Effect of Residents-as-Teachers in Rural Community-Based Medical Education on the Learning of Medical Students and Residents: A Thematic Analysis

Abstract

Residents-as-teachers (RaT) is a theoretical framework emphasizing the significance of the similar learning background of teachers and learners. In Japan, community-based medical education (CBME) is a practical approach to teaching family medicine. This study aimed to investigate the impact and challenges of RaT on the learning of medical students and residents in CBME at a rural community hospital in Japan. Over the course of a year, the researchers conducted one-on-one interviews with three residents and ten medical students participating in family medicine training at the hospital. The interviews were recorded and transcribed verbatim. Grounded theory was used in the data analysis to clarify the findings. Three key themes emerged from the research: lack of educational experience with RaT, effectiveness of RaT, and challenges of RaT. Although participants were prejudiced against RaT, they felt its implementation could facilitate the establishment of beneficial relationships between learners and teachers. They were also able to participate in medical teams effectively. The findings suggest that the increased participation of senior doctors in RaT could strengthen its learning effects. RaT in rural CBME should be applied in various contexts, and its effectiveness should be further investigated both qualitatively and quantitatively.

Bedside Teaching in Rural Family Medicine Education in Japan

“…Initially, I hesitated, but later could understand others through continual discussion and dialogue. ” Learners’ understanding of each other can drive their learning because they provide each other with feedback in the method appropriate to each participant based on near-peer learning [ 22 ].…”

“…The circumstances were good and nobody found fault with what I asked them during bedside teaching. ” The participants shared their ideas about patients and were motivated to participate in active bedside teaching sessions [ 22 ]. Additionally, teachers needed to facilitate participants’ collaboration in solving patients’ problems by using small group discussions, to motivate self-directed learning in participants and encourage them to share their ideas freely [ 26 ].…”

Nurses’ Contributions in Rural Family Medicine Education: A Mixed-Method Approach

“…Residents learned content through cognitive apprenticeship, legitimate peripheral participation, and continuous reflection with medical teachers and students [ 29 ]. The formative and summative assessments of the learners were accomplished using Mini-CEX, multiple-source feedback, and portfolios.…”

Use of Peer Learning Model - In Clinical Skills Training Course

“…In medical education, as in other fields, the role of teacher is sometimes played by students and residents themselves. In this regard we can distinguish three main directions: students teach students (1), residents teach residents (2) and residents teach students (3). The first two models, are socalled "peer learning".…”

“…Although students and residents are at different levels of education, in literature this is sometimes referred to as peer learning as well. According to one study residents spend 20-25% of their time teaching students and peers and medical students learn 30-85% of the curriculum in undergraduate medical education from residents [3,13,14,15]. Consequently, many medical students perceive residents as their most important and valuable clinical mentors or teachers [3,11,16].…”