An Evaluation of a Self-Directed Peer Supported Model with Structured Roles for Clinical Skills Acquisition

Abstract

Background: A flipped classroom approach using videos for acquiring clinical skills may repurpose' the in-class time for clarification and remediation. There is limited evidence examining the best practices for this blended e-learning approach. We hypothesized that insights gained from structured roles will enhance the efficiency in skills acquisition. This study evaluated a self-directed peer-supported teaching model for this purpose. Methods: Fifth year medical students formed learning triads and after either synchronous (in class) or asynchronous (out of class) viewing of an instructional video, each student rotated through three defined roles - performer, coach and monitor. Using an assessment rubric, the coach instructed the performer practicing the simulated skill and the monitor appraised the performance of both the coach and performer. Their performance was then video recorded and were assessed blindly by 2 independent anaesthesiologists. Result: 164 students were included in the analysis out of a cohort of 205. They preferred this flipped approach over the traditional demonstration approach and found both the coach and monitored role useful for acquiring the skills. Less than 1% of students deemed not to have met the standard expected. 44 ranked asynchronous more preferable, 18 ranked synchronous more preferable with 84 ranked them equal. Students found watching video out of class significantly more useful than watching videos in class with peers (p=0.001), but the effect size is small (r = -.29). Conclusion: This peer-supported e-learning approach may enable a reduced an instructor to student ratio without compromise efficacy for acquiring clinical skills.