Undergraduate rheumatology: can peer-assisted learning by medical students deliver equivalent training to that provided by specialist staff?

Abstract

This study addressed whether medical students using peer-assisted learning (PAL) can deliver training comparable with didactic teaching provided by a specialist. Twelve senior students were trained in PAL and the gait, arms, legs, spine (GALS) screening technique for musculoskeletal system (MSS) examination. The students recruited and trained 45 year-2 students in the use of GALS. Nineteen students were recruited by a physiotherapist for GALS training tutorials. Trainee responses were compared by analysis of pre/post training confidence (using 100 mm visual analogue scale), course experience questionnaires (using a 5-point Likert scale) including free text comments, and in end of year examinations. Trainee confidence increased after PAL training from 3.7 to 89.9 (P < 0.0001). There were no significant differences in confidence levels from student trainees after PAL when compared with expert-led teaching. Results from course experience questionnaires demonstrated benefits in all parameters investigated with all students recommending PAL training. No differences between PAL and expert-led training were observed. Free-text comments showed that PAL-trained students perceived that this learning technique has potential to be applied to other areas of training, an observation not raised by expert-trained students. Examination results revealed that PAL-trained and expert-tutored students were respectively, 1.4 and 1.3 times more likely to pass the MSS examination, when compared with students undertaking standard training (P < 0.002 and P = 0.0001, respectively). PAL is a useful adjunct to musculoskeletal clinical skills training. Students using PAL techniques offered a comparable level of training with that provided by an expert.