Innovations in Musculoskeletal Anatomy Education: Clinically‐based Near‐Peer and Reciprocal Peer‐Teaching
Authors: Lackey‐Cornelison Wendy 
Published: November 2023

Introduction

Teaching is a critical skill for physicians and is a requirement for graduation from the Western Michigan University Homer Stryker M.D. School of Medicine (WMed). WMed (Y1) students use reciprocal peer‐teaching (RPT) during the Musculoskeletal and Dermatology (MSK/D) course to satisfy the teaching skills requirement. Near‐peer (NP) teaching by orthopedic residents serves as an important model of clinical relevance of MSK anatomic content. This presentation will describe the NP/RPT program at WMed and address its effectiveness with regard to retention of course content as demonstrated by practical and written MCQ exam scores.

Instructional Method

Students perform two teaching activities during the (MSK/D) course. 1) Students act as in‐lab instructors, assisting their peers to learn the normal anatomy of an assigned region. 2) Students, in their anatomy lab groups (5–6 individuals), develop a didactic case‐based presentation describing a condition/pathology, the anatomy involved, common patient presentation, appropriate imaging studies, and treatment options.

To prepare for teaching sessions students 1) receive instruction on educational theory and effective teaching methodologies from the department of Medical Education, 2) listen to weekly, short (10–15 minute), case‐based presentations delivered by orthopedic surgical residents, which are related to the objectives of that day's laboratory session and model appropriate content and format for the undergraduate medical student presentations; and 3) are assessed on their regional anatomy knowledge prior to their assigned laboratory instruction and receive early feedback on their presentation content and delivery from faculty and peers.

Results

The NP/RPT program has been executed twice during the MSK/D course. The third iteration will be completed April 22,2017. Early results are promising. Class of 2018 and 2019 averages on the anatomy practical examinations were 87% and 83%, respectively. The 2019 average is particularly notable since the class had little anatomy experience prior to the course. The classes also scored well on clinical vignette‐style MCQ exam questions reminiscent of case‐based presentations delivered during lab sessions. Student feedback was also positive. The teaching component and clinical applications were cited as some of the “best aspects of the course” in course evaluations.

Discussion

The NP/RPT program is fairly unique because, in addition to laboratory instruction, students receive training on instructional methods and get weekly reinforcement of clinical applications via the case‐based orthopedic surgical resident presentations. Further, the emphasis on clinical applications via resident and undergraduate medical student presentations may aid long‐term retention of gross anatomy and later recall in patient vignette‐style questions.

Conclusion

1. At the conclusion of NP and RPT sessions, students were able to lead a case‐based learning session effectively. 2. Students were able to provide skilled laboratory instruction and demonstration. 3. The RPT program offered a valuable opportunity to integrate basic and clinical science information during the course. 4. Through the creation, implementation, and delivery of these teaching sessions, students enhanced their communication and collaboration skills. 5. Student led laboratory and case‐based instruction enhanced retention of anatomy content for both the student teacher and learner.