Author/Authors :
RODRIGUEZ, CARLOS E GARCIA College of Medicine - University of Arizona, 1501 N Campbell Ave, Tucson, USA , SHAH, RAJ J College of Medicine - University of Arizona, 1501 N Campbell Ave, Tucson, USA , SMITH, CODY College of Medicine - University of Arizona, 1501 N Campbell Ave, Tucson, USA , GAY, CHRISTOPHER J College of Medicine - University of Arizona, 1501 N Campbell Ave, Tucson, USA , ALVARADO, JARED College of Medicine - University of Arizona, 1501 N Campbell Ave, Tucson, USA , ALVARADO, JARED College of Medicine - University of Arizona, 1501 N Campbell Ave, Tucson, USA , RAPPAPORT, DOUGLAS Department of Emergency Medicine - Mayo Clinic Hospital, Phoenix, AZ, USA , ADAMASRAPPAPORT, WILLIAM J Department of Surgery - University of Arizona, Tucson, AZ, USA , AMINI, RICHARD Department of Emergency Medicine - University of Arizona, Tucson, AZ, USA
Abstract :
Introduction: Increased faculty and resident responsibilities have led
to the decreased time available for teaching clinical skills to medical
students. Numerous advances in education and simulation have
attempted to obviate this problem; however, documented success is
lacking. Our objective was to describe a novel fresh cadaver-based,
student-driven procedural skills lab and to compare the educational
effectiveness of student instructors to the senior instructor (SI).
Methods: This was a prospective study performed at an academic
medical center. A pilot program, “Students Teaching Students,” was
introduced where four trained first-year medical students (TMS)
instructed 41 other untrained first-year medical students in technical
procedures. This study compared the teaching evaluations of the
SI with the TMS teaching equivalent procedures. Paired t-test was
used to determine statistically significant changes in procedural
confidence between pre- and post-training. Utilizing a post-training
questionnaire, average post-training confidence improvement values
and objective post-training test scores of the participants were
compared between TMS and SI, using a 2 sample t-test. Statistical
significance was considered as a p<0.05. All statistical analyses were
conducted in Stata 11 (StataCorp LP, College Station, TX, USA).
Results: Twenty-nine out of 39 (74%) students completed the
questionnaire. Both groups demonstrated a statistically significant
improvement in subjective confidence level in performing each procedure
when pre- and post-training scores were compared, while there was no
statistically significant difference found in cognitive knowledge between
the groups (p=0.73). There was no statistically significant difference in
the mean confidence improvement between the SI and TMS groups for
chest tube insertion (2.06 versus 1.92 respectively, p=0.587), femoral
line placement (2.00 versus 1.94 respectively, p=0.734) or student test
score (88% versus 85% respectively).
Conclusion: Our results demonstrate that first-year medical students
well-trained in technical skills, such as our TMS, may be a valuable
additional teaching resource. The Students Teaching Students
procedure lab employed in this study was effective at immediately
increasing first-year medical students’ confidence and technical skill.
First-year medical students well-trained in technical skills, such as our
TMS, may be a valuable additional teaching resource.