Standardized Near-Peer Clinical Skills Training for Seven Student-Run Clinics: Assessing Impact on Student Confidence

Background First-year medical students volunteering in student-run clinics (SRCs) often perform clinical skills before they are formally introduced in the curriculum. At some institutions, students are trained on an ad hoc basis by individual clinics without centralized oversight or quality control. Near-peer teaching models have shown promise in practical skills training and may benefit pre-clerkship learners prior to volunteering at SRCs. The objective of this study was to evaluate whether a standardized and centrally coordinated near-peer clinical skills curriculum (including modules on Vital Signs, History Taking and Patient Presentations, and Physical Exam) improved medical students' self-reported confidence for SRC work across seven different clinics. Methods Three standardized training modules (Vital Signs, History Taking and Patient Presentations, and Physical Exam) were developed and facilitated by near-peer educators. Each module consisted of didactic instruction followed by hands-on practice and assessment, with close guidance from near-peer trainers. First-year students completed surveys pre-training, post-training, and two months after training ("post-clinic") that assessed self-reported confidence and perceived effectiveness of the training model using 5-point Likert scales. Results There were highly significant confidence improvements across all three training modules (p<0.01). Vital signs confidence increased from 2.69 pre-training to 4.60 post-training (paired n=65) and held at 4.48 post-clinic (paired n=25). History taking and patient presentation confidence increased from 3.03 pre-training to 4.44 post-training (paired n=59) and held at 4.17 post-clinic (paired n=18). Physical exam confidence increased from 2.08 pre-training to 4.46 post-training (paired n=26); post-clinic response rate was insufficient for meaningful analysis. Across the three training modules, all students agreed that the near-peer teaching model was effective for learning how to perform the respective clinical skills, with 92.3% of students in the Vital Signs training (n=65), 86.4% in the History Taking and Patient Presentations training (n=59), and 80.8% in the Physical Exam training (n=26) strongly agreeing. Conclusions Standardized clinical skills training led by near-peer educators significantly improves confidence across three core domains for first-year medical students volunteering at multiple SRCs. This scalable model empowers near-peer educators to create accessible learning environments that supplement the curriculum. Future work will include objective clinical performance assessments to validate whether self-reported confidence translates to enhanced clinical skill competence and improved patient outcomes.