Journal of general internal medicine · 2026
The ACEs of Clinical Reasoning: a Formal, Longitudinal, Leadership Role for Medical Students to Augment Clinical Reasoning Education.
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Tang Zeyu, Swallow Madisen A, Bahar Ryan C, Gaeta Gazzola Marina, Wijesekera Thilan P
Аннотация
BACKGROUND: Clinical reasoning (CR) is integral to undergraduate medical education but requires significant resources to deliver adequate practice and individualized feedback. Peer-assisted learning (PAL) may improve instructional capacity and enhance the learning climate.
AIM: We describe the development, implementation, and impact of the Associate Course Educator (ACE) role, a structured PAL and leadership position for medical students within a CR longitudinal course.
SETTING: A private, not-for-profit U.S. medical school.
PARTICIPANTS: Senior medical students who completed core clerkships.
PROGRAM DESCRIPTION: ACEs completed a 12-month term with optional term renewal for eligible students. They received close mentorship and instruction in CR pedagogy. ACEs delivered at least 20h of teaching annually, led educational projects, contributed to scholarship, and supported curricular review.
PROGRAM EVALUATION: Across six recruitment cycles (2020-2026), 84 students applied and 44 were selected (52.4%). Annual CR sessions increased from eight to 22 and shifted from large-group to predominantly small-group and one-on-one formats. ACEs contributed multiple educational innovations and disseminated scholarship at regional and national venues.
DISCUSSION: The ACE role formalizes PAL as a mentored medical education experience that expands instructional capacity, supports instructor-intensive teaching formats, and enhances feedback mechanisms. For students, the role provides structured mentorship in CR, teaching, and scholarship while enabling meaningful contributions to institutional curricula.
AIM: We describe the development, implementation, and impact of the Associate Course Educator (ACE) role, a structured PAL and leadership position for medical students within a CR longitudinal course.
SETTING: A private, not-for-profit U.S. medical school.
PARTICIPANTS: Senior medical students who completed core clerkships.
PROGRAM DESCRIPTION: ACEs completed a 12-month term with optional term renewal for eligible students. They received close mentorship and instruction in CR pedagogy. ACEs delivered at least 20h of teaching annually, led educational projects, contributed to scholarship, and supported curricular review.
PROGRAM EVALUATION: Across six recruitment cycles (2020-2026), 84 students applied and 44 were selected (52.4%). Annual CR sessions increased from eight to 22 and shifted from large-group to predominantly small-group and one-on-one formats. ACEs contributed multiple educational innovations and disseminated scholarship at regional and national venues.
DISCUSSION: The ACE role formalizes PAL as a mentored medical education experience that expands instructional capacity, supports instructor-intensive teaching formats, and enhances feedback mechanisms. For students, the role provides structured mentorship in CR, teaching, and scholarship while enabling meaningful contributions to institutional curricula.