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Background: The University of Adelaide offers a six-year undergraduate medical degree with a focus on small group learning. Senior medical students had previously received limited formal training in education skills, and were identified as an underutilised teaching resource. Aims: To devise a programme in which senior students are exposed to the various facets of university teaching responsibilities and to evaluate its impact on both the tutors and the students. Methods: A six week rotation in medical education for final year medical students was designed and implemented in 2010 to involve them in the development, delivery and assessment of the 1st and 2nd year medical programme as near-peer tutors (NPTs). Results: Two years after the rotation's implementation, voluntary evaluation of both the junior students and NPTs was undertaken through a mixed methods approach of survey and focus group. Junior students ( n = 358) revealed the NPTs provided non-threatening learning environments, provided helpful feedback and acted as role models. Additionally, the NPTs ( n = 24) reported they had consolidated prior knowledge, developed their teaching skills and expressed a desire to be more involved in teaching in the future. Conclusions: The implementation of NPTs in the teaching of junior medical students appears to benefit both students and their near-peer colleagues. Involvement of NPTs in all facets of medical education through this rotation stands to not only foster potential interest in an academic pathway but also equip them with a variety of transferable skills which they can draw on as future educators in their profession. [ABSTRACT FROM AUTHOR]

One hundred and thirty consecutive patients with anterior myocardial infarction complicated by bundle branch block were retrospectively analyzed. Sixty died within 1 week of infarction. Of the remaining 70 patients, 36 had electrophysiology study with programmed stimulation 8-90 (mean 20) days after infarction. Of these, nine patients (35%) who clinically had not manifested either ventricular tachycardia or ventricular fibrillation more than 72 hours after infarction, had inducible ventricular tachycardia which was sustained more than 30 seconds in eight patients. By contrast, assessment of atrioventricular conduction added little to clinical management, long-term follow-up, extending up to 127 months, was available both in those patients whose therapy was directed by electrophysiology study, and was assessed among the other 34 patients who survived at least 7 days after myocardial infarction, but who did not undergo electrophysiology study. While the overall mortality was 55%, the majority of deaths (22/35) occurred within 4 months of infarction and many long-term survivors enjoy a gratifying quality of life. Although programmed stimulation in survivors of anterior myocardial infarction complicated by bundle branch block may identify a high risk subgroup, a prospective randomized trial is required to define the utility of more aggressive stimulation protocols following NASPE recommendations, to identify subgroups of patients in whom newer therapeutic interventions, including antiarrhythmic agents, electrical devices and surgery may be indicated. [ABSTRACT FROM AUTHOR]

A response to a letter to the editor is presented on cheating in medical school exams, which appeared in the previous issue.

Objectives: Peer-assisted learning (PAL) has been reported to have educational benefits in cross-year, small-group teaching in other contexts. Accordingly, we explored whether senior medical students are effective tutors for their junior peers in clinical skills education, and how the participants in the learning triad (tutors, learners and simulated patients [SPs]) perceive the learning environment created in PAL., Methods: Year 2 students were randomly allocated to one of two groups for skills training. Group 1 (n = 64) were tutored by volunteer Year 6 students, and Group 2 (n = 67) by paid doctors. The results of both groups in a clinical skills examination were compared using an independent samples t-test. Qualitative data, obtained from Year 2 students (n = 125) by written questionnaire and Year 6 students (n = 11) and SPs (n = 3) by focus group interviews, were analysed for themes., Results: Students receiving PAL did at least as well in the clinical skills examination as students with qualified tutors (difference in mean total score: 0.7 marks out of 112; 95% confidence interval--8 to 2.4). The PAL environment was perceived as 'comfortable' and fostered the development of confidence in all participants. Peer tutors created a more active learning environment than doctor tutors for both learners and SPs and reported personal benefits from teaching., Conclusions: With appropriate support, volunteer Year 6 student tutors are as effective as graduate doctors for small-group structured tutorials in clinical skills. Educational relationships were forged between all participants in the learning triad.