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DESCRIPTIVE ARTICLE
Near-Peer Teaching in Anatomy: An Approach for
Deeper Learning
Darrell J. R. Evans,* Tracy Cuffe
Brighton and Sussex Medical School, Sussex University, Brighton, United Kingdom
Peer teaching has been recognized as a valuable and effective approach for learning and
has been incorporated into medical, dental, and healthcare courses using a variety of
approaches. The success of peer teaching is thought to be related to the ability of peer
tutors and tutees to communicate more effectively, thereby improving the learning environment. Near-peer teaching involves more experienced students acting as tutors who are
ideally placed to pass on their knowledge and experience. The advantage of using
near-peer teachers is the opportunity for the teacher to reinforce and expand their own
learning and develop essential teaching skills. This study describes the design and implementation of a program for fourth year medical students to teach anatomy to first- and
second-year medical students and evaluates the perceptions of the near-peer teachers on
the usefulness of the program, particularly in relation to their own learning. Feedback
from participants suggests that the program fulfills its aims of providing an effective environment for developing deeper learning in anatomy through teaching. Participants recognize that the program also equips them with more advanced teaching skills that will be
required as they move nearer toward taking on supervisory and teaching duties. The program has also provided the school with an additional valuable and appropriate resource
for teaching anatomy to first- and second-year students, who themselves view the inclusion of near-peer teachers as a positive element in their learning. Anat Sci Educ 2:227–233,
2009. © 2009 American Association of Anatomists.
Key words: gross anatomy; undergraduate medical education; collaborative learning;
communication skills; anatomical knowledge; dissection; peer teaching
INTRODUCTION
The use of peer teaching has been an integral part of human
learning for centuries and in its most literal sense involves participants that are all of a similar age or level of learning. The
success of peer teaching is thought to be connected to the ability of peer tutors and tutees to communicate more effectively
and, therefore, improve the learning environment (Allen and
Boraks, 1978). Peer teaching has been used in a variety of guises including peer-assisted learning, team-based learning (TBL)
and reciprocal peer teaching, and in many different areas of
health education and the biosciences (Krych et al., 2005; Tariq,
*Correspondence to: Dr. Darrell J. R. Evans, Brighton and Sussex
Medical School, Sussex University, Falmer, Brighton BN1 9PX,
United Kingdom. E-mail: d.evans@bsms.ac.uk
Received 16 July 2009; Revised 28 August 2009; Accepted 28 August
2009.
Published online 15 September 2009 in Wiley InterScience (www.
interscience.wiley.com). DOI 10.1002/ase.110
© 2009 American Association of Anatomists
Anatomical Sciences Education
SEPTEMBER/OCTOBER 2009
2005; Gill et al., 2006; Secomb, 2007; Evans and Canavan,
2008; Shankar and Roopa, 2009). Within anatomy, peer teaching has been widely recognized as a valuable approach for
learning and has been effectively incorporated into medical,
dental, and healthcare curricula (Nnodim, 1997; Brueckner
and MacPherson, 2004; Youdas et al., 2008). The manner of
peer teaching has varied extensively and has included one-toone teacher-tutee interactions, group peer teaching, problembased learning, or even peer-developed learning materials
(Walker-Bartnick et al., 1984; Lake, 1999; Krych et al., 2005;
Nieder et al., 2005; Youdas et al., 2008). While many of these
examples have involved students in the same year of training or
in immediately adjacent years and therefore meet the definition
of peer teaching, other activities which include alternate forms
of tutor-led teaching where direct peers are not involved have
also been regarded as peer teaching. In these cases, tutoring
involves experienced students at more advanced stages of their
training acting as tutors and hence the term of near-peer teaching is more appropriate. The educational concept of near-peer
teaching is different to that of peer teaching as the underlying
principles involved differ. While peer teachers are usually of a
similar age or level of learning and therefore relatively inexperAnat Sci Educ 2:227–233 (2009)
ienced, near-peer teachers are in a position to more easily pass
on their knowledge and experience (near-peer teachers would
typically be 2–5 years ahead in their learning). In addition,
near-peer teachers have an unrivalled opportunity to reinforce
and expand their own learning and usually have increased
motivation as teaching opportunities are often chosen rather
than being part of a curriculum (Josephson and Whelan, 2002;
Bulte et al., 2007). In the healthcare environment, near-peer
teachers are able to use the tutor experience as a relevant educational tool as they move nearer toward taking on supervisory
roles (Haist et al., 1997). In anatomy, near-peer teaching is
widely used (Houwink et al., 2004) and is probably best exemplified by the anatomy demonstrators who are used extensively
across medical schools in the United Kingdom (UK) and elsewhere to help the faculty staff direct student learning within
the anatomy laboratory. Demonstrators are usually junior doctors within the early postgraduate training years and who, in
general, intend to follow careers within surgery or radiology.
