Sarah J. Flynn,University of Maryland,Baltimore,Maryland,Linda O. Lewin,University of Maryland,Baltimore,Maryland
Background: The current curriculum at the University of Maryland, School of Maryland (UMSOM) does not provide formal training in physical exam skills to first year medical students. A peer-led workshop could address this deficiency.
Objective: Design, implement, and evaluate a clinical skills workshop facilitated by upper-level medical students for first year medical students in the Primary Care Track at UMSOM.
Methods: Primary Care Track faculty members provided a 1 hour training session to upper-level medical students serving as peer-mentors. These students then facilitated a 2 hour clinical skills workshop for first year medical students providing instruction on select elements of the physical exam: vital signs, blood pressure measurement and basic cardiac and pulmonary assessment techniques. We hypothesized that first year students would have increased confidence in their abilities to perform elements of the physical exam as a result of their participation in this workshop. Additionally, we theorized that upper level medical students would have increased confidence in their abilities to perform the same clinical skills by learning to teach these methods to their first year colleagues. We tested these hypotheses using a paired pre- and post- survey model and used chi-squared analyses to determine statistical significance. To further evaluate the workshop, the surveys also included free response questions.
Results: There was significant improvement (p<.01) in self-reported confidence by first year medical students (n=47) after the completion of the workshop for each item tested: ability to measure radial pulse, respiratory rate, and blood pressure, and to auscultate lung fields and heart valves. After participating in the faculty-led training session, upperclassmen (n=43) reported significant improvement (p<.01) in self-reported confidence for the same items. Both first year students and upperclassmen reported positive feedback regarding the use of peer-mentoring as a model for the workshop.
Discussion: Implementing a peer-facilitated workshop led to increased confidence in performing clinical skills associated with the physical exam by both first year medical students and upper-level student facilitators. Given the success of this workshop, it is feasible and appropriate to further integrate peer mentoring programs into the wider curriculum at UMSOM.