An Observational Case Study of Near-Peer Teaching in Medical and Pharmacy Experiential Training

By Sharif-Chan, Bayan; Tankala, Dipti et al. | American Journal of Pharmaceutical Education, September 2016 | Go to article overview

An Observational Case Study of Near-Peer Teaching in Medical and Pharmacy Experiential Training


Sharif-Chan, Bayan, Tankala, Dipti, Leong, Christine, Austin, Zubin, Battistella, Marisa, American Journal of Pharmaceutical Education


INTRODUCTION

Experiential peer teaching involves students teaching one or more fellow students. (1) In particular, near-peer teaching (involving senior trainees, who are more advanced by at least one year, teaching junior trainees). (2,3) Near-peer teaching is deeply rooted in the tradition of medical experiential training despite the paucity of evidence for its use. Although near-peer teaching is commonly used in medical experiential training, it is less often used in pharmacy experiential training. Consequently, there is an absence of literature on the implementation and benefits of near-peer teaching for pharmacy experiential training. (4-7)

Benefits of near-peer teaching in the medical field include alleviating faculty teaching burden, providing role models for junior students, enhancing intrinsic motivation, and preparing physicians for their future role as educators. (3) This may interest pharmacy educators facing the challenge of providing high-quality practice experiences for students as more Canadian pharmacy schools establish an entry level doctor of pharmacy (PharmD) program. (5) The establishment of the entry level PharmD and concurrent legislative changes to enhance the scope of pharmacy practice in Canada demands research on the utility of near-peer teaching within pharmacy experiential education. The primary objective of this research was to compare and explore themes related to peer teaching in a medical clinical teaching unit and a pharmacy clinical teaching unit, based on qualitative observations. Secondly, the research aimed to provide suggestions for future research in pharmacy experiential near-peer teaching.

METHODS

An exploratory observational study guided by ethnographic principles for data collection and analysis was employed. (8) Ethnographic principles were used to describe the social interaction, behaviors, and perceptions of two clinical teaching units. (9-12) All participants provided informed consent before observations began. The study was approved by the research ethics board at the teaching hospital. A final-year PharmD research student collected observations through field notes and informal interviews at a large downtown teaching hospital. The student received informal training from two pharmacists familiar with ethnographic principles. The PharmD research student spent 4-6 hours per day observing a team of medical trainees from the faculty (school) of medicine in the general internal medicine unit for two weeks, followed by a team of pharmacy trainees in an ambulatory hemodialysis (HD) unit for two weeks. In addition, 15-minute personal interviews were conducted three times per week that were audiotaped and subsequently transcribed. Data were interpreted by the observer and reviewed weekly by two impartial pharmacists. Only one pharmacy team (HD unit) within the hospital used near-peer teaching, and as the HD unit at the hospital did not employ near-peer teaching for medical trainees, a clinical teaching unit from general internal medicine was selected. Thus, two different units were selected for observation for this study.

The pharmacy clinical teaching unit included one attending, a pharmacy resident, a PharmD student, and a bachelor of science in pharmacy (BScPhm) student. In Ontario, programs are transitioning from a BScPhm to a PharmD. Therefore, in this study, pharmacy trainees from both programs were included. The participants in the pharmacy clinical teaching unit each had varying levels of experience. The BScPhm program included four months of experiential training with a maximum of two months in the hospital. Prior to this study, only the BScPhm student had direct patient care experience in the community setting. The newly implemented PharmD program outlined nine practice experiences, each five weeks in length, and a minimum of 10 weeks in the hospital setting. The pharmacy resident had 34 weeks of hospital experience while the PharmD student had 24 weeks of hospital experience. …

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