An Untapped Resource: Students as Near-Peer Teachers in Medical Education

Near-peer teaching (NPT) is a pedagogical approach that has been receiving increasing recognition worldwide as an effective supplement to formal medical education. The project is a student-led NPT initiative at HKUMed designed and implemented by MBBS Year 5 peer teachers (PT), who undergo training in fundamental teaching skills and provide both academic and non-academic support to Year 2 peer learners (PL) through systematically developed and delivered tutorial sessions.

The NPT programme is unique because it is an initiative entirely led, designed and implemented by students, for students. Through NPT sessions, both PTs and PLs are able to consolidate their medical knowledge and gain skills that are transferable to medical school and beyond in their professional careers. Furthermore, it provides an opportunity for junior students to connect with their seniors who have experienced similar struggles and are thus better positioned to understand the needs and concerns of their younger peers.

Dr Julie Chen (Associate Professor (Teaching)), Evelyn Chan (MBBS V) and Vernice Chan (MBBS V) share their winning project and their aspirations for the NPT Programme.

Interview with Evelyn Chan & Vernice Chan (MBBS V)

As a student, why were you interested in hosting this project?
Having gone through preclinical and now clinical years of medical school, we’ve realised how important it is to have a strong support system and role models to help navigate the path forward. We believed that a NPT programme could serve as a means to build a mutually-supportive community within the student body spanning across cohorts, so that no student would feel like they are on this journey alone. Through NPT, we also hoped to address two aspects of medical education which we feel are important but under-emphasized in the formal curriculum – the integration of preclinical and clinical knowledge, and the development of soft skills to become good educators.

What were the biggest challenges you faced?  Was it challenging to be a student-teacher?
One of the most challenging aspects of being a student-teacher was overcoming our own sense of self-doubt about whether we were capable enough to teach. As students who have only been learning medicine for a few years, it is easy to feel like we barely know anything in the face of seemingly boundless information. However, the positive feedback we received from our juniors was very motivating and showed us that sharing the knowledge we have, regardless of how limited we believe it is, can still be helpful to others on the same path.

 Which part of the project you found most interesting?
It was definitely exciting to step into the shoes of a teacher for the first time and practise how to communicate our knowledge in engaging, memorable ways to our fellow juniors, which required a skillset that was entirely different from what we have learned thus far in medical school. We always found it interesting to receive questions from students that challenged our own ways of thinking, or approached a topic from a new perspective that we had not considered previously.

Is there anything that will affect your learning after running the project?
The process of preparing and delivering teaching sessions (based on preclinical content) has encouraged us to be more intentional in relating our own clinical experiences to concepts that we learnt in preclinical years. We’ve realised the importance of building a strong foundation grounded in these concepts in order to make better sense of the conditions that we learn about from patients we encounter. We’ve also found ourselves incorporating more peer teaching into our own studying practices – both teaching and being taught by our peers have been effective ways to help us process and understand difficult concepts.

What did you learn in this process?
We learnt that we shouldn’t let the fear of making mistakes stop us from making an attempt. As PTs, and as students in general, we tend to put a lot of pressure on ourselves to only say things we’re certain, we’re correct about, and shy away from acknowledging our knowledge gaps. However, we’re realizing how that mindset holds us back from making the most of our learning opportunities. By being more open about our uncertainties and recognising that most students – no matter what year we’re in – share the sentiment of feeling like we don’t know enough, we can be more accepting and supportive of ourselves and our peers, and have the courage to try even if we may be wrong. We certainly made mistakes throughout the NPT programme, yet we learnt the most from reflecting on them. We hope NPT can be a platform for students to feel comfortable acknowledging their uncertainties, asking questions and making mistakes.

What will be the next move of the project?
We’ll be continuing the programme with a new team of peer teachers and student leaders in the upcoming academic year, and we’re aiming to expand the reach of our teaching sessions to include more student cohorts. We’re hopeful that near-peer initiatives such as this can continue to grow and become a resource that students can both contribute to and gain support from.

Interview with Dr Julie Chen

As a teacher, what is your view on student-led teaching?  Is it effective?  How effective is it?
I think there are many paths to effective learning.  In our existing curriculum, the PBL approach, when done properly, is an example of effective student-led learning.  The process relies on students themselves to ultimately teach each other and help each other learn.  Even though it might sometimes feel like the blind leading the blind, result in frustration and mistakes, in the long run, students gain confidence and learn self-reliance. In our project, near-peer teachers are offering another path to learning by sharing, clarifying, consolidating; an approach we hope will also lead to improved confidence and self-efficacy.  When we complete this study in the coming months, I hope the results will validate our hypothesis and provide evidence of the effectiveness of this model of student-led learning, but maybe just as importantly, highlight other benefits such as cross-cohort social support and skills development among peer teachers.

How did the students perform?
Vernice and Evelyn have truly exceeded expectations!  Our academic team has been blown away by their initiative, effort and critical insight in every step of the process – raising the idea, drafting the proposal, collaborating with CETL to develop a foundational teacher training programme, recruiting equally dedicated classmates to be near-peer teachers, developing the content and evaluating the outcomes. This underscores just how capable students are and how they can do amazing things when given free rein.

What are the benefits of engaging students in T&L?
Having students more deeply involved in T&L, beyond giving feedback, helps develop a sense of personal ownership of the learning, offers an opportunity for students and teachers to work together and allows the complexity of the curriculum and the compromises that sometimes have to take place to be more visible. All of this can only lead to a more cooperative and communal learning culture. I also think there are exciting possibilities for more active involvement of students along the entire continuum of the educational process: from direct teaching and facilitation of learning in the formal curriculum, to curriculum development, assessment and evaluation.

What you have learned from the experience and how you could adopt this to your future curriculum planning and teaching?
I’ve discovered that there are many students with expertise and interest in various aspects of medical education.  Some have subject or experiential expertise, others have published scholarly work in teaching and learning or are designing educational interventions. Some are just interested and don’t know where or how to start. There is so much potential for synergy here that is just beginning to be tapped.  In the coming year I hope to bring students with experience/interest in medical education into the planning and delivery of classes that I teach or coordinate and to be partners in future teaching development projects.