Effectiveness of Near-Peer-Taught Case Reviews on Students' Confidence in National Board of Medical Examiners (NBME) Exams

Introduction A key element to a first-year medical student's (MS1) education is guidance and practice in applying anatomy, pathophysiology, diagnosis, and treatment concepts to clinical vignettes. One potential solution to providing effective clinical reasoning training is the involvement of second-year medical students (MS2s) in small group sessions as teachers to provide more personalized instruction via case-based learning sessions. Near-peer teaching has been shown to benefit students' confidence in learning and improve test scores. Similarly, case-based learning is heavily associated with an improved understanding of complex topics. As such, this study assessed the efficacy of near-peer teaching with concomitant case-based style presentations on improving the comfort of MS1s with their understanding of the curriculum content and their comfort with applying their knowledge to clinical scenarios. Methods This randomized controlled crossover trial included several small-group study sessions, each consisting of five MS1s and led by an MS2 who reviewed selected clinical cases in a standardized slide decks. The control arm was provided the same slide decks but did not participate in the MS2-led sessions. During the first course, students were assigned to either the control or intervention group and then crossed over to the opposite group (control to intervention and vice versa) in every subsequent course. Comfort with the curriculum material was then assessed through pre and post surveys, with the post surveys administered after the MS1s took their final NBME examination for that course. Results The study was cut short due to COVID-19 precautions limiting in-person sessions. Nevertheless, the post survey demonstrated an increased understanding of pathological concepts for the intervention group compared to the control group. Conclusions Future work on near-peer group study sessions should enroll a larger sample size with measures to improve the response rate to better test whether near-peer-led case reviews had a significant effect on students' understanding of anatomical concepts and confidence during NBME examinations.