1. Medical Students as Teachers: Can They Be Effective Lecturers? Kit Montgomery, Terry Stratton, Tom McLarney, Donna Weber Methods Required fourth-year interdepartmental course. Ten minute “guided student teaching” (GST) of assigned learning objective based on clinical paper case. Faculty instruction on preparation/presentation: —PowerPoint presentation —Two-page handout Key points bolded, references, clinical case tie-in, etc. Basic and clinical scientists attended all student lectures to guide questions/discussion. Exam questions were authored by same two faculty members. Post-exam review of item analysis was conducted. Using two-tailed t-tests (p = <.05), end-of-course evaluations and exam scores were compared between large-group lectures by faculty (FL) and GST.

2. Results Students rated lectures given by peers (GST) lower than those given by faculty (FL) (Table 1). Among 2010 and 2011 cohorts, GST and FL exam scores differed significantly (Table 2). (Item difficulty did not differ between groups). 200920102011 Overall quality of faculty instruction 3.173.033.26 Learning benefit of student lectures 2.542.742.92 Table 2: Exam scores and exam item difficulty for three years comparing guided student teaching (GST) to faculty lectures (FL) Table 1: Student evaluations using a four-point Likert-type scale [1 (< adequate) - 4 (outstanding)]

3. Course evaluation comments implied that learners lacked confidence in their peers as teachers - consistently rating them lower as lecturers. GST Lectures: Representative Student Comments “The GST was not the best way to learn... too much shifting of topic and long lecture days.” “Although some of the GSTs were very well done, I would prefer to learn some of this important material from a lecturer who is more experienced.” “The GST questions were great. Actual presentations were overkill in terms of content. Is there a way to encourage the students to cut them down to important, memorable things?” Discussion As faculty instructional time and educational resources become more strained, alternative means of delivering content become increasingly necessary. Although didactic sessions continue to be supplemented or replaced with more active learning approaches, lectures remain a viable pedagogy in many contexts. In our examination of student lecturers in a required 4 th year pharmacology and anesthesiology course, we found no degradation of learning – although students did exhibit less confidence in their peers’ abilities to convey the material.