gms | German Medical Science

Background: Medical education has a two-fold objective: to provide novice students the opportunity to acquire the best available knowledge and skill of practical medicine, and to support them to develop a professional identity so they can think, act, and feel like a physician [2]. Professional identity is formed mostly through implicit experiences alongside role models as part of a hidden curriculum of rules, regulations and routines; much of which is transmitted by residents – rather than faculty – in informal teaching situations [3]. One of these teaching situations is Problem Based Learning (PBL), where the development of teamwork and leadership skills is one of the primary goals [1].

Methods: We explored the development of team oriented attitudes like cooperation and responsibility during the process of the definition of shared goals and the joint pursuit of knowledge in PBL sessions. We use a cross-over design in which first-year medical students were sequentially taught either first by student-tutors followed by faculty members/clinicians or vice versa. Experiences were analyzed using qualitative methodologies, namely ten interviews with tutors, comparative reflections on student-tutors and faculty members/clinicians during six focus group discussions with first-year students, and participant observation during one semester of PBL sessions. Interviews and focus groups were guideline based, audio-recorded and transcribed verbatim for analysis. We analyzed our data using the methodology of constant comparison.

Results: We found that the main factor for successful PBL sessions for first-year medical students was the previous educational experiences of the student-tutors. Student-tutor’s social congruence enabled them to create a non-hierarchical cooperative learning atmosphere, while cognitive congruence led to manage learning efficiently. Frist-year students stressed that this allowed them to develop earlier responsibility and autonomy in relation to setting goals and pursuit of knowledge. In reflections, the student-tutors were seen as a bridge between novice students and the aspired identity as physician.

Outlook: The ability to draw on prior personal experience allowed student-tutors to create propitious conditions for first-year students to make their own experiences – and create a shared intermediate professional identity as “Tomorrow’s Doctors”.