Peer-teaching: an important skill for all medical students and doctors?

effective educational experience from someone they see as being congruent and perceptive of their educational needs; someone with a better understanding of what they do or don’t know: the well-established features of so-called cognitive congruence [6]. Furthermore, peer-teachers not only develop the skills of teaching that are vital for all doctors but also, thereby, increase their own clinical knowledge and other professional skills [7, 8]. Such research and developments have helped to promote an enthusiasm for peer-teaching [5–7] which is surely now to be welcomed and promoted. As described in this issue [1], and elsewhere [9], involvement in peer-teaching can have positive educational outcomes at different levels of medical training and should probably, therefore, be actively advocated for both undergraduate and postgraduate medical training. Perhaps surprisingly, this recent study [1] found that the doctors involved in the teaching activity felt the need to be monitored by a faculty preceptor to ‘ensure patient safety and adequacy of the educational experience’ and, quite rightly, the authors indicate the resource implications of requiring supervision for all such peer-teaching interactions. This perceived need for adequate supervision might be due to the complexity of the task involved in this specific situation: teaching a peer and, at the same time, being responsible for patient care. This contrasts with most other published medical peer-teaching experiences, especially at an undergraduate level, which usually consist of a specific teacher-learner interaction without, understandably, direct responsibility for patient care [7]. This creates the image of a peer-teaching ladder of progression where initial peer-teaching interactions are less complex, involving a teacher-learner relationship based perhaps in a non-clinical environment; an example might be a thirdyear medical student teaching anatomy to first-year students in a classroom setting. Climbing up the peer-teaching ladder might involve the teaching of skills in a clinical environment Research findings from Canada, published in this issue [1], describe the teaching experiences of a small number of postgraduate doctors training in primary care. A first-year resident is observed by a more senior, second-year colleague who provides teaching and feedback on doctor-patient interactions in an ambulatory clinical setting. The interaction between the firstand second-year residents is observed by a faculty preceptor. The doctor undertaking the teaching receives feedback from his junior colleague and from the experienced educator. It is interesting to note at the outset that all the three levels of clinical experience involved in these processes describe the interactions in extremely positive ways. The first-year resident is provided with a worthwhile educational experience by a colleague he can very easily relate to on an educational, professional and perhaps even social level. The second-year resident not only develops confidence in his capacity to teach but also increases his depth of selfreflection in the clinical setting, an essential skill for doctors at any level of experience. And finally, the faculty preceptor found that ‘the experience of observing and providing feedback of supervision skills promoted reflection of their own teaching methods and effectiveness’. Involvement in these peer-teaching activities had the power to improve professional competencies at three entirely different levels of medical training and practice. Is this unusual? Perhaps not. There is an increasing amount of published work that has demonstrated the profound benefits of peer-teaching to teachers and learners alike [2–5]. Peer-teaching can provide learners with an