Peer-assisted Learning Approach Research Articles

Promoting physician-patient language concordance in undergraduate medical education: a peer assisted learning approach

BackgroundVerbal communication plays an important role in the patient-physician relationship. Research shows that language concordance, when a healthcare professional communicates fluently in the patient’s preferred language, contributes to patient satisfaction and improves healthcare outcomes. Yet, many medical schools worldwide, including most institutions in the Arab world, use English as the language of instruction. As a result, students lack confidence and feel unprepared to communicate effectively with the local population. This manuscript describes the development, implementation and early perceptions of an Arabic language program for medical students in the United Arab Emirates.MethodsIn 2020, the learning communities at Khalifa University College of Medicine and Health Sciences launched a pilot program implementing a Peer Assisted Learning (PAL) framework to teach Arabic medical terminology and language to both native and non-native Arabic speaking medical students. A web-based survey was administered to the first two cohorts of students to assess satisfaction with the classes and the program’s impact on students’ communication skills during clinical encounters.ResultsEarly perceptions of the program were very positive, with 43/48 students (89.6%) reporting that they used the information during home visits and clinical rotations, and 42 students (87.5%) admitting that the classes made them feel more comfortable in communicating with the Arabic speaking local patient population.ConclusionThis paper explores a new educational approach to address the challenge of language barriers in healthcare. A feasible, low cost program using peer assisted learning can improve students’ comfort in communicating with patients in the local language.

Mixed reality model for learning and teaching in anatomy using peer assisted learning approach

The objective of this study was to evaluate the effectiveness of mixed reality models in anatomy teaching and learning at Kirkpatrick’s level I, using Peer Assisted Learning approach. This study was based on a single group, post-test study design and was carried out at three affiliated medical schools of Khyber Medical University, Peshawar, over four months. A total of 97 first- and secondyear medical students from three medical schools were enrolled. All students received a basic introduction to the use of Hololens (Microsoft), the mixed-reality simulator-based course on the anatomy of the heart and liver via peer-assisted learning (PAL) method. Student satisfaction was evaluated at Kirkpatrick Level I of program evaluation using a validated and structured PAL questionnaire. Most students agreed or strongly agreed to the effectiveness of questions (mean ± SD 4.3±0.2, percentage 86±4.4%). There was no difference between the satisfaction scores of male and female students (p=0.34), whereas a slight difference was seen between 2nd- and 1st-year students’ satisfaction scores (88% versus 85%, p=0.03). There was also a statistically significant difference of perceptions between different medical schools’ students’ scores (p=.000). Students appear to be satisfied with the use of the mixed reality model for learning anatomy. A randomized trial to directly compare the satisfaction levels between traditional methods and mixed-reality model may be conducted and the effects of mixed-reality models on learning should be assessed.

Interprofessional education in medical and physiotherapy studies for future collaboration

BackgroundInterprofessional education (IPE) for medical and healthcare professions is highly relevant. It increases knowledge and skills, but also helps to foster the development of collaboration, which is essential for optimal patient care. One important aspect of IPE is to better understand profession’s individual attitudes and perceptions towards interprofessionalism and the expected roles and skills for future collaboration in the context of patient care. MethodsWe offered IPE workshops using a peer assisted learning approach, with the focus on anatomy in the area of the lower back and hip. The workshops were attended by medical and physiotherapy students and consisted of three consecutive training sessions with the topics anatomical prosections, anatomy in vivo and orthopedics testing. We focused on student’s attitudes and perceptions regarding the relevance of IPE and their expected skills in interprofessionalism. An established questionnaire was used as an instrument for self-assessment before and after the interprofessional experience. To evaluate for significance, analysis was carried out for all groups on pre- and post-course item mean differences. ResultsPre-post score comparison for all groups combined demonstrated significant increase in terms of perceptions and attitudes for several items related to interprofessionalism and interprofessional skills. Medical and physiotherapy students rated themselves significantly higher for different questionnaire items. Students, who had obtained a professional qualification prior to their current studies, rated themselves significantly higher on certain items compared to those who had not. ConclusionsThe results from this brief interprofessional anatomy experience are encouraging. The course led to meaningful improvements in competencies that are highly relevant for effective interprofessional collaboration in the future. Furthermore, identification of differences in professional group perceptions can be useful for development of future IPE workshops.

