Distant peer-tutoring of clinical skills, using tablets with instructional videos and Skype: A pilot study in the UK and Malaysia

Objectives: To assess the feasibility and impact of using low-cost Android tablets to deliver video tutorials and remote online peer-tutoring for clinical skills between two countries. Methods: Nine junior medical students from Malaysia were paired with five senior medical students from the UK, who played the role of peer-tutors. Students from Malaysia were given a low-cost Android tablet from which they could access instructional video tutorials. At the end of each week, the peer-tutors would observe their peer-learners as they performed a clinical examination. Tutors would then provide individual feedback using a videoconferencing tool. Outcomes were assessed using Observed Structured Clinical Examination (OSCE) scores, post-study questionnaires and semi-structured interviews with participants. Results: Peer-learners reported an increased confidence in clinical examination of 8.4 (+/- 1.0) on a 10-point scale and all nine said they would recommend the scheme to their peers. Both peer-tutors and peer-learners were able to establish a strong rapport over video, rating it as 8.4 (+/- 0.6) and 8.4 (+/- 0.9), respectively. Peer-learners' rated the sound and video quality of the tablet as 7.0 (+/- 1.1) but were less satisfied with the screen resolution of the tablet, rating this as 4.0 (+/- 1.5). Conclusion: This preliminary pilot study presents an innovative, low cost approach to international medical education with significant potential for future development.