Similar approaches have been used in the United States with
upper classmen and residents taking the role as demonstrator
(Lee et al., 1999). The use of demonstrators in anatomy has
been seen as a successful approach for both student learning and
demonstrator learning and development and probably reflects
the fact that it encompasses many of the attributes of peer teaching as well as incorporating such characteristics as mentorship
and role modeling. Unfortunately, there has been a reduction in
the availability of these clinical trainees due to reform of the
postgraduate training programs in the UK (Fraher, 2007), which
together with the reported deficit in experienced anatomy faculty (Malamed and Seiden, 1995; Monkhouse, 1996; McKeown
et al., 2003; McCuskey et al., 2005) has meant that there is a relative lack of suitable teachers to inspire and develop the knowledge of students in anatomy. This is particularly unfortunate
given the recent resurgence in the demand for effective anatomical teaching and communication of anatomical information
(Evans, 2008; Pawlina and Drake, 2008). Despite this, the utilization of demonstrators is still widely seen as one of the primary
and favored methods of anatomical tutoring and, therefore, the
identification of additional demonstrator resources has been
investigated by a number of schools.
At Brighton and Sussex Medical School (BSMS) in the UK,
this issue has been tackled by developing a formalized nearpeer teaching program in anatomy where fourth year students
are given the opportunity to act as ‘‘junior’’ demonstrators and
teach first- and second-year students in the anatomy laboratory. Offering such a program provides an ideal environment
for medical students to develop their teaching skills as recommended by the General Medical Council (GMC, 2003) which
governs all medical courses in the UK. Anatomy within the 5year undergraduate medical program at BSMS is delivered as
an integrated element within the system-based modules in years
one and two and within year four clinical rotations (Evans and
Watt, 2005). The dominant mode of learning for anatomy is
student-led dissection with accompanying lectures, tutorials,
and living anatomy sessions including imaging. Like many UK
medical schools, BSMS uses a team of traditional demonstrators as well as anatomy faculty within the dissecting room;
however, students are urged to make their own ‘‘journey of discovery’’ during the dissection sessions and we use an informal
TBL approach. Working in groups of eight, students lead the
dissection process using specially designed worksheets and
with the guidance of staff. Students are encouraged to teach
each other through demonstration and the inclusion of checklists in the worksheets provides an opportunity for peer-led
228
assessment of the knowledge and understanding gained in the
session. These checklists are then used by demonstrators and
faculty to ensure learning outcomes have been achieved. In
addition, each worksheet contains a series of applicable questions designed to make students think about the relevance of
the anatomical region they are studying. These questions are
for students to explore and answers are not directly given
within the session. Instead students are encouraged to discover
possible answers after the session, with the formal answers
released at a later date. While achievement in anatomy is
described as above average (compared to other disciplines) for
the majority of the students as exemplified by analysis of the
results of summative module assessments, it has been necessary
to ensure that this knowledge and understanding is not just superficial with deeper learning the goal. Deeper learning is
encouraged where possible through the chosen teaching methods, the extensive formative assessments we have developed
online, and by bringing students back to the dissecting room in
the fourth-year when taking rotations such as ENT and orthopedics to refresh and develop relevant anatomy (Evans and
Watt, 2005). However, it was recognized that the creation of a
near-peer teaching program would provide some students with
additional opportunities to re-enforce understanding of anatomy, as well as equipping them with educational training and
developing their career competitiveness. This study describes
the design and implementation of the near-peer teaching program and evaluates the near-peer teacher perceptions of the
usefulness of the program, particularly to their own learning.
