"Rebuilding what has eroded": a descriptive, survey-based study of near-peer instructors' experiences in a critical...

Purpose: Near-peer assisted learning has been deployed in numerous settings within medical education with promising results. However, there is very little experience utilizing near-peers in sociomedical or cultural competency training. We recently described a novel model for sociomedical learning based on Introduction to Medicine and Society (IMS), a critical pedagogy-based course at the Perelman School of Medicine at the University of Pennsylvania (PSOM). Near-peer facilitation, by senior medical students, is central to this model. The aim of this descriptive study is to examine how facilitating within this curriculum impacts senior medical students' self-reported attitudes toward course content, medical education, as well as self-care and medical practice. Methods: At the conclusion of the course, near-peer facilitator attitudes were assessed in three key domains through an anonymous survey. Attitudes were rated according to a 5-point Likert scale. Data from subgroups were analyzed using standard two-tailed t-tests. Optional narrative data were also collected. Results: Twenty six of 34 (76%) eligible facilitators completed the survey. Strong majorities of facilitators felt that their experience facilitating IMS had a favorable effect on attitudes related to course content (sociomedical issues and communication skills). A majority also endorsed favorable changes in their attitudes toward teaching and medical education. Large proportions of facilitators endorsed positive changes in a number of domains linked to trainee resilience. Conclusions: Our descriptive data suggest that acting as a near-peer facilitator as a senior medical student within a critical pedagogy-based course could help to fill multiple important curricular gaps at the transition from medical school to residency. Moreover, we find that a sociomedical facilitation experience during this important transition may increase enthusiasm for careers in medical education and undo some of the negative impacts of clinical training during medical school.