Developing Clinician-Educators: a Qualitative Analysis of Structured Reflections from Participatory Teaching in the Final Year in an Integrated Medical School Program.

Abstract

This study aimed to describe fourth-year medical students' experiences, recorded and tracked in structured reflective teaching logs (RTLs), as participants in a year-long longitudinal medical student-as-teacher elective. Thirteen (13) participants from two medical student-as-teacher elective cohorts completed 20 contact hours of self-selected teaching. Participants chose three different learning environments spanning the first 3years of the medical school curriculum. Reflections were entered into an online spreadsheet with guided prompts (RTL). Open-ended text in the RTLs was analyzed using an inductive qualitative research approach. Open coding was applied across all meaningful segments of text, identifying themes that were validated internally with three co-authors and one methodology expert without formal program involvement. Narratives revealed detailed descriptions and reflections of participant experiences. Analysis revealed eight themes: (1) Joy of Teaching; (2) Teaching Effectiveness; (3) Feedback; (4) Effective Patient-Physician Communication; (5) Assessment; (6) Differential Diagnosis Development; (7) Standardized Case Development; and (8) Training for Teaching in Residency. Fourth-year medical student participants in a longitudinal medical student-as-teacherelective effectively used RTLs from participatory teaching to help facilitate their own development as clinician-educators. Themes identified in RTLs reflect students' awareness of teaching skill requirements and readiness for the next workplace, residency. Informed by situativity theory, formal teaching opportunities in authentic learning environments bestow students with critical formative teaching experience and awareness of the roles as clinician-educators during their undergraduate years.