EXPERIMENTAL PROCEDURES
Program Design and Development
The near-peer teaching program was developed in the first
instance to enhance opportunities for fourth year students (in
their penultimate year of medical school) to try to develop
deeper learning of anatomy and provide educational training.
An additional objective was to increase numbers of demonstrators to teach first- and second-year undergraduate medical
students. In terms of specific outcomes, it was hoped that by
the end of the program cycle, near-peer (NP) teachers would
have:
Gained an enhanced understanding of anatomy in specific
regions and systems of the body;
Gained significant exposure to the theory and practice of
teaching;
Further developed oral communication skills;
Recognized the importance of the near-peer teaching experience to both tutor and tutee and its relevance to future
career development.
For the tutees it was hoped that they would have:
Gained from the interaction with students at a different
level of learning and therefore provide an enhanced learning environment;
Gained from an increased number of demonstrators acting
as guides and tutors in the anatomy laboratory.
Invitations were sent to all medical students toward the
end of their third year of undergraduate study asking them to
express an interest in joining the near-peer teaching program.
Evans and Cuffe
Students were informed that this was a voluntary experience
and one that should not compete with their own timetabled
activities. Interested students were subsequently invited to
attend a training and selection session organized by the anatomy faculty. Short presentations were given on aspects of
medical education with an emphasis on ‘‘becoming an effective teacher,’’ the UK anatomy regulatory system (Human Tissue Act, 2004) and details of the selection procedure. The
next stage of the training was designed to give all participants
an example of teaching practice within the anatomy laboratory and remind them of the style of teaching that underpins
anatomy at BSMS (Evans and Watt, 2005). Each member of
anatomy faculty led small groups for a 20-minute cadaveric
demonstration. Finally, trainees were given an opportunity to
illustrate their own teaching skills, anatomical knowledge,
and general ability to interact with students by presenting a
short practical demonstration on an element of thoracic anatomy using cadaveric specimens to a member of experienced
anatomy faculty and a group of fellow trainees. All trainees
were given prior warning of what area would be covered and
advised that they should attempt to deliver at the level of a
first-year undergraduate medical student with level descriptors provided.
The selection process was semi-structured and one that
involved experienced anatomy faculty judging the ability of
students based on four criteria: (1) anatomical knowledge demonstrated, (2) enthusiasm shown, (3) ability to provide clarity
and achieve the necessary level, and (4) ability to fit within the
team dynamic. These criteria were used by the anatomy faculty
to shortlist candidates. The merits of each shortlisted candidate
were discussed by all faculty in relation to the original criteria
and a decision was made on the final selection. It was decided
not to use previous summative assessment success in anatomy
as a selection criterion so as not to disadvantage or discourage
any candidate. On subsequent evaluation, selected candidates
were shown to be those who had performed above average or
average in anatomically related assessments in the first two
years of the course. All students completing the initial training
session were provided with attendance certificates for their
career development portfolios.
Following the training session, all selected NP teachers
were provided with a timetable of available teaching sessions
within first- and second-year modules and asked to highlight
their availability. Each was subsequently assigned to up to
three dissection sessions for each of six modules, with two to
three teachers selected for each session. NP teachers were
provided with detailed tutor notes (containing details of the
dissection to be carried out by the students and answers to
predicted questions) at the start of each module to prepare
them for each teaching session. In addition, they were able to
arrange visits to the Anatomy Laboratory before each session
to prepare with prosected cadaveric material. On the day of
each session, NP teachers were given a final training session
by the lead faculty on the available prosections; a reminder
of any specific points of note regarding the forthcoming dissection; and an opportunity to pose any questions or seek
clarification. During each session, the lead faculty member
informally observed each NP teacher and senior demonstrators and faculty were available to help when any difficulties
arose or the NP teacher was unable to answer a student question (students were advised not to step outside their limits of
knowledge). At the end of each session, an informal debriefing was held to assess how the session had gone and to make
any necessary changes to subsequent sessions.
