Abstract

A �near-peer� assisted learning approach to teaching undergraduate basic surgical skills

Author(s): Dr Michael J Keogh,Mr John M Findlay,Mr David Foreman

Objectives: The benefits of peer and near-peer assisted learning (PAL and NPAL) are recognised across numerous areas of medical education, and particularly in the USA. However, no literature currently exists as to their effectiveness in teaching basic surgical skills to medical students. This prospective study assessed the efficacy of UK Foundation Year 1 doctors writing and teaching a pilot surgical skills course to senior medical students.

Design: The course comprised single sessions covering the theoretical and practical components of: surgical scrubbing and patient positioning, suturing & knot tying, minimal access surgery and minor surgical procedures e.g. skin excisions. 30 students enrolled onto the course. Student outcome measures comprised online case-based assessments and a pass/fail objective structured clinical examination (OSCE); tutor outcome measures comprised a competence and attitudinal parameter questionnaire.

Results: Significant improvements in online assessment scores were demonstrated for each course component (scrubbing and positioning 34.2%, suturing and knot tying 42.8%, minimal access surgery 30.1% and minor surgical procedures 58.5%; p = 0.000). There were no differences between undergraduate entry and postgraduate entry students. All students passed the OSCE. Qualitative improvements were reported in tutor skills and teaching parameters.

Conclusions: Foundation Year 1 doctors can develop and teach a near-peer assisted course to significantly improve the knowledge and basic surgical skills of students and tutors alike. We advocate its development and further assessment in both undergraduate and postgraduate surgical education.