Teaching scripts via smartphone app facilitate resident-led teaching of medical students

Abstract

Background: Previous studies have suggested that resident physicians are the most meaningful teachers during the clinical clerkships of third-year medical students (MS3s). Unfortunately, residents often feel unprepared for this crucial role. The pediatrics clerkship at our institution identified a paucity in the frequency of resident-led teaching with MS3s. Lack of confidence, suboptimal teaching space, and insufficient time were cited as the most significant barriers. To enhance resident-led teaching of MS3s, we created teaching scripts of general pediatrics topics accessible via a smartphone application (app).

Methods: Prior to the implementation of the app, MS3s and pediatric residents were surveyed on clerkship teaching practices. From May 2017 through July 2018, pediatric residents working with MS3s were introduced to the app, with both groups queried on resident teaching habits afterward. We compared pre-intervention and post-intervention data of time spent teaching, teaching frequency, and a ranking of pediatric resident teaching performance compared to residents of other MS3 core clerkships.

Results: 44 out of 90 residents (49%) responded to a pre-intervention survey on baseline teaching habits. 49 out of 61 residents (80%) completed our post-intervention survey. Pre-intervention, 75% (33/44) of residents reported spending less than 5 min per teaching session on average. Post-intervention, 67% (33/49) reported spending more than 5 min (p < 0.01). 25% (11/44) of residents reported teaching at least once per day pre-intervention, versus 55% (27/49, p = 0.12) post-intervention. Post-intervention data demonstrated a statistically significant correlation between app use and increased frequency of teaching (p < 0.01). The MS3 average ranking of pediatric resident teaching increased from 2.4 to 3.4 out of 6 (p < 0.05) after this intervention.

Conclusions: Residency programs looking to reform resident-led teaching, particularly of residents early in their training, should consider our novel approach. In addition to addressing barriers to teaching and creating a platform for near-peer teaching, it is adaptable to any specialty or learner level. Future direction includes developing objective measures for teaching performance and content proficiency to better assess our intervention as an educational curriculum, as well as further investigation of the intervention as a controlled trial.

Keywords: Medical student clerkship; Near-peer teacher; Pediatrics; Resident-led teaching; Smartphone app; Teaching scripts.

Fig. 1

Minutes spent teaching MS3s per teaching session before (n = 44) and after (n = 49) introduction of smartphone-based teaching app. p < 0.01 for increased time spent teaching per session post-intervention (Mann-Whitney U Test)

Fig. 2

Frequency of resident-led teaching of MS3s before (n = 44) and after (n = 49) introduction of smartphone-based teaching app. p = 0.12 for increased teaching frequency post-intervention (Mann-Whitney U Test)

Fig. 3

MS3 ranking of the quality of pediatric resident teaching relative to other core clerkships before (2017, n = 51) and after (2018, n = 41) introduction of smartphone-based teaching app. p < 0.05 for improved clerkship ratings post-intervention (Kolmogorov-Smirnov comparison of distributions)