Anatomical Sciences Education
SEPTEMBER/OCTOBER 2009
Program Evaluation
During the final module of the academic year, feedback was
collected from all NP teachers through an anonymous 5-point
Likert questionnaire. NP teachers were asked to assess the
standard of the training and selection procedure, the value of
the ongoing training and preparation received and the effect
of the program on improving their deeper knowledge of anatomy, enhancing their oral communication skills and developing their teaching skills. In addition, participants were asked
about their perception of how the program had affected their
career development plan. A definition of deeper learning was
given to participants. In addition to numerical scoring, NP
teachers were also asked a number of open-ended questions
to solicit comment on the positive and negative aspects of the
program and where improvements could be made. Openended responses were categorized into common themes.
While the focus of evaluation was directed toward the perceptions of the NP teachers, students (tutees) were also informally asked to comment upon the value of having the fourth
year NP teachers present in the dissection sessions in addition
to the more ‘‘traditional’’ demonstrator.
RESULTS
Participation
Initial interest shown by fourth year students to participate in
the near-peer anatomy teaching program was in excess of
what had been anticipated. A total of 65 expressions of interest from a cohort of 135 students were received. The initial
intention was to select a team of eight NP teachers, however,
given the interest it was agreed to expand this to 12 teachers.
Thirty-four students were able to attend the training and
selection event, which was held toward the end of a day to
encourage attendance of those particularly committed to
wanting to become an NP teacher. The standard of student
teaching in the practical demonstration segment of the training event was high when marked against the selection criteria. The final team of 12 NP teachers was chosen after collective discussion of each of the shortlisted candidates and in
relation to the selection criteria. All students attending and
completing the training event received their certificates at the
end of the session and successful students were informed subsequently. Selected NP teachers were able to partake in a
minimum of five to six sessions during the course of the academic year and the program achieved a zero drop-out rate,
although one student chose not to complete the training/selection event. All NP teachers were provided with an additional
certificate of program completion for their career development portfolios.
Teaching Sessions
Two or three NP teachers were assigned to each dissection
session within the six first- and second-year modules in which
anatomy appears. Before each session, NP teachers were provided with detailed tutor notes and given ongoing training
and guidance. During the teaching sessions, NP teachers were
initially encouraged to shadow faculty and senior demonstrators before gaining ‘‘independence’’ and NP teachers felt that
this helped with confidence building. The faculty leads for
each session informally observed interactions between NP
teachers and the students and were on hand in case of diffi229
The NP teacher ‘‘open-ended’’ comments reflected much of
the statistical feedback with teachers citing the program as
successful and highly beneficial to their development. Openended responses were categorized into common themes with
positive comments grouped into four themes: deeper learning,
teaching skills, career development, and enjoyment. Areas for
improvement were divided into three themes: session numbers, feedback, and training (Table 1). Most NP teachers
made comments on how the program had provided an opportunity to revise and develop their anatomical knowledge and
understanding with one NP teacher remarking ‘‘I cannot
believe how far I’ve come since year one and how my anatomy has improved.’’ Many also expressed the benefit from
the experience of teaching less experienced colleagues. There
were fewer responses given in the ‘‘areas for improvement’’
but the most prominent of these reflected the usefulness of
the program with NP teachers requesting further teaching sessions. Some NP teachers would like to receive increased feedback on performance and further training.
Figure 1.
All selected NP teachers were asked to fill in formal questionnaires at the end
of the program. As a part of the feedback, NP teachers were requested to give
numerical scores (5-point Likert scoring where 1 5 highly negative, 5 5 highly
positive) to specified aspects of the program and its outcomes. Key: training—
standard of training and selection event; preparation—usefulness of ongoing
session training and preparation; knowledge—improvement in knowledge and
understanding of anatomy; teaching—development of teaching skills; communication—improvement in oral communication skills; career—contribution to
individual career development plan. n 5 12 respondents, which equals a
response rate of 100%.
culty or where a teacher was unsure of the answer to a particular student enquiry. Most NP teachers were found to be
competent in their teaching skills as observed by anatomy
faculty and in many cases were able to demonstrate the
required level of knowledge and understanding of both functional and clinically related anatomy as defined by the learning outcomes. Some NP teachers had to be guided on particular areas of anatomy during the session and some asked faculty for particular help at different stages. The end of session
debriefing did not highlight specific problem areas and was
used to clarify any points of anatomical confusion and also
to prepare for subsequent sessions.
