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      Effectiveness of a multi-session combined near-peer and faculty-led surgical skills course on self-perceived ability to perform basic surgical skills

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          Abstract

          Background

          Newly qualified UK doctors report feeling unprepared to perform basic practical procedures. The Royal College of Surgeons of England (RCSEng) responded to this concern by developing a national surgical curriculum, however, a national survey of UK medical schools identified that surgical skills teaching is inconsistent throughout the UK.

          Peer assisted teaching sessions are delivered by senior students to junior peers and have been demonstrated to be effective in a number of settings. We aimed to develop a peer-led surgical skills course for medical students and assess its efficacy in teaching surgical skills.

          Methods

          Combined near-peer and faculty-led teaching sessions were delivered to medical students (N = 14). We assessed for confidence in these skills using pre- and post-course Likert scale questionnaires to determine self-perceived benefit.

          Results

          Overall, student confidence in all skills improved by +1.254 (p < 0.0001). Individually, confidence in every skill increased significantly, including continuous suturing, knot tying and excision and closure, which improved by +1.45 (p < 0.001), +1.22 (p < 0.05) and +1.59 (p < 0.0001), respectively.

          Discussion

          This study demonstrates that teaching provided through near-peer faculty improves medical student confidence in basic surgical skills. A similar course design could be implemented in other UK medical schools to improve the surgical skills of newly graduated doctors

          Highlights

          • This study shows an objective benefit to peer-led teaching surgical skills on undergraduate medical students' confidence.

          • Near-peer learning is a beneficial process to students and teachers; equipping both with valuable skills and knowledge.

          • Future medical curricula should consider incorporating near-peer style teaching in undergraduate surgical training. .

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          Most cited references11

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          Dimensions and psychology of peer teaching in medical education.

          Peer teaching, an educational arrangement in which one student teaches one or more fellow students, is applied in several forms in medical education. A number of authors have linked peer teaching to theories of education and psychology. Yet no comprehensive overview of what theory can offer to understand dynamics of peer teaching has been previously provided. A framework is designed to categorize forms of peer teaching, distinguishing three dimensions: distance in stage of education, formality of the educational setting and size of the group taught. Theories are categorized in two dimensions: theories that explain benefits of peer teaching from a cognitive versus a social-psychological perspective, and theories that explain benefits for peer learners versus peer teachers. Both dimensional frameworks help to clarify why and in what conditions peer teaching may help students to learn.
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            Medical students-as-teachers: a systematic review of peer-assisted teaching during medical school

            Introduction International interest in peer-teaching and peer-assisted learning (PAL) during undergraduate medical programs has grown in recent years, reflected both in literature and in practice. There, remains however, a distinct lack of objective clarity and consensus on the true effectiveness of peer-teaching and its short- and long-term impacts on learning outcomes and clinical practice. Objective To summarize and critically appraise evidence presented on peer-teaching effectiveness and its impact on objective learning outcomes of medical students. Method A literature search was conducted in four electronic databases. Titles and abstracts were screened and selection was based on strict eligibility criteria after examining full-texts. Two reviewers used a standard review and analysis framework to independently extract data from each study. Discrepancies in opinions were resolved by discussion in consultation with other reviewers. Adapted models of “Kirkpatrick’s Levels of Learning” were used to grade the impact size of study outcomes. Results From 127 potential titles, 41 were obtained as full-texts, and 19 selected after close examination and group deliberation. Fifteen studies focused on student-learner outcomes and four on student-teacher learning outcomes. Ten studies utilized randomized allocation and the majority of study participants were self-selected volunteers. Written examinations and observed clinical evaluations were common study outcome assessments. Eleven studies provided student-teachers with formal teacher training. Overall, results suggest that peer-teaching, in highly selective contexts, achieves short-term learner outcomes that are comparable with those produced by faculty-based teaching. Furthermore, peer-teaching has beneficial effects on student-teacher learning outcomes. Conclusions Peer-teaching in undergraduate medical programs is comparable to conventional teaching when utilized in selected contexts. There is evidence to suggest that participating student-teachers benefit academically and professionally. Long-term effects of peer-teaching during medical school remain poorly understood and future research should aim to address this.
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              From undergraduate medical education to pre-registration house officer year: how prepared are students?

              Studies in the United Kingdom show that the first year of being a new doctor is a difficult transition from being an undergraduate medical. These doctors feel ill-prepared by their undergraduate medical student education and ill-equipped for their new role. This is a questionnaire study looking at 193 pre-registration house officers (PRHOs) and 212 consultant educational supervisors within the West Midlands Deanery in England, UK. The study asked how well prepared these new doctors were in seventeen basic subject areas (using a General Medical Council based template), and also, using the same template, how well prepared their consultant educational supervisors felt they were. Statistical testing included ranking of subject areas for each group, reliability testing and comparisons of views of house officers and consultants. Both groups ranked communication skills areas highest (best prepared) and ranked basic doctoring skills (such as prescribing, treatment, decision making and emergencies) lowest. House officers rated themselves significantly higher than did their consultant supervisors in thirteen out of the seventeen areas tested. In discussion, we ask if we have gone too far in teaching effective communication at the expense of basic doctoring skills. We also consider whether indeed young doctors have an inflated opinion of their own competencies, or are the older generation seeing the world through rose tinted spectacles?
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                Author and article information

                Contributors
                Journal
                Ann Med Surg (Lond)
                Ann Med Surg (Lond)
                Annals of Medicine and Surgery
                Elsevier
                2049-0801
                28 July 2020
                September 2020
                28 July 2020
                : 57
                : 153-156
                Affiliations
                [a ]Swansea University Medical School, Swansea University, Swansea, SA2 8PP, UK
                [b ]Morriston Hospital, Swansea, SA6 6NL, UK
                [c ]Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, UK
                Author notes
                []Corresponding author. Milton Keynes University Hospital, Standing Way, MK6 5LD, UK. billydaviddown@ 123456gmail.com
                Article
                S2049-0801(20)30228-4
                10.1016/j.amsu.2020.07.045
                7393464
                32760585
                2c0a743f-4abb-4863-b912-2cf02c32ef71
                © 2020 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 16 May 2020
                : 20 July 2020
                : 21 July 2020
                Categories
                Original Research

                medical students,curriculum,medical education,surveys and questionnaires

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