Peer teaching in medical education

Society appropriately sets high expectations for our profession. Physicians should be able to articulate clearly diagnostic and treatment plans with their patients. We should be able to inform our patients about the risks and benefits of diagnostic and therapeutic options and educate them about the complexities of their disease(s) to include implications that are specific and practical to their unique life situations and preferences – we are expected to develop expertise as teachers. This notion is reflected in competency frameworks (Harden et al. 1999), initiatives such as Residents as Teachers as well as evaluation frameworks including RIME where ‘‘R’’ stands for Reporter, ‘‘I’’ is Interpreter, ‘‘M’’ is Manager, and ‘‘E’’ stands for Educator (Pangaro 1999). Developing expertise in an area requires time for introduction and practice of the subject matter expected to be mastered. In light of these high expectations that society places on physicians as teachers, we need to provide our trainees sufficient time for introduction and deliberate practice of teaching before they are expected to function independently – i.e., one on one with patients without a supervisor. Indeed, it can be argued that an overarching goal of medical education is progressive independence of the learner (ten Cate et al. 2004); the learner (trainee) strives to be able to assume increasing responsibility with interacting with the ‘‘content’’ (patients) with decreasing dependence on the ‘‘teacher’’ or ‘‘educational program’’. A phase in this developmental model, ‘‘the journeyman’’, is addressed by ten Cate and Durning (2007b) in this themed issue.