Program Evaluation
Figure 1 shows the mean scores achieved for various aspects
of the NP teaching program as identified by the NP teachers
through an end of program questionnaire (return rate 5
100%). In the case of the training and selection event, and
the subsequent training/preparation sessions, NP teachers
scored the program 4.5 and 4.6, respectively. All NP teachers
expressed the view that the program had significantly
enhanced their knowledge and understanding of anatomy,
scoring a maximum 5.0 and were convinced that the program
had enabled them to develop effective teaching skills (score of
4.9). NP teachers also viewed their general oral communication skills to have improved from interactions with the firstand second-year students scoring 4.7. Finally, most NP teachers recognized that the program has contributed significantly
to their overall career development plan (score of 4.6).
230
First- and Second-Year Observations
Although not formally requested, students receiving teaching
from NP teachers were encouraged to comment on the value
of having the fourth years present in the dissection sessions.
A number of students mentioned the NP teachers in end-ofmodule questionnaires and in all cases these were of a positive nature with students noting that they were impressed by
the level of knowledge of the NP teachers and found little difference to that of more senior demonstrators. They also commented that they had benefited from the increased numbers
of demonstrators in the Anatomy Laboratory. Students’ oral
comments made to faculty mirrored those of the results from
questionnaires with some students remarking that they felt
more comfortable asking NP teachers for help in view of
their near-peer status and that the level of knowledge disseminated was appropriate. In contrast, several students commented independently that some of the NP teachers did not
know the answers to all their questions and were unable to
help fully with the dissection element.
DISCUSSION
Despite recommendations from the General Medical Council
(GMC, 2003) that all medical students should be trained as
teachers, formalized opportunities within most UK medical
curricula for developing teaching skills appears to be limited
(Pasquinelli and Greenberg, 2008) with most teaching experience gained informally, usually within a clinical setting and
without any training or feedback. This is particularly unfortunate for those students entering the later phases of their
courses where they will soon be appointed in teaching or supervisory roles (Hasit et al., 1997). Indeed one of the key
activities of a doctor is teaching, whether this is directed at
teaching skills or knowledge to colleagues or explaining a diagnosis or care plan to a patient (Bulte et al., 2007). Enabling
students at this stage of their studies to engage in some aspect
of teaching encourages deeper learning of the subject area
with opportunities to teach being an opportunity to ‘‘learn
twice’’ (Annis, 1983) or an alternative strategy for learning
(Topping, 1996; Youdas et al., 2008). As most students have
little or no previous teaching experience, incorporation of
teaching possibilities will hopefully help to re-enforce positive
Evans and Cuffe
Table 1.
Open-ended Questionnaire Responses Categorized into Common Themes
Category
Positive
comments
Theme
Number of
comments
Deeper learning
9
Selected comments
The program allowed me to refresh and
deepen my knowledge of anatomy through
teaching younger students.
I have greatly improved my
anatomical knowledge.
It helped me clinically as anatomy is
fundamental and has definitely increased
my understanding.
Teaching skills
7
I am developing my basic teaching skills,
which can only be a positive for my future career.
As an aspiring surgeon, it has been
very useful to develop my teaching skills.
Reward from being able to help someone understand
anatomical principles and ideas.
Career
development
6
I feel this experience will
help me get into a career in surgery.
Experience on this program is a great
asset for early career development.
Enjoyment
4
Extremely enjoyable experience and nice
to interact with senior demonstrators.
I enjoyed this innovative experience.
Areas for
Improvement
Session numbers
5
The only issue is the small number
of sessions each student gets.
