Near-peer role modeling: Can fourth-year medical students, recognized for their humanism, enhance reflection among second-year students in a physical diagnosis course?

Introduction: Humanism is cultivated through reflection and self-awareness. We aimed to employ fourth-year medical students, recognized for their humanism, to facilitate reflective sessions for second-year medical students with the intention of positively influencing reflective process toward humanistic development.

Methods/analysis: A total of 186 students were randomly assigned to one of three comparison arms: eight groups of eight students (64 students) were facilitated by a fourth-year student who was a Gold Humanism Honor Society member (GHHS); eight groups (64 students) by a volunteer non-GHHS student; and seven groups (58 students) were non-facilitated. Before sessions, second-year students set learning goals concerning interactions with patients; fourth-year students received training materials on facilitation. Groups met twice during their 10 clinical site visits. At the last session, students completed a reflective assignment on their goal progress. Comparative mixed method analyses were conducted among the three comparison arms on reflection (reflective score on in-session assignment) and session satisfaction (survey) in addition to a thematic analysis of responses on the in-session assignment.

Results: We found significant differences among all three comparison arms on students' reflective scores (p=0.0003) and satisfaction (p=0.0001). T-tests comparing GHHS- and non-GHHS-facilitated groups showed significantly higher mean reflective scores for GHHS-facilitated groups (p=0.033); there were no differences on session satisfaction. Thematic analysis of students' reflections showed attempts at self-examination, but lacked depth in addressing emotions. There was a common focus on achieving comfort and confidence in clinical skills performance.

Discussion/conclusions: Near peers, recognized for their humanism, demonstrated significant influence in deepening medical students' reflections surrounding patient interactions or humanistic development. Overall, students preferred facilitated to non-facilitated peer feedback forums. This model holds promise for enhancing self-reflection in medical education, but needs further exploration to determine behavioral effects.