Introduction:

Third-year medical students traditionally receive their didactic or small group teaching sessions from clinical faculty during clerkship rotations. Near-peer teaching is increasingly recognized as an acceptable method for teaching, however most near-peer teaching takes place during the pre-clinical curriculum. We sought to determine if fourth year medical students were noninferior to faculty in facilitating small group discussions during clerkship rotations.

Methods:

Seventy-five third-year medical students participated in a small group session focused on rheumatologic diseases during their internal medicine clerkship rotation. Students were taught by fourth-year medical students who self-selected to participate as near-peer teachers at 1 clinical site (near-peers, N = 36) and by clinical faculty at another site (N = 39). At the end of the session, third-year medical students completed a survey evaluating teacher performance and effectiveness.

Results:

There was no significant difference between the 2 groups on each of the 17 survey items assessing teacher performance, the total teaching performance score, and the teaching effectiveness rating (all P-values >.05). A mean between-group difference of 2% in favor of the near-peers indicated noninferiority of the near-peer teachers compared with faculty teachers on the total teaching performance score. An absolute difference of 14% in favor of the near-peers indicated noninferiority of the near-peer teachers compared with faculty teachers on the teaching effectiveness score. Near-peer teachers reported several benefits, including improving their own medical knowledge and skills as a future educator.

Discussion:

Our data supports the noninferiority of the perceived performance and effectiveness of near-peer teachers compared to faculty teachers in the clerkship setting. Adding near-peer teachers to the clerkship setting is feasible and can be beneficial to all stakeholders.

中文翻译：

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学生在内科实习期间近同行和教师对案例教学的看法：一项非劣效性研究

介绍：

三年级医学生传统上在见习轮换期间接受临床教师的教学或小组教学课程。近同伴教学越来越被认为是一种可接受的教学方法，但大多数近同伴教学发生在临床前课程期间。我们试图确定四年级医科学生在实习轮换期间在促进小组讨论方面是否不逊于教职员工。

方法：

七十五名三年级的医学生在他们的内科见习轮换期间参加了一个专注于风湿病的小组会议。学生由四年级医学生授课，他们自选在 1 个临床站点（近邻，N = 36）和另一个站点的临床教师（N = 39）作为近等教师参与。在会议结束时，三年级医学生完成了一项评估教师绩效和有效性的调查。

结果：

在评估教师绩效的17个调查项目中，两组之间没有显着差异，教学绩效总分和教学效果评分（所有P值>.05）。有利于近同龄人的平均组间差异为 2%，表明近同龄教师与教师教师在总教学绩效得分上的非劣效性。有 14% 的绝对差异有利于近同龄人，这表明近同龄教师与教师教师在教学效率得分上的非劣效性。近邻教师报告了一些好处，包括提高自己作为未来教育工作者的医学知识和技能。

讨论：

我们的数据支持与见习环境中的教职教师相比，近缘教师的感知绩效和有效性的非劣效性。在见习环境中增加近乎同行的教师是可行的，并且对所有利益相关者都有好处。