Supervised near-peer clinical teaching in the ambulatory clinic: an exploratory study of family medicine residents' perspectives.

Abstract

Near-peer teaching is used extensively in hospital-based rotations but its use in ambulatory care is less well studied. The objective of this study was to verify the benefits of near-peer teaching found in other contexts and to explore the benefits and challenges of near-peer clinical supervision unique to primary care. A qualitative descriptive design using semi-structured interviews was chosen to accomplish this. A faculty preceptor supervised senior family medicine residents as they supervised a junior resident. We then elicited residents’ perceptions of the experience. The study took place at a family medicine teaching unit in Canada. Six first-year and three second-year family medicine residents participated. Both junior and senior residents agreed that near-peer clinical supervision should be an option during family medicine residency training. The senior resident was perceived to benefit the most. Near-peer teaching was found to promote self-reflection and confidence in the supervising resident. Residents felt that observation by a faculty preceptor was required. In conclusion, the benefits of near-peer teaching previously described in hospital settings can be extended to ambulatory care training programmes. However, the perceived need for direct observation in a primary care context may make it more challenging to implement.