A flipped classroom, same-level peer-assisted learning approach to clinical skill teaching for medical students.

BackgroundClinical procedural skills are vital components of medical education. Increased student intake and limited capacity of medical schools necessitate more efficient ways to deliver clinical skill teaching. This study employed a flipped classroom, peer-assisted learning approach to deliver clinical skill teaching. It aimed to determine the influence of pre-class demonstration video watching and in-class student-student interactions on clinical skill acquisition.MethodsIn 2017, a cohort of 205 medical students in their penultimate year of undergraduate medical study were recruited, and they learned bag mask ventilation and intravenous cannulation during this study. The participants watched a demonstration video before class, and then underwent self-directed practice as triads. Afterwards, each participant video-recorded their skill performance and completed post-class questionnaires. The videos were evaluated by two blinded assessors.ResultsA hundred and thirty-one participants (63.9%) completed the questionnaire. For bag mask ventilation, participants who claimed to have watched the corresponding demonstration video before class achieved higher performance scores (those who watched before class: 7.8 ± 1.0; those who did not: 6.3 ± 1.7; p < 0.01). For intravenous cannulation, while there is no significant difference in performance scores (those who watched before class: 14.3 ± 1.3; those who did not: 14.1 ± 1.4; p = 0.295), those who watched the video before class received less interventions from their peers during triad practice (those who watched before class: 2.9 ± 1.8; those who did not: 4.3 ± 2.9; p < 0.05). The questionnaire results showed that most participants preferred the new approach of clinical skill teaching and perceived it to be useful for skill acquisition.ConclusionThe flipped classroom, same-level peer-assisted learning model is potentially an effective way to address the current challenges and improve the efficiency of clinical procedural skill teaching in medical schools.

COMBINATION OF SGT (SMALL GROUP TEACHING) AND PAL (PEER ASSISTED LEARNING) APPROACH TO FACILITATE LEARNING AMONG MBBS STUDENTS FROM A PRIVATE UNIVERSITY IN MALAYSIA DURING PRE-CLINICAL YEARS

Didactic lecture promotes passive learning and fails to motivate students. Small group learning has been widely recommended as it helps to refine understanding of complex issues, to solve the problems, develop critical thinking and apply knowledge to new situations. PALS – a “peer assisted learning” mode where in students discuss in groups and learn from each other. They get motivated and set a platform, which encourages them to communicate and do problem solving. The present study was aimed to evaluate the effectiveness of small group teaching (SGT) and peer assisted learning (PAL) approach among pre clinical medical students. Small groups of students were selected for this study out of the big batch of students pursuing 2nd year MBBS program at AIMST University who were undergoing “respiratory system” block. At the end of lecture-based sessions, a few topics were selected for SGT- PAL session. Students were asked to complete the pretest questions on the selected topics and they were then explained the topics selected for this session. Students had SGT PAL on those selected topics. Then they completed the post test questions on the same topic. Responses obtained for the pre- test and post-test questions were analyzed using SPSS using paired t test and the perceptions on their own understanding using marginal homogeneity test, both showed a significant improvement. SGT and PAL approach helped students to improve understanding of important concepts and can be adopted more widely as an alternative to lectures.

An investigation into the use of Rasch analysis to aid L2 writers in anonymized peer-assisted learning

This study critically evaluated an anonymized peer feedback and assessment design for L2 writers enhanced by the use of Rasch analysis. This approach centered on the acts of giving assessment (Topping, 1998) and feedback (Lundstrom &amp; Baker, 2009) in exchange with multiple peers. Each participant received feedback comments and class-wide statistical measures summarized for students without the need for their peers to rate all papers. Anonymity was maintained to bring unencumbered attention to the role of the reader (Booth et al., 2008) and to provide a space for interpretation and reflection on the potentially contrasting data and experiences that emerge. This process is argued to drive cognitive development and improve L2 writing skills. An initial trial with 15 high-proficiency EFL learners indicated that the design facilitated an effective exchange for each participant. The effects of anonymously including teacher comments also brought informative insights about the perception of feedback and its sources. Issues were found regarding overly narrow use of the ratings scales by some participants. A 6-point rating scale is proposed for more differentiated scoring. Overall, positive engagement and reception by the participants suggests that this peer assisted learning approach holds promise for L2 writers.

