Learning from peers and patients

Clinical teachers are a diverse group of people sharing a commitment to the development and provision of quality educational experiences to all types of learners in practice environments. They belong to different health professions or come from various disciplinary backgrounds, such as education and psychology. Some have formal teaching qualifications and some are working towards these; all draw on their personal experiences of learning and working to motivate health professionals to enhance practice and patient outcomes. Our readership, of course, reflects this diversity. We advise reviewers and associate editors reading potential papers for The Clinical Teacher to have in mind busy colleagues juggling the demands of service delivery (either within health or academic settings) with mentoring, supervision and facilitation. What do these people want to read? What do they need to help broaden their knowledge and improve their skills in relation to education? Which articles do clinical teachers recommend to others, saying: ‘that was really interesting’ and ‘I am going to try that out’? Last year we surveyed our readership to find out more about who they are, what they want to read and to solicit feedback on what we are doing well or might improve. Being such a diverse readership you provided a range of opinions. Now we have to plan for the future and try to respond to as much feedback as possible, starting here by summarising some of your key messages. First, a few words about the respondents. There was almost an even divide between the genders, and a good spread across years of experience, with about 50 per cent having more than 10 years of experience. Respondents ranged from senior academics to teachers working mainly in service delivery. There were nurses, midwives, doctors from across disciplines, and pharmacists, working in universities, hospitals and in the community. Each continent was represented, with the majority of replies from Asia. Most respondents access the journal via the Wiley Online Library. In terms of developing the journal, several readers would like the articles to be longer and more scholarly, whereas others would prefer a more practical approach. Our sister journal Medical Education is suitable for the former group of readers, with its emphasis on research and theory-driven studies, whereas at The Clinical Teacher we look for the shorter pieces that may be of immediate use. Of course, we still have a commitment to publishing quality papers that reference appropriate literature, and that move beyond simple evaluations of small numbers of participants. We feel that the overall standard of work has improved over the last few years, but we are not aiming to emulate Medical Education in the length and focus of articles. Our new series The Clinical Teacher's Toolbox had not started at the time of the survey, but we hope that it responds to the recommendation for teaching tips and techniques (‘how to’ articles). We have already published a paper on ‘Writing for publication’,1 which meets a suggestion from the survey asking for advice for potential writers. Several respondents would like to see papers from health professions other than medicine and more of a focus on post-graduates and continuing professional development (CPD), rather than pre-qualification (pre-licensure) education. We would also like to expand in these areas, but we are reliant on the papers submitted. We receive far fewer in these areas, and still not many with a non-medical focus; some of these suggestions therefore need action by you, our potential authors. Thank you to all who completed the survey and for the very complimentary comments. Many respondents saw no reason for change – they like the journal as it is. But of course nothing can ever keep still and, just like curricula and educational interventions, we need to keep up with latest developments and refresh the journal from time to time. In this edition of the journal there are three papers on peer learning and teaching, one of which focuses primarily on peer feedback. (And of course we see the survey discussed above as an example of peer feedback.) There are several definitions of peer teaching in use,2 and it is a commonly used method of helping medical students develop teaching skills.3 Lillie et al. report on a partnership between Zambia and the UK, which they describe as ‘a cross-cultural peer-directed co-learning model’.4 Senior British anaesthetic postgraduate trainees spend 6 months in Lusaka, teaching local anaesthetists about management, leadership and governance, while learning themselves about global medicine from their hosts. This ‘synergistic model’ ensures that both visitors and locals learn with, from and about each other, thereby improving the chance that the programme will be sustained. From Canada, Doumouras et al. describe a model in which senior medical students teach junior students in clinical settings – at the bedside.5 Again both groups benefited from the experience: the juniors gained confidence and comfort with patients, whereas the seniors learned from preparing for and delivering the teaching. Finally, Burgess and Mellis of Australia investigate how medical students perceive the experience of being formatively assessed by, and receiving feedback from, their peers.6 Involving peers in this way has been shown to enhance learning, as peer teachers understand the difficulties that their colleagues face and learners appear more comfortable asking questions in these situations, although not all experiences reported elsewhere have been positive.3 As is so often the case, further evaluation is needed to explore what works in which contexts. The toolbox article is a practical guide to involving patients as educators beyond their traditional roles as patients seeking health care from professionals.7 Towle and Godolphin have been championing the ‘patient's voice’ in health professions education for many years. In 2005 I attended a conference in Vancouver, Where's the patient voice in health professions education, which changed my thinking. Ten years on, our toolbox authors are instrumental in organising a follow-up conference, also in Vancouver, that will explore what has changed in this area and what more can and should be done to enhance the role of patients as educators in the future.

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