The Effect of Senior Medical Student Tutors Compared to Faculty Tutors on Examination Scores of First- and Second-Year Medical Students in Two Problem-Based Learning Courses

Main Article Content

Damon H. Sakai
Marcel D'Eon
Krista Trinder
Richard T. Kasuya

Abstract

At the University of Hawaii John A. Burns School of Medicine, senior medical student volunteers are used as tutors for some problem-based learning groups in both the first and second years. Previous studies on the advantages and disadvantages of student tutors compared to faculty tutors have been equivocal. This study expected to answer the following question: Are there differences in examination scores for learners in their first or second year tutored by fourth-year medical students compared to those tutored by faculty members on two different types of examinations? Students were assessed using more clinically relevant, modified essay question examinations and multiple-choice question examinations. Student grades for eight consecutive years were sorted for year and type of examination into those tutored by a faculty member and those tutored primarily by a senior medical student. The only difference favored faculty tutors on second-year examinations that contained more clinically relevant questions. This phenomenon may be explained by the clinical expertise of faculty tutors making a difference in the second year but not the first year.

Article Details

Section
Articles

References

Albanese, M. (2010). Problem-based learning. In T. Swanwick (Ed.), Understanding medical education: Evidence, theory and practice (pp. 37-52). London, UK: Wiley- Blackwell.

Albanese, M., & Mitchell, S. (1993). Problem-based learning: A review of literature on its outcomes and implementation issues. Academic Medicine, 68(1), 52–81.

Barrows, H. S. (1986). A taxonomy of problem-based learning methods, Medical Education, 20(6), 481–486. http://dx.doi.org/10.1111/j.1365-2923.1986.tb01386.x

Barrows, H., & Wee Keng Neo, L. (2007). Principles and practice of a PBL. Singapore: Pearson Prentice Hall.

Bereiter, C., & Scardamalia, M. (2000). Commentary on part I: Process and product in problem-based learning (PBL) research. In D. H. Evensen & C. E. Hwelo (Eds.), Problem-based learning: A research perspective on learning interactions (pp. 185–195). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

Bulte, C., Betts, A., Garner, K., & Durning, S. (2007). Student teaching: Views of student near-peer teachers and learners. Medical Teacher, 29(6), 583–590. http://dx.doi.org/10.1080/01421590701583824

Das, M., Mpofu, D. J. S., Hasan, M. Y., & Stewart, T. S. (2002). Student perceptions of tutor skills in problem-based learning tutorials. Medical Education, 36(3), 272–278. http://dx.doi.org/10.1046/j.1365-2923.2002.01148.x

Davis, W. K., Nairn, R., Paine, M. E., Anderson, R. M., & Oh, M. S. (1992). Effects of expert and non-expert facilitators on the small-group process and on student performance. Academic Medicine, 67(7),470–474. http://dx.doi.org/10.1097/00001888-199207000-00013

de Volder, M. L., de Grave, W. S., & Gijselaers, W. H. (1985). Peer teaching: Academic achievement of teacher-led versus student-led discussion groups. Higher Education, 14(6), 643–650. http://dx.doi.org/10.1007/BF00136502

Dolmans, D. H. J. M., Gijselaers, W. H., Moust, J. H. C., Degrave, W. S., Wolfhagen, I. H. A. P., & Van der Vlueten, C. P. M. (2002). Trends in research on the tutor in problem-based learning: Conclusions and implications for educational practice and research. Medical Teacher, 24(2), 173–180. http://dx.doi.org/10.1080/01421590220125277

Eagle, C. J., Harasym, P. H., & Mandin, H. (1992). Effects of tutors with case expertise on problem-based learning issues. Academic Medicine, 67(7), 465–469. http://dx.doi.org/10.1097/00001888-199207000-00012

Kassab, S., Abu-Hijleh, M. F., Al-Shboul, Q., & Hamdy, H. (2005). Student-led tutorials in problem-based learning: Educational outcomes and students’ perceptions. Medical Teacher, 27(6), 521–526. http://dx.doi.org/10.1080/01421590500156186

McKee, N., D’Eon, M., & Trinder, K. (2013). Problem- based learning for interprofessional education: Evidence from an interprofessional problem-based module on palliative care. Canadian Medical Education Journal, 4(1), e35–e48.

Moust, J. H. C., de Volder, M. L., & Nuy, H. J. P. (1989). Peer teaching and higher level cognitive learning outcomes in problem-based learning. Higher Education, 18(6), 737– 742. http://dx.doi.org/10.1007/BF00155664

Moust, J. H. C., & Schmidt, H. G. (1995). Facilitating small-group learning: a comparison of student and staff tutors’ behavior. Instructional Science, 22(4), 287–301. http://dx.doi.org/10.1007/BF00891782

Piaget, J. (1971). Psychology and epistemology. Harmondsworth, Middlesex: Penguin Books.

Ross, H. S., & Cameron, M. T. T. (2007). Peer assisted learning: A planning and implementation framework: AMEE Guide no. 30. Medical Teacher, 29(6), 527–545. http://dx.doi.org/10.1080/01421590701665886

Schmidt, H. G., & Moust, J. H. (2000). Factors affecting small group tutorial learning: A review of the research. In D. H. Evensen & C. E. Hwelo (Eds.), Problem-based learning: A research perspective on learning interactions (pp. 19–51). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

Sobrol, D. T. (1994). Peer tutoring and student outcomes in a problem-based course. Medical Education, 28(4), 284-289. http://dx.doi.org/10.1111/j.1365-2923.1994.tb02713.x

Ten Cate, O., & Durning, S. (2007a). Dimensions and psychology of peer teaching in medical education. Medical Teacher, 29(6), 546–552. http://dx.doi.org/10.1080/01421590701583816

Ten Cate, O., & Durning, S. (2007b). Peer teaching in medical education: Twelve reasons to move from theory to practice. Medical Teacher, 29(6), 591–599. http://dx.doi.org/10.1080/01421590701606799

Ten Cate, O., van de Vorst, I., & van den Broek, S. (2012). Academic achievement of students tutored by near-peers. International Journal of Medical Education, 3, 6–13. http://dx.doi.org/10.5116/ijme.4f0c.9ed2

Topping, K. J. (1996). The effectiveness of peer tutoring in further and higher education: a typology and review of the literature. Higher Education, 32(3), 321–345. http://dx.doi.org/10.1007/BF00138870

Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University Press.

Walsh, A. (2005). The tutor in problem-based learning: A novice’s guide. Hamilton, Ontario: McMaster University.

Zeitz, H. J., & Paul, H. (1993). Facilitator expertise and problem-based learning in PBL and traditional curricula. Aca- demic Medicine, 68(3), 203–204.