Effectiveness of student tutors in problem-based learning of undergraduate medical education.

Problem-based learning (PBL) is a teaching and learning method designed to develop clinical reasoning skills. Tutor performance in PBL affects both the process and outcome of student learning. In this study, we investigated the factors that influence the evaluation by undergraduate students on the performance of tutors in medical education. From April 2009 to February 2010, 49 PBL sessions were conducted for 191 3rd- and 4th-year medical students at Saga Medical School in Japan. Twenty-nine 6th-year students and 205 faculty members tutored these sessions. After each session, students evaluated their tutor by a Likert scale. This evaluation score was dichotomized and used as the dependent variable. A multivariate logistic regression analysis was used to assess the contribution of student's gender and year level (3rd or 4th), the tutor's gender and background, and the quality of the case scenario to evaluation ratings. A total of 4,469 responses were analyzed. Male student and tutor background were associated with excellent tutor evaluation. Concerning the tutor background, compared with basic scientists, the 6th-year students and content-expert clinicians were positively associated with excellent tutor evaluations (ORs of 1.77 [95% CI: 1.15-2.72] and 1.47 [95% CI: 1.11-1.97]), while non-content-expert clinicians received negative evaluations (OR of 0.72 [95% CI: 0.55-0.95]). The quality of the case scenario was also associated with excellent tutor evaluation (odds ratio [OR] of 12.43 [95% CI: 10.28-15.03]). In conclusion, excellence of case scenarios, 6th-year student tutors, and content-expert clinicians show positive impact on tutor evaluation in a PBL curriculum.