Training peer instructors for a combined ultrasound/physical exam curriculum

The integration of bedside ultrasound into medical school curricula is limited by the availability of skilled faculty instructors. Peer mentors have been utilized successfully to teach clinical and procedural skills and may serve as a valuable resource for potential ultrasound instructors. We describe a method to train senior medical students as peer instructors for a combined ultrasound/physical exam curriculum and assessed junior medical students' perceptions of peer instruction relative to faculty.

The University of Colorado has incorporated ultrasound into ocular, abdominal, musculoskeletal, cardiac, vascular, and pulmonary physical exam instruction for 1st-year (n=155) and 2nd-year (n=155) medical students. Fourth-year medical students who completed a 2- or 4-week bedside ultrasound elective were recruited as peer instructors. Both peer and faculty instructors received similar session training and were assigned to random groups of junior medical students. Instructor evaluation scores completed by students were collected after every session.

Twenty students and 29 faculty served as instructors for the curriculum. Comparisons of evaluation scores between faculty and student teachers were equivalent (α>.05) in 5 out of 6 sessions. In addition, students who taught more than 1 session showed improvement in their instructor scores and had higher average scores than students who taught only 1 session. Student instructors who completed the 4-week elective had higher average scores than students who completed the 2-week elective.

Students' perception of peer instructors' teaching competency was equivalent to faculty instructors for the majority of sessions. Senior students who have completed an elective ultrasound rotation may serve as a useful resource for circumstances where the availability of skilled instructors is limited. However, further research is required to evaluate their effectiveness.