More sessions please.
Feedback
3
If possible it would be useful to receive more
detailed feedback from the students so we can see
where we need to improve.
It would be helpful to have increased feedback as I am
keen to develop my teaching style.
Training
2
attitudes toward teaching, prepare students for continued and
independent self-learning, and direct their communication
skills toward effective transfer of understanding to patients
and colleagues. Some medical schools have developed activities to promote teaching experience with peer teaching being
recognized as one particular technique and used to train lessexperienced colleagues in areas such as clinical examination
skills (Gill et al., 2006; Buckley and Zamora, 2007; Evans
and Canavan, 2008). This study examined the implementation of a near-peer teaching program in anatomy where more
experienced medical students acted as NP teachers to firstand second-year medical students. Analysis focused on the
subsequent perceptions of the NP teachers as to the effectiveAnatomical Sciences Education
SEPTEMBER/OCTOBER 2009
Possibly more help with guiding the dissection as
I felt less confident taking the student through the
dissection.
ness of such a method for encouraging their deeper understanding of anatomy and advancing their teaching skills.
Questionnaire feedback demonstrates that the students
undertaking the role of an NP teacher in anatomy at BSMS
viewed the opportunity in a positive way and the program
was found to be a useful experience in developing their anatomical knowledge and understanding and their teaching
skills. The program appeared to be a popular development as
demonstrated by initial expressions of interest being submitted by almost 50% of the student cohort and the subsequent
25% who took part in the training and selection event. Interest was not restricted to those students with surgical or radiological career aspirations and most students commented that
231
the opportunity to both re-enforce their anatomy and develop
teaching skills (important for their future practice) were the
key drivers behind their participation. The program appeared
to meet their expectations with NP teachers indicating that
they had gained an improvement in their anatomical knowledge during the teaching preparation stage and most commented that the face-to-face teaching had resulted in them
evolving a deeper understanding of anatomical principles and
concepts. Whether this perception of a deeper understanding
will be evident at a later stage when the NP teachers progress
through later stages of their training is unclear. Therefore,
future evaluation will be necessary. Many NP teachers recognized that the ability to teach is an essential aspect of their
future career and felt that the program has created an ideal
opportunity to develop some teaching skills. Although many
NP teachers expressed nervousness before each session and
wondered whether they were adequately prepared, most
found the experience to be rewarding.
First- and second-year student perceptions of the NP
teachers were positive and feedback indicated that the students interacted equally well with NP teachers and the more
Senior Demonstrators. Students found the level of knowledge
of the NP teachers to be appropriate in almost all cases
although two students commented independently that some
of the NP teachers did not know the answers to all their
questions. It is important that students recognize that teachers
do not always know the answer to every question and students should be encouraged to discover answers for themselves. Incorporation of a series of questions within the worksheet is aimed at making students think about the relevance
of the anatomical region they are studying, but the outcomes
of the feedback demonstrates that further guidance on a selfdirected learning route in anatomy might be required. It was
expected that the NP teachers’ level of knowledge would be
weaker than that of more experienced demonstrating staff
and, therefore, it was not viewed negatively by the faculty if
NP teachers were unable to answer some questions posed to
them. NP teachers had been advised not to step outside their
level of knowledge and this, therefore, acted as an important
representation by the NP teachers of the guidance given by
the General Medical Council for demonstrating good medical
practice (GMC, 2003) and the need to recognize when to
seek appropriate help. The class attainment in anatomy was
similar to previous years’ averages suggesting that the inclusion of the NP teachers had not impacted negatively on student learning and may have had positive affects on some students particularly as some found they were more comfortable
asking NP teachers for help. Peer and near-peer teachers have
been recognized to be better in understanding particular
learning difficulties faced by other students because of their
more recent exposure to and experience of the material being
studied (Brueckner and MacPherson, 2004; Lockspeiser et al.,
2008) and this may lead to a more effective learning environment for some students and create cognitive congruence.
