Comparison of Practical Skills Teaching by Near-Peers and Faculty.

Purpose: Near-peer teaching is a vital teaching resource in most medical schools, but little is known about the comparative benefits of near-peers and faculty teaching or the learning mechanisms that underlie them. This study explored near-peers' and students' perceptions of differences between the way near-peers and faculty teach practical skills.

Method: Using qualitative methods, the authors conducted 4 focus groups with near-peers (n = 22) and 4 focus groups with students (n = 26, years 3-6) at the University of Bern, Bern, Switzerland, between September and December 2022. All participants recently participated in near-peer skills training. Vignettes of typical teaching situations guided the focus group discussions. The reflexive thematic analysis was both inductive and deductive; cognitive apprenticeship teaching methods informed the deductive analysis.

Results: Three major areas of difference were identified in near-peers and faculty skills teaching methods: (1) learning climate, (2) teaching orientation, and (3) reaction to identified competence gaps and students' questions. Near-peers were perceived to establish a safer learning climate than faculty, lowering the threshold to ask questions. Near-peer teaching was oriented toward the formal curriculum and students' learning needs, resulting in more tailored explanations focused on examination-relevant content. Faculty oriented their teaching toward clinical practice, which helped students transition to clinical practice but could overwhelm novice students. Faculty better stimulated students to think critically about unanswered questions and how to fill their competence gaps.

Conclusions: Skills teaching by near-peers and faculty differed in teaching climate and orientation. Near-peers saw students as learners, focused on the learning climate and on students' needs. Faculty saw students as future physicians and facilitated the transition from curricular learning to clinical practice. Curricular design should capitalize on the complementary benefits of near-peer and faculty skills instructors and seek to get the best of both worlds.