settings. They cited senior near-peer facilitators as the strongest aspect of the curriculum for their social and cognitive congruence. Senior students who had facilitated sessions regarded the peer teaching experience as formative to their own understanding of professionalism. Formal medical curricula on professionalism should emphasize near-peer-led small-group discussion as it fosters a nuanced understanding of professionalism for both early level students and senior students acting as teachers.
医学教育者认识到，在基于讲座或教师主导的环境中向学生传授专业精神是具有挑战性的。一种未被充分利用但具有潜在价值的替代方法是招募近龄同伴来教授专业精神。我们描述了皇后大学医学院开发的一种新颖的近龄同伴专业精神课程。被同学视为榜样的高年级医学生被提名，以便在专业精神主题方面为低年级学生举办小组研讨会。每次会议前都有简短的预习或提示，并让学生参与半结构化、开放式讨论。每年进行三次 2 小时的会议。近龄同伴课程是皇后大学一年级专业课程（30 小时）的必修组成部分（6 小时；20%），该课程还包括教师主导的研讨会、讲座和在线模块。高级协调员通过在医学院三年级期间的同学提名过程中选出。这种形式是为了创造一个备受推崇的职位，让学生通过展示积极的专业精神来向往。我们对近龄同伴课程进行了定性描述性评估。56 名医学生参加了 11 次焦点小组访谈，对访谈内容进行了编码和分析，采用归纳和演绎法提取主题。对学生反馈表的定量审查和第三方主题分析进行了三角分析，以验证结果。医学生更喜欢近龄同伴主导的讨论式课程，而不是教师主导的研讨会、讲授式或在线课程。低年级学生可以描述课程如何影响他们在学术、临床和个人环境中的行为的具体例子。他们提到高年级近龄同伴协调员是课程的最强方面，因为他们在社交和认知方面与学生非常契合。参与过课程的高年级学生认为，同伴教学经验对他们自己对专业精神的理解具有形成性。专业精神的正式医学课程应强调近龄同伴主导的小组讨论，因为这可以促进早期阶段学生和担任教师的高年级学生对专业精神的深入理解。