The positive response from the first set of NP teachers was
generally encouraging and suggested the program could serve
a role in the professional development and anatomical learning of these individuals. While these first participants
appeared to enjoy the experience it must be recognized that
not all future participants may feel the same and may have a
less successful experience. Following the program they may
feel less confident about their anatomical knowledge, more
self-conscious about their ability to convey information to
others and find the teaching element intimidating. A further
232
potential downside to the program would be if participants
viewed this as their only opportunity to refresh their anatomical knowledge and not embark on continued self-directed
learning. The perceived ‘‘endorsement’’ of the NP teachers
has led to the continuation of the program for a second year
and once again there has been a similar level of interest from
fourth-year students and the training and selection event has
been oversubscribed. The second iteration of the program has
provided an opportunity for the ‘‘areas for improvement’’
identified by some NP teachers to be looked at. These
included the need for increased feedback opportunities,
enhanced training, and additional teaching sessions. While
the standard of the NP teachers, as assessed by the faculty,
was deemed to be of a competent level, a more formal peer
observation process has now been developed whereby the faculty member in charge of each session will spend a short period of time with each NP teacher to assess directly their
interactions with students and their level of relevant knowledge. Within the subsequent debriefing period, faculty can
feedback areas of good practice to the team and those aspects
that need further development.
The Senior Demonstrators have taken responsibility for
further training opportunities and will provide additional
(voluntary) sessions for NP teachers to go through the teaching outcomes for each session and to explore prosected material in greater detail. The resident prosector will also be on
hand to provide guidance on each dissection. However, the
emphasis will remain on the NP teachers to direct their own
anatomical learning. In view of the desire to give an appropriate number of fourth-year students the opportunity to act
as NP teachers and given the first- and second-year class size,
the presence of the senior demonstrators and the size of the
anatomy laboratory, it has not been possible to improve on
the number of sessions available to each NP teacher. Each NP
teacher, however, is able to take on between five to eight sessions depending on their availability. In the first iteration of
the program, NP teachers took part in a number of sessions,
most of which were unrelated to each other and were not sequential. Emphasis has now been placed on NP teachers demonstrating in several successive sessions within a module to
provide continuity in their learning of a particular body system and to encourage them to use self-directed learning in
those areas which are not part of their teaching experience.
There are additional opportunities being developed for the
NP teachers in other undergraduate degree courses and widening participation programs currently taught by the Anatomy Department. While the main objective of the NP teaching program was to provide opportunities for more experienced students to interact with less-experienced students and
to expand their own knowledge and establish some teaching
proficiency, the program also provided an additional valuable
and appropriate resource to BSMS for teaching anatomy.
CONCLUSION
In conclusion, this study demonstrates a way of incorporating
near-peer teaching into medical curricula to provide opportunities for more experienced students to further develop their
anatomical knowledge and to advance their teaching skills.
The development of a near-peer teaching program for fourthyear medical students has proved to be a useful innovation at
BSMS and has enabled students to be given hands-on teaching experience as they move nearer toward taking on the suEvans and Cuffe
pervisory and teaching duties that are a part of the doctor’s
role. Feedback from participants suggests that the program
fulfills its aim of providing a forum for encouraging deeper
learning in anatomy. However, only time will tell if deeper
learning has really been achieved and it will be necessary to
assess the level of anatomical knowledge and understanding
of NP teachers as they move through later stages of their
medical training.
ACKNOWLEDGMENTS
The authors thank the near-peer teachers for their thoughtful
engagement during the evaluation process, Alison Bryson for
helping to develop the selection criteria, and Lisa Costick for
administering the training program and help during the subsequent evaluation. They are also grateful to some of our students for agreeing to appear in the cover image.
NOTES ON CONTRIBUTORS
DARRELL J. R. EVANS, B.Sc., Ph.D., F.H.E.A., M.I.B.M.S.,
is a professor of anatomy and developmental tissue biology,
Head of Anatomy and the Associate Dean at Brighton and
Sussex Medical School, Brighton, UK.
TRACY CUFFE, B.Sc., M.Sc., is a prosector in anatomy
at Brighton and Sussex Medical School, Brighton, UK, and
an education officer for the Institute of Anatomical Sciences.
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