The "Near-Peer" Approach to Teaching Musculoskeletal Physical Examination Skills Benefits Residents and Medical Students.
BACKGROUND
The musculoskeletal physical examination (MSK PE) is an essential part of medical student training, and it is best taught in a hands-on, longitudinal fashion. A barrier to this approach is faculty instructor availability. "Near-peer" teaching refers to physicians-in-training teaching their junior colleagues. It is unknown whether near-peer teaching is effective in teaching this important physical examination skill.


OBJECTIVE
To investigate attitudes of medical students and physical medicine and rehabilitation (PM&R) residents regarding near-peer teaching in an MSK PE curriculum.


METHODS
Qualitative, anonymous paper and online surveys.


METHODS
Tertiary academic center with a medical school and PM&R training program.


METHODS
Ninety-nine second- and third-year medical students and 13 PM&R residents in their third or fourth postgraduate year.


METHODS
Attitudes of second- and third-year medical students were measured immediately after their MSK PE course. Resident attitudes were measured in a single cross-sectional sample.


METHODS
Student attitudes were assessed via a questionnaire with 5-point Likert scales and a free-text comment section. The resident questionnaire included a combination of multiple-choice questions, rankings, free-text responses, and Likert scales.


RESULTS
All 99 students completed the questionnaire. The majority of students (n = 79 [80%]) reported that resident involvement as hands-on instructors of examination skills was "very useful," and 87 (88%) indicated that resident-led small discussion groups were "very helpful" or "somewhat helpful." Fifty-seven of 99 students (58%) reported that the resident-facilitated course was "much better" than courses without resident involvement. Twelve of 13 eligible residents completed the survey, and of those, 8 found teaching "very helpful" to their MSK knowledge, and 11 became "somewhat" or "much more confident" in clinical examination skills.


CONCLUSIONS
Our study supports educational benefits to medical students and resident instructors in our MSK PE program. We recommend including near-peer teaching in medical student education, particularly for hands-on skills; we also recommend providing opportunities for PM&R residents to participate in formal near-peer education.


METHODS
Not applicable.
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN(∗).
Casandra J
CJ
Rosenberg
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN(†).
Katherine N
KN
Nanos
Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First St SW, Rochester, MN 55905(‡). Electronic address: newcomer.karen@mayo.edu.
Karen L
KL
Newcomer
D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003479:Curriculum; D006801:Humans; D007396:Internship and Residency; D009140:Musculoskeletal Diseases / Q000175:diagnosis; D010379:Peer Group; D010808:Physical Examination; D010810:Physical and Rehabilitation Medicine / Q000193:education*; D013663:Teaching