Improving Medical Student Confidence in Clinical Skills through a Peer-Facilitated Workshop

Abstract

University of Maryland, School of Maryland’s (UMSOM) curriculum does not provide training in physical exam skills to first year medical students (MS1s). A peer assisted learning model offered a unique way to address this deficiency. We aimed to design, implement, and evaluate a clinical skills workshop facilitated by upper-level medical students (upper MSs) that could be replicated by other medical schools. Faculty provided a one-hour training session to upper MSs. These students then facilitated a two-hour workshop for MS1s providing instruction on select elements of the physical exam. We theorized that upper MSs would have increased confidence in their abilities to perform the physical exam by learning to teach these skills. Additionally, we hypothesized that MS1s would have increased confidence in their abilities to perform the same skills after participating in the peer-facilitated workshop. We tested these hypotheses using a paired pre- and post-survey model and used paired sample t test analyses to determine statistical significance. We used thematic analyses to analyze free response answers. After training, upper MSs (n = 43) reported a significant improvement (p < .01) in self-reported confidence for each item: measure radial pulse, respiratory rate, and blood pressure, and auscultate lung fields and heart valves. There was a significant improvement (p < .01) in self-reported confidence by MS1s (n = 47) for the same items after the workshop. Students reported positive feedback regarding the use of peer assisted learning. Implementing a peer-facilitated workshop led to increased self-confidence in performing clinical skills by MS1s and upper MSs with minimal faculty demand. Similar models could be feasibly implemented at other institutions.