title: To observe or not to observe peers when learning physical examination skills; that is the question.
abstract: BACKGROUND
  Learning physical examination skills is an essential element of medical education. Teaching strategies include practicing the skills either alone or in-group. It is unclear whether students benefit more from training these skills individually or in a group, as the latter allows them to observing their peers. The present study, conducted in a naturalistic setting, investigated the effects of peer observation on mastering psychomotor skills necessary for physical examination.
  
  
  METHODS
  The study included 185 2nd-year medical students, participating in a regular head-to-toe physical examination learning activity. Students were assigned either to a single-student condition (n = 65), in which participants practiced alone with a patient instructor, or to a multiple-student condition (n = 120), in which participants practiced in triads under patient instructor supervision. The students subsequently carried out a complete examination that was videotaped and subsequently evaluated. Student's performance was used as a measure of learning.
  
  
  RESULTS
  Students in the multiple-student condition learned more than those who practiced alone (81% vs 76%, p < 0.004). This result possibly derived from a positive effect of observing peers; students who had the possibility to observe a peer (the second and third students in the groups) performed better than students who did not have this possibility (84% vs 76%, p <. 001). There was no advantage of observing more than one peer (83.7% vs 84.1%, p > .05).
  
  
  CONCLUSIONS
  The opportunity to observe a peer during practice seemed to improve the acquisition of physical examination skills. By using small groups instead of individual training to teach physical examination skills, health sciences educational programs may provide students with opportunities to improve their performance by learning from their peers through modelling.
authors.affiliation: Université de Sherbrooke, Faculté de médecine et des sciences de la santé, 3001 12ème avenue nord Sherbrooke, Québec J1H 5N4, Canada. Bernard.martineau@usherbrooke.ca
authors.forename: Bernard
authors.initials: B
authors.lastname: Martineau
authors.forename: Sílvia
authors.initials: S
authors.lastname: Mamede
authors.forename: Christina
authors.initials: C
authors.lastname: St-Onge
authors.forename: Remy M J P
authors.initials: RM
authors.lastname: Rikers
authors.forename: Henk G
authors.initials: HG
authors.lastname: Schmidt
mesh_terms: D002983:Clinical Competence / Q000592:standards; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D010379:Peer Group; D010808:Physical Examination / Q000379:methods / Q000592:standards; D013337:Students, Medical; D055815:Young Adult