Peer mentorship in student-run free clinics: the impact on preclinical education.

BACKGROUND AND OBJECTIVES: Our study examines the perceptions of first-year medical students (MS1s) toward fourth-year colleagues (MS4s) in student-run free clinics to investigate the impact of peer mentorship on augmenting the clinical education received by MS1s in a primary care setting. To our knowledge, this is the first study examining the impact of MS4 mentorship in free clinics.

METHODS: A 55-item online questionnaire was administered to MS1s 9 months after matriculation in April 2012. Questions focused on MS1 perceptions of MS4 impact on comfort with patients, self-reported improvement in clinical skills, and overall satisfaction with mentorship in free clinics. The MS4s referenced in the questionnaire were enrolled in a longitudinal service-learning elective. Results were analyzed using one-sample Wilcoxon sign-ranked median test and ordered logistic regression with STATA software.

RESULTS: Fifty-five of 77 (71.4%) eligible students began the online survey, with 48 (62.3%) completing it. Responses reflected experiences at four student-run free clinics. Overall, MS4 presence improved MS1 comfort with patients and enhanced interactions with attendings. MS1s were satisfied with the level of MS4 mentorship and agreed that MS4s had a distinct mentoring role from attendings. Ordered logistic regression showed that presence of MS4s was significantly associated with self-reported improvements to physical exam skills at one clinic.

CONCLUSIONS: At each clinic, MS1s reported improved comfort with patients and satisfaction with mentorship received from MS4s. MS4s did not merely duplicate the role of attending physicians but enhanced interactions between MS1s and physicians. This suggests that the consistent presence of MS4s is a valuable adjunct to the educational experience of free clinics volunteering for MS1s.