Defining Student-as-Teacher Curricula in the Absence of National Guidelines: An Innovative Model.

Teaching is a critical skill in the medical profession, yet has only recently gained recognition as a core skill for medical students and trainees. Student-as-teacher (SAT) programs provide medical students formal teaching instruction with opportunities for practice. While efforts to determine how SAT courses should be taught are ongoing, the authors' review of SAT programs in medical schools' curricula shows they are diverse and often developed by faculty and trainees who advocate for formal teacher training at their institutions, rather than by medical school leadership. Consequently, there is significant heterogeneity among known SAT programs with regard to content, format, and evaluation methods. As efforts are underway to create guidelines and competency frameworks for SAT programs, medical educators must engage in open and critical discussion about the optimal content and organization for SAT educational experiences, emphasizing outcomes-based value and curricular and experiential consistency across programs. The authors describe an innovative SAT elective at Harvard Medical School (HMS), discuss research supporting curricular content and decisions, and emphasize potential implications for the conception and implementation of SAT programs at other institutions. The HMS SAT course is a year-long, elective, longitudinal curriculum built on a community of practice model and comprising 5 key components: Fundamentals of Medical Education seminar series, teaching field experiences, teaching observations, final educational product, and self-reflection. This 5-component theoretically justified model covers essential topics of SAT programming, providing students a comprehensive educational skills training curriculum. Medical educators developing SAT courses must identify common core competencies and curricular activities to implement SAT programs informed by the perspective of local stakeholders and institutional needs. Further growth of SAT programs in medical education offers opportunities for collaboration and coordination among medical educators, institutions, and licensing and accreditation bodies, to further develop consistent guidelines for teaching medical education skills to future medical educators.