Abstract
BackgroundStudents are largely providing feedback to one another when instructor facilitates peer feedback rather than teaching in group training. The number of students in a group affect the learning of students in the group training. We aimed to investigate whether a larger group size increases students’ test scores on a post-training test with peer feedback facilitated by instructor after video-guided basic life support (BLS) refresher training. Students’ one-rescuer adult BLS skills were assessed by a 2-min checklist-based test 1 year after the initial training.MethodsA cluster randomized controlled trial was conducted to evaluate the effect of student number in a group on BLS refresher training. Participants included 115 final-year medical students undergoing their emergency medicine clerkship. The median number of students was 8 in the large groups and 4 in the standard group. The primary outcome was to examine group differences in post-training test scores after video-guided BLS training. Secondary outcomes included the feedback time, number of feedback topics, and results of end-of-training evaluation questionnaires.ResultsScores on the post-training test increased over three consecutive tests with instructor-led peer feedback, but not differ between large and standard groups. The feedback time was longer and number of feedback topics generated by students were higher in standard groups compared to large groups on the first and second tests. The end-of-training questionnaire revealed that the students in large groups preferred the smaller group size compared to their actual group size.ConclusionsIn this BLS refresher training, the instructor-led group feedback increased the test score after tutorial video-guided BLS learning, irrespective of the group size. A smaller group size allowed more participations in peer feedback.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0682-5) contains supplementary material, which is available to authorized users.
Highlights
Students are largely providing feedback to one another when instructor facilitates peer feedback rather than teaching in group training
We aimed to investigate the effect of peer-group size on competency-based skills assessment in medical students undergoing a structured basic life support (BLS) refresher training
Study design A single-blind cluster randomized controlled trial was conducted on final-year (6th year) undergraduate medical students completing BLS refresher training during their emergency medicine (EM) clerkships
Summary
Students are largely providing feedback to one another when instructor facilitates peer feedback rather than teaching in group training. The group size for BLS training is flexible, and there is currently no evidence-based recommendation for ideal student-instructor ratio. The recommended group sizes for ERC/AHA BLS courses are for the instructor-led training. The number of students in group feedback could affect students’ learning in different ways. A larger size of group permits intermittent rather than constant feedback to the students from instructor, but in turn, students have more opportunities to engage in peer facilitation. In a study that involved teaching manual chiropractic skills, intermittent feedback resulted in the best learning on acquisition and retention trials, while constant instructor feedback resulted in the most accurate acquisition of the manual skill on initial hands-on practice. The constant feedback was beneficial when used to reduce error during practice but detrimental when relied upon for retention and learning [3]
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