A Hypothesis-Driven, Near-Peer Physical Diagnosis Module on Streptococcal Pharyngitis Within the Pediatrics Clerkship

MedEdPORTAL. 2024 Oct 4:20:11448. doi: 10.15766/mep_2374-8265.11448. eCollection 2024.

Abstract

Introduction: In busy clinical settings, there is limited time to teach physical examination (PE) and procedural skills, particularly when the traditional head-to-toe PE approach is time-consuming. Near-peer teaching of a more efficient approach, the hypothesis-driven PE (HDPE), increases students' learning opportunities. We developed a near-peer HDPE module to improve medical student confidence, knowledge, and skills for diagnosing and managing streptococcal pharyngitis.

Methods: During this 1-hour module, residents taught the diagnostic approach for a patient with sore throat and facilitated small groups for practicing PE and throat swab skills. We assessed students using pre- and postmodule surveys including Likert-scale confidence scores (1 = not at all confident, 5= extremely confident), multiple-choice knowledge questions, and a skills rubric. A control group was surveyed at clerkship conclusion.

Results: Of the 71 pediatric clerkship students who participated, 69 (97%) completed premodule surveys and 65 (91%) completed skills assessments. Twenty-eight (39%) completed postmodule surveys and skill assessments. After participation, students' survey responses and rubrics indicated significant increase in confidence (Mdn pre = 2 [IQR = 1,2], Mdn post = 4 [IQR = 4,5]; p < .001), knowledge (M pre = 40%, M post = 77%; p < .001), and skills (M pre = 5.3, M post = 7.5; p < .01). Participating students also had significantly higher confidence (p < .005) and knowledge (p < 0.01) compared to the control group.

Discussion: This near-peer HDPE module improved students' knowledge, confidence, and skills related to streptococcal pharyngitis diagnosis and management and achieved compliance for a required clerkship skill.

Keywords: Clinical Skills Assessment/OSCEs; Clinical Teaching/Bedside Teaching; Clinical/Procedural Skills Training; Near-Peer Learning; Pediatrics; Physical Diagnosis; Physical Examination; Residents as Teachers.

MeSH terms

  • Clinical Clerkship* / methods
  • Clinical Competence*
  • Curriculum
  • Educational Measurement / methods
  • Humans
  • Pediatrics* / education
  • Peer Group*
  • Pharyngitis* / diagnosis
  • Pharyngitis* / microbiology
  • Physical Examination* / methods
  • Streptococcal Infections* / diagnosis
  • Students, Medical / statistics & numerical data
  • Surveys and Questionnaires