The survey was sent to 184 learners, past and present, and 45 tutors. Twelve tutor surveys and 15 learner surveys were incomplete and eliminated from review. Of the learners, 54 (29.3%) completed the survey. Twenty of the 45 tutors completed the survey (44.4%). Quotations pulled from survey responses are written throughout in italicized text.

Learner Responses

Of the 56 learners who completed the survey, the largest percentage (42/54, 77.8%) received tutoring in the 18-month Foundation (Pre-clinical) Phase of the SOM curriculum that precedes the United States Medical Licensing Exam (USMLE) Step 1 (Fig. 1). Following this phase, students take the USMLE Step 1 after a dedicated 2-month study period and, if they are determined to be at risk of failure, an extended study period. After taking the USMLE Step 1, students are able to advance to the Application (Clerkship) Phase of the curriculum during which they take standardized subject (Shelf) exams prior to taking the USMLE Step 2 Clinical Knowledge exam. All but six respondents (11%) had participated in the PTP for greater than 1 month (Fig. 2). Most respondents meet with their tutor at least weekly (40/54, 74.1%).

Fig. 1

Responses to the prompts “During what phase of the curriculum did you receive tutoring? (Select all that apply)” (Learners, N = 94) and “What areas of the curriculum have you tutored? (Select all that apply)” (Tutors, N = 57). Note that respondents were allowed to select more than one response resulting in a larger number of responses than participants

Fig. 2

Responses to the prompts “For how many months total did you receive tutoring?” (Learners, N = 54) and “During what phase of the curriculum were you in primarily while serving as a tutor?” (Tutors, N = 20)

The research team identified seven codes in the learners’ responses describing aspects of the PTP. These codes coalesced around three overarching themes: creating a safe learning environment, direct coaching skills, and pitfalls. These themes are described in more detail below. Additional examples of exemplar quotes are in Table 1.

1.

Creation of a Safe Learning Environment

Table 1 Summary of themes and codes found within survey responses from learners with example quotes from survey responses listed in italics

Learners commented on multiple interpersonal qualities that made tutors well suited for the role. They emphasized the benefit of having tutors that were “kind,” “encouraging,” or “compassionate.” Initially, the team coded these responses into those about interpersonal skills (such as kindness, honesty, friendliness) separate from those directly related to the learning environment and tutoring work (encouraging, patient, flexible, etc.). The more responses that were compared, the more the two codes intertwined. Interpersonal relationships appeared to inform the learning environment because of peer tutoring and how individualized it can be when done well:

“There was this perceived stigma that was associated with having a tutor in medical school, that was often isolating. I appreciated that my tutor would share with me times when they didn’t get topics and needed a bit more help AND then offering the strategies that helped them.”

2.

Direct Coaching Skills

Learners identified multiple tutoring activities that were beneficial in the PTP. Many learners found it helpful to review or complete practice questions from a question bank under the supervision of their tutor. Practice questions allowed learners to review the material and their thinking or medical decision-making processes with their tutor. Respondents often stated that their tutors would have them start “…thinking aloud and [talk] through good and bad things that [the learner] did as [they] worked through the questions…” in an attempt to facilitate deeper learning. This also provided the opportunity for tutors to “…tell [learners] about important concepts [they were] missing…” and reteach foundational concepts.

3.

Pitfalls

There were several examples of juxtaposed responses from other learners. For example, while many learners found practice questions completed under the supervision of their tutor to be a valuable learning experience, some students indicated that practice questions were “time consuming” and didn’t support their learning. Some learners found sessions so structured that “planning for tutoring [was] a little stressful,” while others reported that their “tutor[s] did not really have any direction with their sessions.” These juxtapositions highlight learners’ desire for sessions customized to fit their needs.

Tutor Responses

Of the 20 tutors who completed the survey, their experience tutoring was spread throughout the curriculum. The majority of tutors served during an academic leave of absence such as a research year, co-curricular master’s degree, or Ph.D. program (8/20, 40%) or during the Individualization Phase of the SOM curriculum (the last 14 months of our curriculum) (9/20, 45%). Most tutor respondents (14/20, 70%) had been working in the PTP for over 6 months at the time of the survey.

The research team identified three overarching themes amongst several codes: tutoring activities, key characteristics of learners, and key characteristics of tutors. As before, these themes are described in more detail below. Findings are summarized in Table 2.

1.

Tutoring Activities

Table 2 Summary of themes and codes found within survey responses from tutors

Tutors indicated that working on practice questions, reviewing content, and focusing on their learners’ wellbeing were key activities during tutoring sessions. Practice questions allowed tutors to work on metacognitive strategies with learners and focus on knowledge gaps that they could then address. Question review allowed tutors to review effective test-taking strategies such as answer elimination and efficiently reading the question. Tutors commented that content review needed to be specific to the learner’s needs and that more general review or “lecture” type sessions were unhelpful:

“Going through questions is the single most helpful thing we do. This gives me a chance to see how they approach test taking and to work on improving test taking strategies while also modeling how to learn from practice questions and allows me to review relevant content from the questions…”

Aside from the more direct academic activities, tutors commented on emotional support as another essential part of their tutoring sessions. It allowed tutors to “discuss learners’ wellbeing/how they are coping with the stresses of medical school….” Tutoring sessions allowed tutors to have open conversations with learners about their well-being with opportunities for support and referral to a faculty member in the OAE if necessary.

2.

Key Characteristics of Learners

Tutors identified four characteristics of learners critical to a beneficial learner-tutor relationship: openness to change, acknowledging knowledge gaps, self-motivation, and active engagement. Having learners who were “open and willing to get questions wrong” was a helpful trait because it allowed tutors and learners to identify and address knowledge gaps. Tutors appreciated learners who were willing to adopt new study methods and routines in response to this feedback. Willingness to change allowed tutors to help them more easily adapt to address shortcomings in their study strategies.

Self-motivation and active engagement, in several forms, were identified by tutors as beneficial learner traits. Multiple tutors indicated that frequent and active communication from learners about their studying, questions, and concerns was beneficial to their partnership. Tutors also indicated that engaging in sessions by showing up on time and ready to engage made sessions more enjoyable.

3.

Key Characteristics of Tutors

Two themes emerged from the responses regarding the traits a tutor needs to be successful. These themes involved either personal traits of the tutor or professional traits. Personally, tutors needed patience, commitment, enthusiasm, empathy, and creativity to connect with their learners. These qualities created an open learning environment where learners can thrive. One tutor commented: “Your [learner] will always do their best with you when they feel comfortable around you and know that it is a safe space to get things wrong.”

Professionally, tutors felt that it was essential to be knowledgeable, organized, and communicate well. The tutor’s knowledge base was identified as vital as it “help[ed] lead the [learner] to the right answer.” Being organized and communicating with learners helped facilitate sessions and ensure that the learner-tutor relationship was beneficial.