Fourth-year medical students and faculty teaching first-year students the physical examination: who is better?

S. A. Haist, J. F. Wilson, N. L. Brigham, S. E. Fosson, A. V. Blue

Research output: Contribution to journalArticlepeer-review

Abstract

Demands on faculty time are increasing. For a variety of reasons, including providing faculty more time, fourth-year students have been used as preceptors to teach first-year students (M1s) the physical examination at the study institution. M4 preceptors (M4Ps) were as effective as faculty preceptors (FPs) based on objective evaluation of M1's performances and M1s' ratings of their preceptors during the first year of the project. We report on the second year of the project. M4s who received an A in their Physical Diagnosis course and had at least a 3.4 GPA third year were asked to participate. Ten of 32 participated. M1s were first stratified by sex and then randomized into groups of four: 10 M4Ps and 15 FPs. Mean scores on the standardized patient examination of the M1s with FPs was 93.6 (SD= 1.9) and with M4Ps was 93.1 (SD=2.1), a no difference (t (1,88)=1.54, p=.22). The written examination mean scores were 86.7(SD=7.7), and 82.9 (SD=8.2) respectively. M1s who had FPs versus M1s who had M4Ps scored no differently on the written examination when controlling for GPA (F=0.51,p=0.61). M1s rated their preceptors using 13 Likert-scale items (1=strongly agree to 5=strongly disagree). An example of one item is: My preceptor....was enthusiastic about teaching (M4Ps =1.29, SD 0.53 and FPs=1.68, SD 1.04). The M4Ps were rated higher than FPs on all 13 items, (10 of the items at p<.05). In addition, the M4Ps rated the experience favorably. 9 of 10 M4Ps responded to a post-experience survey (10 Likert scale items and 3 open-ended questions). 88/90 responses to the Likert scale items were positive (2/90 were neutral). Open-ended responses were also positive (i.e. "Thank you for letting me do this. It was one of the most positive experiences I had in medical school.") Based on the objective evaluations of M1s, we conclude M4Ps are as effective preceptors as FPs. M1s rated M4Ps more favorably than FPs and M4Ps valued the experience. Fourth-year medical students are effective teachers and should be considered as a resource for teaching more junior students.

Original languageEnglish
Pages (from-to)82A
JournalJournal of Investigative Medicine
Volume44
Issue number1
StatePublished - 1996

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology

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