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One-to-one peer tutoring for failing medical students: A novel intervention

Failing medical students are of great concern to medical educators. Poor exam performance is a significant source of stress in medical students (Sreeramareddy et al. 2007), with consequent effects on personal health. Consistent sub-par exam performance leads to student drop-out (Maher et al. 2013), which has substantial financial and emotional costs for the student. Also, there is a financial cost to society associated with student attrition, with long-term impact on workforce planning for health services. Faculty time and resources will be under significant stress in dealing with failing students. Therefore, it is imperative that a support system, that is accessible and effective, exists for failing students. We identified a crucial need for academic support for failing Year 1 & 2 students at our institution. In response, we implemented a novel one-to-one peer tutoring support system. At our institution, organ systems-based modules are taught in Year 1 & 2, with in-course assessments (ICA) testing students’ knowledge. Failure to pass ICAs can prevent students sitting the end-of-year examinations, and predicts strong likelihood of failing these examinations. Senior medical students volunteered as peer tutors and were paired one-to-one with students who failed an ICA. Confidential tutoring sessions were held once a week until their end-of-year examinations. Tutoring efficacy was measured with paired T-tests. Forty-seven students (22 male, 25 female) failed an ICA and received tutoring between 2011 and 2013. 15/47 (32%) and 12/47 (26%) consented to share their ICA and end-of-year results, respectively. Mean post-tutoring ICA scores improved by 11% (44.7% to 55.7%, p50.001). Mean post-tutoring end-of-year exam scores improved by 13.5% in comparison to mean pre-tutoring ICA scores (45.2% to 58.9%, p50.001). Overall, 40 students (85%) passed the respective year: 31 (66%) at first attempt, 9 (19%) after resits. 5 students (11%) failed resits: of which, 3 retook the year and 2 were deregistered. 2 students withdrew before end-of-year exams. To our knowledge, this is the first such peer tutoring programme designed to support failing medical students. Our one-to-one peer tutoring support system improves failing students’ mean ICA and end-of-year results by 11% and 13.5%, respectively (p50.001). Statistically significant increases in post-tutoring results demonstrate the effectiveness of a low-cost, peer-led and peer-taught tutoring programme. The limited response rate for examination results in our study affects the power of the analysis of preand posttutoring results. However, strong statistical significance and large post-tutoring improvements indicate the efficacy of our results.