teaching medical students how to teach in us medical schools

Teaching Teaching Medical Students How to Teach: A National Survey of Students-as-Teachers Programs in U.S. Medical Schools Rainier P. Soriano, MD, Benjamin Blatt, MD, Lisa Coplit, MD, Eileen CichoskiKelly, PhD, Lynn Kosowicz, MD, Linnie Newman, MS, ANP, Susan J. Pasquale, PhD, MT-BC, NMT, Richard Pretorius, MD, MPH, Jonathan M. Rosen, MD, Norma S. Saks, EdD, and Larrie Greenberg, MD Abstract Purpose A number of U.S. medical schools started offering formal students-as -teachers (SAT) training programs to assist medical students in their roles as future teachers. The authors report results of a national survey of such programs in the United States. Method In 2008, a 23-item survey was sent to 130 MD-granting U.S. schools. Responses to selective choice questions were quantitatively analyzed. Open-ended questions about benefits and barriers to SAT programs were given qualitative analyses. Results Ninety-nine U.S. schools responded. All used their medical students as teachers, but only 44% offered a formal SAT program. Most (95%) offered formal programs in the senior year. Common teaching strategies included small-group work, lectures, role-playing, and direct observation . Common learning content areas were small-group facilitation, feedback, adult learning principles, and clinical skills teaching. Assessment methods included evaluations from student–lea rners (72%) and direct observation/video taping (59%). From the qualitative analysis, benefit themes included development of future physician– educators, enhancemen t of learning, and teaching assistance for faculty. Obstacles were competition with other educational demands, difficulty in faculty recruitment/retention , and difficulty in convincing others of program value. Conclusions Formal SAT programs exist for 43 of 99 U.S. medical school respondents. Such programs should be instituted in all schools that use their students as teachers. National teaching competencies, best curriculum methods, and best methods to conduct skills reinforcement need to be determined. Finally, the SAT programs’ impacts on patient care, on selection decisions of residency directors, and on residents’ teaching effectiveness are areas for future research. The word “doctor” is derived from the Latin verb “docere,” meaning “to teach.” First used in the 14th century, its persistence over 800 years as a designation for a practitioner of medicine underscores the importance of teaching in medical practice and medical education. Teaching as a necessary skill and duty has been reaffirmed by the Liaison Committee on Medical Education and Accreditation Council for Graduate Medical Education (ACGME), the major accrediting bodies that oversee medical student and resident training in the United States, respectively. 1,2 Providing teaching skills to doctors-in- training has roots in graduate medical education. Residents are charged with the educational responsibility of teaching their medical students and peers. So crucial is their teaching role that 67% of medical students in one survey felt that residents played a significant part in their learning and that one-third of their knowledge could be attributed to residents’ teaching. 3 In response to the need to make residents better teachers, training programs established residents- as-teachers curricula. A 2001 survey of U.S. residency programs revealed that 740 out of 1,346 (55%) offered formal instruction in teaching skills. 4 Evidence suggests that such programs have been increasing, especially with the advent of the ACGME competencies. 2 For example, between 1993 and 2001, internal medicine programs offering teaching instruction more than tripled: from 20% in 1993 to 65% in 2001. 4 In the 1990s, at the same approximate time as the initiation of the first residents-as-teachers programs, published accounts of medical students serving as teachers began to appear. The rationale for the emergence of medical students-as-teachers (SAT) training programs at the undergraduate level is summarized in a recent literature review by Dandavino et al 5 : Medical students are future residents and faculty members who will have teaching roles; as teaching is an essential aspect of physician–patient interaction, medical students may become more effective communicators as a result of such training; and medical students with a better understanding of teaching and learning principles may become better learners. A case can be made for senior medical students in particular as candidates for SAT programs. Having had four years of medical training and about to transition to the teaching responsibilities of internship and residency, they are at a developmentally ideal stage for training as teachers. Although it is difficult to precisely chronicle the evolution of SAT programs, Pasquinelli and Greenberg 6 recently Please see the end of this article for information about the authors. Correspondence should be addressed to Dr. Soriano, One Gustave L. Levy Place, Box 1070, Departments of Medical Education, Medicine, and Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, NY 10029; telephone: (212) 241-1519; fax: (212) 860-9737; e-mail: [email protected]. Acad Med. 2010;85:1725–1731. First published online September 28, 2010 doi: 10.1097/ACM.0b013e3181f53273 Academic Medicine, Vol. 85, No. 11 / November 2010 1725

teaching medical students how to teach in us medical schools

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