Interdisciplinary Workshop Using Applied Models to Increase Collaboration and Satisfaction between Medical Students and Standardized Patient Instructors

In an article published in 1993 by Shulman about higher education it was stated that, Teaching takes practice. It takes feedback. It takes instruction. More and more we are becoming aware of that. There has been increasing recognition of the need to prepare medical students for their future teaching roles as intern/residents and physicians. There have been numerous publications addressing peer teaching in undergraduate education, but sparse literature addressing how medical students co-teach physical diagnosis to pre-clinical students in lieu of faculty. Traditionally in North America, full-time faculty members have assumed the major responsibility for teaching first- and second-year medical students physical examination skills. This historic model has its barriers, as recruiting busy faculty without compensation is a problem as is the lack of standardization of teaching content from one faculty member to another. To address these issues, we introduced the concept of Standardized Patient Instructors (SPIs) joining with fourth year medical students (MS-4s) to teach physical examination skills to the first-year medical students (MS-1s) in 2010. The SPIs were trained to teach physical examination maneuvers in a standardized fashion while the MS-4s were in charge of overseeing the MS-1s practice these skills and providing relevant clinical context to the maneuvers. The George Washington University is the first reported school to have such an interdisciplinary program. It has been shown in the literature that with appropriately motivated and mentored senior students, successful courses could be created to meet educational requirements at educational institutions with available resources. Recognizing that some individuals were interested in learning advanced teaching skills and could be used as a valuable asset to teaching alongside appropriate faculty, our goal was to create a program utilizing motivated students and provide a framework that could be implemented in other institutions. The multidisciplinary program was successfully implemented into the curriculum, but not without some unforeseen problems. SPI and MS-4 feedback after the first iteration of this course in the 2010-2011 cycle was fraught with confusion about what were the roles of each group, how the sessions were supposed to run, who assumed a leadership role in the group interaction, and how evaluation was to take place. It was from this feedback that theoretical constructs were examined to help improve the program; namely, the GRPI model and Mezirow\u27s Transformative learning theory. AAMC MedEdPORTAL publication ID 4152. Link to original

Interdisciplinary Workshop to Increase Collaboration Between Medical Students and Standardized Patient Instructors in Teaching Physical Diagnosis to Novices

Traditionally, full-time faculty members have assumed major responsibility for teaching physical examination skills to first- and second-year medical students. Problems with faculty recruitment and adhering to a standardized way of teaching have challenged educators to seek alternatives to teaching the physical examination to novices. To address these problems, we created and implemented a novel curriculum that has standardized the teaching of physical examination skills to novice students by using standardized patient instructors and fourth-year medical students working as an interdisciplinary team (known as a dyad). Feedback after the first iteration of this course revealed confusion about roles, goals, and responsibilities for feedback and evaluation amongst the dyads. To address these issues, an interdisciplinary workshop was created using the theoretical constructs of the GRPI (goals, roles and responsibilities, process, and interpersonal skills) model and Mezirow’s transformative learning theory, both of which address gaps in the dyad relationship. Initial feedback from fourth-year students and standardized patient instructors was enthusiastically positive. Evidence showed the dyad could be strengthened by (1) providing time to learn the theoretical scaffolding underlying working together, (2) meeting and planning approaches to teaching efforts, and (3) enabling medical students and standardized patient instructors to apply the theoretical constructs as the foundation to reflect on their teaching roles in effectively instructing novices in physical exam skills