Effekte von Peer Teaching in einem geburtshilflich-gynäkologischen Praktikum

BACKGROUND: Due to limited staffing resources and the need to preserve patients' privacy, it is difficult to improve the assessed practical courses in gynecology required by law for the licensing of physicians in Germany ( ARZTLICHE APPROBATIONSORDNUNG, AAppO). A previously published project showed that including structured practical teaching (skills training) using suitable obstetric and gynecological models in courses taught by specially trained student teachers (peer teachers) represents a potential solution to the problem. However, there are as yet no data regarding the effectiveness of this approach. AIM: Aim of the study was to determine the effectiveness of a peer-assisted skills training for students as part of a gynecological and obstetric practical course for theoretical and practical examinations (objective structured clinical examination, mini-OSCE) (primary end point). How do students who have been taught in this way rate the educational quality, teaching atmosphere, personal learning progress, and this type of practical course overall (secondary end points)? METHODS: Following the implementation of a skills training section during a practical course, students (n = 139) were randomly assigned to 24 groups. Most groups consisted of six participants. Half of these groups, with a total of 71 students, received peer teaching during skills training, while the other half (n = 68) were taught by postgraduate lecturers. The rest of the one-week practical course, including the theoretical and practical examinations, was identical for all groups. The results of a theoretical and practical examination, also newly implemented (primary end point) and the results of the evaluation before (comparability of the groups) and after the practical course (secondary end points) were analyzed. RESULTS: The groups taught by postgraduate lecturers did not differ with regard to age, sex, number of completed semesters, or prior specialist training from the students who were taught by the peer teachers. In the purely practical OSCE stations, the students in the postgraduate group achieved 58.26 ± 3.2 (95 % CI, 57.5-59.5) out of a total of 62 points, while in the peer teacher group they scored 58.82 ± 2.6 (95 % CI, 58.2-59.4) (p = 0.27). In dealing with the case descriptions, for which material taught to both groups in seminars by postgraduate lecturers was relevant, the postgraduate group achieved 26.52 ± 3.2 (95 % CI, 25.7-27.3) of 30 points, while in the peer teacher group the figure was 26.29 ± 2.7 (95 % CI, 25.6-27.0) (p = 0.64). In the final evaluation regarding the motivation of the trainers, the teaching atmosphere, and the effectiveness of preparation for the practical examination, no significant differences were found. The postgraduate lecturers only had significantly better results than the peer teachers when conveying the theoretical background and responding to questions. CONCLUSIONS: To communicate the principles of basic practical medical skills in a gynecological practical course, teaching by specially trained peers is just as effective as teaching by postgraduate teachers.