Background: Peer-teaching is an educational format in which one student teaches one, or more, fellow students. Self-determination theory suggests that intrinsic motivation increases with the enhancement of autonomy, competence and relatedness. Aims: This qualitative study sought to explore and better understand the lived experiences, attitudes and perceptions of medical students as peer-teachers at the University of Rwanda when participating in a peer-learning intervention in the pediatric department. Methods: Students participated in a 3-h peer-taught symposium, supervised by a pediatric specialist or resident. Students worked in small groups to deliver a short didactic presentation related to acute illness in children. The symposium prepared the students for simulation-based teaching activities. In-depth, semi-structured, interviews were then employed to explore the students' experiences of the peer-teaching symposium. We specifically aimed to scaffold the analysis of these experiences on the themes of autonomy, competence and relatedness. Results: Saturation was achieved after interviews with ten students. Students described developing their own autonomous learning strategies, but despite developing this autonomy had a desire for support in the delivery of the sessions. Competence was developed through enhanced learning of the material, developing teaching skills and confidence in public speaking. Students valued the different aspects of relatedness that developed through preparing and delivering the peer-teaching. Several other themes were identified during the interviews, which are not described here, namely; i. Satisfaction with peer-teaching; ii. Peer-teaching as a concept; iii. Practical issues related to the peer-teaching session, and iv. Teaching style from faculty. Conclusions: This is the first study to assess peer-learning activities in Rwanda. It has used qualitative methods to deeply explore the lived experiences, attitudes and perceptions of medical students. The peer-teaching strategy used here demonstrates the potential to enhance intrinsic motivation while increasing knowledge acquisition and teaching skills. We postulate that students in resource-limited settings, similar to Rwanda, would benefit from peerteaching activities, and in doing so could enhance their intrinsic motivation.

PurposeTo identify the causes of delayed consultation of patients with undescended testis (UDT) at a Rwandan referral hospital.MethodsThis was a retrospective descriptive study of patients with delayed UDT from 2012 – 2016. Delayed UDT was defined as any patient presenting with UDT at >1 year of age. Relevant data was extracted from patients’ files.ResultsOver the study period, there were 44 cases of delayed presentation of UDT. Most patients (n=35, 80%) were born at a hospital and 9 (21%) were born at home. Most (n=29, 65%) parents had primary level of education, 6 (14%) secondary level, 1 (2%) university level, and 8 (18%) never went to school.Overall, 16 (36%) patients reported that they delayed due to ignorance, 12 (27%) due to poor physical examination at birth, 7 (16%) due to poor guidance, 4 (9%) due to poverty and 5 (11%) due to long appointments. Patients born at home were more likely to identify ignorance as a reason for delayed presentation (p=0.007). Of the 16 patients who delayed due to ignorance, 12 parents had primary level of education and 3 had no education.Most (n=34, 77%) patients were fertile during their adulthood, but 9 (21%) presented with infertility and 1 (2%) presented with testicular torsion.ConclusionA number of reasons are responsible for delayed consultation in patients with UDT including ignorance, poor physical examination at birth by physicians, poor guidance, and poverty. Most causes are preventable. Henceforth, urgent need for population awareness on UDT and collaboration between physicians is paramount for early consult and timely management.