Calisi Olivia, King Steven, Berger Daniel J, Nasir Munima, Nickolich Sarah
Medicine, Penn State University College of Medicine, Hershey, USA.
Department of Family and Community Medicine, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA.
Cureus. 2023 Feb 27;15(2):e35535. doi: 10.7759/cureus.35535. eCollection 2023 Feb.
The Objective Structured Clinical Examination (OSCE) is utilized by medical schools to assess students' competency in clinical skills. Literature has shown that first-year students who were tutored by fourth-year students (MS4s; near-peer) in practice OSCEs reported self-perceived improvement in OSCE skills. There is a lack of research regarding the effectiveness of first-year (MS1) pairs for reciprocal-peer practice OSCEs. This study aims to assess if virtual reciprocal-peer OSCEs provide comparable learning opportunities to virtual near-peer OSCEs.
MS1 students were assigned to work with a near-peer or a reciprocal-peer for one week, and then switched protocols the second week. One student in each reciprocal-peer pair was assigned to act as a standardized patient (SP). Their partner took a history, interpreted physical exam findings, prepared a note, and gave an oral presentation. The pair then switched roles using a second case. The near-peer group followed the same procedure, without the reversal of roles.
A total of 135 MS1s participated in the first week and 129 in the second week. Students agreed that working with a near-peer was more valuable than a reciprocal-peer in the following parameters: peer feedback (N=113, 89%), history-taking skills (N=101, 80%), physical exam skills (N=102, 81%), and note-writing skills (N=109, 89%). Pairwise comparison utilizing Wilcoxon signed-rank test indicated participants preferred the choice of a fourth-year student partner over an MS1 partner (Z=1.436, p<0.001).
Participants found working with a near-peer increased confidence in their clinical skills and near-peer feedback was more valuable. Although MS1s found that watching and evaluating their peers in a reciprocal-peer exercise was beneficial, students overwhelmingly preferred working with MS4s due to more valuable feedback.
医学院校采用客观结构化临床考试（OSCE）来评估学生的临床技能水平。文献表明，在OSCE实践中接受四年级学生（MS4；近龄同伴）辅导的一年级学生报告称，他们自我感觉OSCE技能有所提高。关于一年级学生（MS1）配对进行对等同伴OSCE实践的有效性，目前缺乏相关研究。本研究旨在评估虚拟对等同伴OSCE是否能提供与虚拟近龄同伴OSCE相当的学习机会。
MS1学生被分配与一名近龄同伴或一名对等同伴合作一周，第二周则更换方案。每对对等同伴中的一名学生被指定扮演标准化病人（SP）。其搭档进行病史采集、解读体格检查结果、撰写记录并进行口头报告。然后，两人使用第二个病例互换角色。近龄同伴组遵循相同程序，但不互换角色。
共有135名MS1学生参与了第一周的活动，129名参与了第二周的活动。学生们一致认为，在以下方面，与近龄同伴合作比与对等同伴合作更有价值：同伴反馈（N = 113，89%）、病史采集技能（N = 101，80%）、体格检查技能（N = 102，81%）和记录撰写技能（N = 109，89%）。使用Wilcoxon符号秩检验进行成对比较表明，参与者更喜欢选择四年级学生作为搭档，而不是MS1搭档（Z = 1.436，p < 0.001）。
参与者发现与近龄同伴合作能增强他们对临床技能的信心，并且近龄同伴的反馈更有价值。尽管MS1学生发现在对等同伴练习中观察和评估同伴是有益的，但由于更有价值的反馈，学生们绝大多数还是更喜欢与MS4学生合作。
