To observe or not to observe peers when learning physical examination skills; that is the question

BMC Medical Education

Henk G Schmidt¹  Remy MJP Rikers¹  Christina St-Onge²  Sílvia Mamede¹  Bernard Martineau² 

[1] Institute of Psychology, Erasmus University Rotterdam, P.O. Box 17383000 DR, Rotterdam, The Netherlands;Université de Sherbrooke, Faculté de médecine et des sciences de la santé, 3001 12ème avenue nord Sherbrooke, Québec J1H 5N4, Canada

关键词: Peer observation;    Psychomotor skills;    Undergraduate students;    Skills training;    Physical examination skills;    Medical education;   

Others  :  1138949
DOI  :  10.1186/1472-6920-13-55

 received in 2012-11-28, accepted in 2013-03-27,  发布年份 2013

【 摘 要 】

Background

Learning physical examination skills is an essential element of medical education. Teaching strategies include practicing the skills either alone or in-group. It is unclear whether students benefit more from training these skills individually or in a group, as the latter allows them to observing their peers. The present study, conducted in a naturalistic setting, investigated the effects of peer observation on mastering psychomotor skills necessary for physical examination.

Methods

The study included 185 2^nd-year medical students, participating in a regular head-to-toe physical examination learning activity. Students were assigned either to a single-student condition (n = 65), in which participants practiced alone with a patient instructor, or to a multiple-student condition (n = 120), in which participants practiced in triads under patient instructor supervision. The students subsequently carried out a complete examination that was videotaped and subsequently evaluated. Student’s performance was used as a measure of learning.

Results

Students in the multiple-student condition learned more than those who practiced alone (81% vs 76%, p < 0.004). This result possibly derived from a positive effect of observing peers; students who had the possibility to observe a peer (the second and third students in the groups) performed better than students who did not have this possibility (84% vs 76%, p <. 001). There was no advantage of observing more than one peer (83.7% vs 84.1%, p > .05).

Conclusions

The opportunity to observe a peer during practice seemed to improve the acquisition of physical examination skills. By using small groups instead of individual training to teach physical examination skills, health sciences educational programs may provide students with opportunities to improve their performance by learning from their peers through modelling.

【 授权许可】

   
2013 Martineau et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Peterson MC, Holbrook JH, Von Hales D, Smith NL, Staker LV: Contributions of the history, physical examination, and laboratory investigation in making medical diagnoses. West J Med 1992, 156(2):163-165.
• [2]Windish DM, Paulman PM, Goroll AH, Bass EB: Do clerkship directors think medical students are prepared for the clerkship years? Acad Med 2004, 79(1):56-61.
• [3]Small RM, Soriano RP, Chietero M, Quintana J, Parkas V, Koestler J: Easing the transition: medical students' perceptions of critical skills required for the clerkships. Educ Health (Abingdon) 2008, 21(3):192.
• [4]Cox K: How well do you demonstrate physical signs? Medical Teacher 1998, 20(1):6-9.
• [5]Ste-Marie DM, Law B, Rymal AM, Jenny O, Hall C, McCullagh P: Observation interventions for motor skill learning and performance: an applied model for the use of observation. Int Rev Sport Exerc Psychol 2012, 1(1):1-32.
• [6]Bandura A: Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall; 1986.
• [7]Adams JA: Use of model's knowledge of results to increase the observer's performance. J Hum Mov Stud 1986, 12:89-98.
• [8]Pollock BJ, Lee TD: Effects of the model's skill level on observational motor learning. Res Q Exerc Sport 1992, 63(1):25-29.
• [9]Schunk DH: Self-efficacy and academic motivation. Educ Psychol 1991, 26(3 & 4):207-231.
• [10]Shea CH, Wulf G, Whitacre C: Enhancing Training Efficiency and Effectiveness Through the Use of Dyad Training. J Mot Behav 1999, 31(2):119-125.
• [11]Granados C, Wulf G: Enhancing Motor Learning Through Dyad Practice: Contributions of Observation and Dialogue. Res Quater Exerc Sport 2007, 78(3):197-203.
• [12]Custers EJ, Regehr G, McCulloch W, Peniston C, Reznick R: The Effects of Modeling on Learning a Simple Surgical Procedure: See One, Do One or See Many, Do One? Adv Health Sci Educ Theory Pract 1999, 4(2):123-143.
• [13]Magill RA: Motor learning. Concepts and applications. 4th ed. Brown & Benchmark: Madison, Wisconsin; 1993.
• [14]Martineau B, Waddell G, Bourque S, Hivon R: Early Integration of Clinical Skills in a Problem Based Learning curriculum. Melbourne: Centre for Medical and Health Sciences Education, Monash University; 2005:134-138. [Conference Proceedings of the First International Clinical Skills Conference: May 9 2005]
• [15]Field A: Discovering statistics using SPSS. 2nd edition. London, UK: Sage; 2005.
• [16]Salkind NJ: Encyclopedia of Research Design. Thousand Oaks, CA: Sage Publications, Inc.; 2010.
• [17]Cohen J: Statistical Power Analysis for the Behavioral Sciences. 2nd edition. Hillsdale, HJ: Lawrence Erlbaum Associates, Inc.; 2010.
• [18]Hodges B, McNaughton N, Regehr G, Tiberius R, Hanson M: The challenge of creating new OSCE measures to capture the characteristics of expertise. Medical Educ 2002, 36:742-748.
• [19]Martin JA, Regehr G, Reznick R, Macrae H, Murnaghan J, Hutchison C, Brown M: Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 1997, 84:273-278.
• [20]Gielen S, Peeters E, Dochy F, Onghena P, Struyven K: Improving the effectiveness of peer feedback for learning. Learn Instruct 2010, 20:304-315.