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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's Transformative learning theory.

AAMC MedEdPORTAL publication ID 4152. Link to original.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

GRPI MODEL.pdf (345 kB)
GRPI Model

Mezirow's Transformative Learning.pdf (50 kB)
Mezirow's Transformative Learning

Self-Reflection Questionnaire for Dyads.pdf (178 kB)
Self Reflection Questionnaire

Team Based Learning Interdisciplinary workshop Questions and Answer Key.pdf (106 kB)
Team Based Learning Interdisciplinary workshop Questions and Answer Key

Workshop Evaluation.pdf (91 kB)
Workshop Evaluation



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