Residents as teachers: outcomes of a brief training programme

Residents (RMOs) teach medical students in hospital wards, yet little evidence of efficacy is available for this activity. This study undertook to test the effectiveness of RMO teaching, and to delineate the principal barriers encountered.

Medical students in their fourth year were assessed at baseline for clinical examination skills in ophthalmoscopy, neurological examination of the legs, and rheumatological examination of the hands. One group of RMOs (n=6) taught ophthalmoscopy to the students attached to their unit, while the second group of RMOs (n=6) taught leg examination to their students. The third examination skill was not taught, but was used as a control intervention. The students were evaluated in all three skills by an observed, structured clinical examination at the beginning and end of their six-week attachments.

There was a significant improvement in the skill of ophthalmoscopy in the intervention group (p<0.02), while the control group of students showed a decline in their abilities. The skill of examination of the legs improved after being taught, but not significantly. The RMOs universally reported that difficulty in finding time was a major barrier to their ability to teach medical students, and most set up additional teaching sessions rather than incorporate the teaching into their routine ward work.

RMO teaching of medical students is effective, particularly for a skill which is novel. The difficulties arise in finding a suitable time for these important clinical teachers to transfer their skills.