The backbones of traditional medical education are becoming increasingly obsolete. With textbooks taking years to update, this previously sacred source of medical information cannot keep pace with guideline changes & medical advancements (1). In-person lectures fair no better, with regular lecture attendance dropping to <50% in favour of rewindable pre-recorded lectures & YouTube content (2). Passive learning through lectures and textbooks is subpar compared to the collaborative, active learning approaches needed for future generations of doctors (3).
An emerging form of medical education during the COVID-19 pandemic was online near-peer teaching. Whilst pre-recorded lectures replaced in-person lectures, clinical experiences had no replacement (4). This left students unprepared in history taking & examinations as they began their clinical years or first F1 rotations. I supplemented my studies with online near-peer teaching sessions by student-led organisations (e.g. ‘OSCEazy’) ahead of my Year 2 Integrated Structured Clinical Examination (ISCE), and have continued this revision method in my clinical years.
Online sessions hosted for free through global platforms provide many advantages, including allowing everyone with internet access to receive this teaching, irrespective of their financial situation or location (5). Abraham Flexner’s 1910 report led to the design of the distinct pre-clinical and clinical years of medical training (6), but many students struggle to maintain their science knowledge to graduation. Students can attend online teaching for many stages of medical training to refresh their knowledge or get ahead in areas of their interest. Additionally, video-conferencing platform polling & chat features (4) allow students to actively engage with content (7) and practice examination-style questions and clinical skills. Gamification of learning increases enjoyment and motivates students to continue self-directed learning (8).
Starting as informal teaching between students, near-peer teaching has become a staple within medical education (9). Near-peer teaching is less stressful than clinician-led teaching, as senior students make learners feel more comfortable and provide feedback tailored to the medical school curriculum (10), which has been shown to be as effective as clinician-led teaching (11). This could further support medical education as clinicians have increasing commitments within the NHS (12).
After attending OSCEazy lectures, I have been teaching pre-clinical and clinical content for 2.5 years. Near-peer teaching benefits teachers, as well as learners. The General Medical Council’s ‘Outcomes for graduates’ states that newly qualified doctors must “work effectively as a teacher for other learners”, which near-peer teaching satisfies (13). Near-peer teachers improve themselves by re-enforcing and building on their previous knowledge to consolidate complex topics to concise resources for learners (9). Interprofessional communication skills also improve (14) and correlate to higher academic performance in medical school and beyond (9).
Beyond this pandemic, a blend of online & in-person teaching increases student interactivity during teaching, boosts productivity and provides learning flexibility (4). Although online near-peer teaching has many benefits for all, from my experience, student video-conferencing fatigue is reducing attendance at these sessions. Near-peer teaching will persevere, but new online platforms for education will need to be found to continue its impact on medical students across the globe.
References
1. Tez M, Yildiz B. How Reliable Are Medical Textbooks? J Grad Med Educ. 2017;9(4):550. doi: 10.4300/JGME-D-17-00209.1
2. Emanuel EJ. The Inevitable Reimagining of Medical Education. 2020;1(12):1127-8. doi: 10.1001/jama.2020.1227
3. Krisberg K. Flipped Classrooms: Scrapping Lectures in Favor of Active Learning. 2017 [accessed 9 Nov 2023]. Available from: https://www.aamc.org/news/flipped-classrooms-scrapping-lectures-favor-active-learning
4. Hilburg R, Patel N, Ambruso S, Biewald MA, Farouk SS. Medical Education During the Coronavirus Disease-2019 Pandemic: Learning From a Distance. Adv Chronic Kidney Dis. 2020;27(5):412-7. doi: 10.1053/j.ackd.2020.05.017
5. Kruger JM, Chowers I. The ethical advantages of video conferencing in medical education. Med. 2020;25(1):178-80. doi: 10.1080/10872981.2020.1787310
6. Samarasekera DD, Goh PS, Lee SS, Gwee MCE. The clarion call for a third wave in medical education to optimise healthcare in the twenty-first century. Med Teach. 2018;40(10):982-5. doi: 10.1080/0142159X.2018.1500973
7. Guarino S, Leopardi E, Sorrenti S, De Antoni E, Catania A, Alagaratnam S. Internet-based versus traditional teaching and learning methods. Clin Teach. 2014;11(6):449-53. doi: 10.1111/tct.12191
8. Lohitharajah J, Youhasan P. Utilizing gamification effect through Kahoot in remote teaching of immunology: Medical students' perceptions. JAMP. 2022;10(3):156-62. doi: 10.30476/JAMP.2022.93731.1548
9. Bowyer ER, Shaw SC. Informal near-peer teaching in medical education: A scoping review. Educ Health. 2021;34(1):29-33. doi: 10.4103/efh.EfH_20_18
10. Sader J, Cerutti B, Meynard L, Geoffroy F, Meister V, Paignon A, et al. The pedagogical value of near-peer feedback in online OSCEs. BMC Med Educ. 2022;22(1):572. doi: 10.1186/s12909-022-03629-8
11. Bantounou MA, Kumar N. Peer-Led Versus Conventional Teacher-Led Methodological Research Education Sessions: An Initiative to Improve Medical Education Research Teaching. Medical Science Educator. 2023;33(4):935-43. doi: 10.1007/s40670-023-01818-8
12. Rees PJ, Stephenson AE. The future of medical education in the UK. 2010;1(580):795-6. doi: 10.3399/bjgp10X538903
13. Council GM. Outcomes for graduates. 2018 [accessed. 9 Nov 2023]. Available from: https://www.gmc-uk.org/-/media/documents/outcomes-for-graduates-2020_pdf-84622587.pdf
14. Hall S, Harrison CH, Stephens J, Andrade MG, Seaby EG, Parton W, et al. The benefits of being a near-peer teacher. Clin Teach. 2018;15(5):403-7. doi: 10.1111/tct.12784
