Near-peer teaching in simulation

Development, implementation and evaluation of a simulation curriculum is time and resource intensive. Limited faculty time and training are cited as primary barriers to adopting simulation into medical education. Near-peer teaching is a potential solution to manage the increased teaching demands that occur with simulation use.

In 2022, we implemented a near-peer simulation curriculum for teaching junior physical medicine and rehabilitation (PM&R) residents high-acuity low-opportunity events commonly seen on the inpatient rehabilitation unit. The curriculum was taught by senior residents to supplement faculty lectures. Senior residents completed facilitator training on simulator logistics, debriefing and formative assessment.

Residents completed an end-of-course questionnaire evaluating teaching effectiveness and perceived knowledge acquisition. All items were scored on a 5-point Likert-type scale. Learners rated their near-peers as having good clinical teaching effectiveness (mean [SD], 4.66[0.38]). Senior residents (n = 6) disclosed feeling knowledgeable about the topics they instructed (baseline 3.9[3.2-4.4]; after 4.6[4.1-4.9]; p = 0.19), and junior residents (n = 6) felt they gained knowledge and improved their ability to manage patients as a result of the near-peer curriculum (baseline 2.4[2.3-2.5]; after 3.9[3.5-4.2]; p = 0.005).

This educational programme is an example of how near-peer teaching can be used in simulation. Our simulation curriculum taught by near-peers was valued by learners as well taught and educational. Research is needed that directly compares the effectiveness of near-pear teaching to faculty instruction. We hope that by sharing our work, educators will feel inspired to use near-peer teachers for simulation instruction when faculty availability for teaching is scarce.