'Lurker' to learner: Encouraging collaborative learning using a scaffolding and peer assisted learning approach

'Lurker' to learner: Encouraging collaborative learning using a scaffolding and peer assisted learning approach

Peer-assisted Learning (PAL) as an Instructional Tool in Undergraduate Dental Education.

To evaluate the difference in peer-assisted learning (PAL) and expert-assisted learning (EAL) sessions for selected topics of orthodontics, conducted by either a peer or faculty member, respectively as measured by their test scores. Experimental study. Place andDuration of Study: Department of Orthodontics, Altamash Institute of Dental Medicine (AIDM) Karachi, Pakistan, from October 2019 to March 2020. Methodology: The study was carried out with the final year undergraduate dental students in the subject of orthodontics, selected by using non-probability sampling method. Selected students were given an introductory lecture on PAL approach at the start of the study. Two PAL sessions were conducted in smaller groups with all students utilised as an adjunct to traditional large group lectures; and at the end assessment was conducted comprising of multiple choice questions (MCQ). For the consecutive four weeks, same students went through traditional EAL, followed by similar type of assessment. Their test scores were compared for significance, set at p <0.05. A total of six sessions were conducted, two faculty members (professors of orthodontics) conducted two sessions each, and subsequent two sessions were conducted by employing PAL approach by students (earlier trained by the faculty). The mean differences in the scores of students was compared between faculty teaching and PAL-related teaching. It was observed that the EAL group significantly performed better than PAL group (p<0.05). In terms of test scores, academic performance and overall learning in PAL sessions was not higher than EAL group. Nonetheless, PAL can be utilised as an important supplement to synchronous teaching tele-presence by faculty as being practised during current pandemic situation in many medical and dental institutes. Key Words: Peer-assisted learning, Educational strategies, Professional development, Expert-assisted learning, Ethical review committee, Team-based learning.

Can We Use Peer-Assisted Learning to Teach Basic Surgical Skills?

BackgroundIt is reported that medical students do not receive adequate opportunities to learn surgical skill and are at risk of being unable to perform simple surgical procedures safely. The usefulness of peer-assisted learning (PAL) as a tool to assist in delivering surgical skills training is worth exploring.MethodsThis is a randomised single blinded controlled trial. Fourth-year students from the university’s Surgical Society were asked to volunteer as peer tutors and those in 3rd-year were asked to undertake surgical skills training. A cohort of 35 students were selected and randomised to receive basic surgical skills training conducted either by faculty members or peers. The students’ performance of basic suturing skills was assessed using a checklist, through directly observed procedural skills (DOPS) technique. The assessment was conducted by faculty blinded to the training. Students’ perception to surgical skills training was assessed using a questionnaire survey.ResultsThe suturing and knotting skills of students learned from their peers was comparable to that acquired from faculty. The students’ perceived that their peers could conduct surgical skills training similar to their faculty.ConclusionPAL approach for basic surgical skills training is as effective as faculty-led training. PAL has the potential to optimise the delivery of surgical skills training in undergraduate medical education.

A nationwide peer-assisted learning program in disaster medicine for medical students

The Sendai Framework advocates the importance of training in disaster medicine as a way to improve health system resilience. In Italy, despite the official recognition of disaster medicine as a mandatory discipline in the standard curriculum, most students are never exposed to its basic concepts. DisasterSISM is a nationwide educational program in disaster medicine developed in 2008. Given the scarcity of experienced instructors, in 2013, the course adopted a peer-assisted learning (PAL) approach to correct the omission identified in the national curriculum. The new approach involved a training of trainers (ToT) and a basic course organized and delivered by certified student teachers. The authors gathered and analyzed data from demographic questionnaires, pretest and posttests, and satisfaction questionnaires. From 2013 to 2018, 42 medical students attended the ToT becoming student teachers. From 2014 to 2018, 2316 medical students attended the basic course delivered by the student teachers across Italy. Thirty-six out of 41 medical schools were reached. Participation in the program improved students' knowledge in disaster medicine. Participants were satisfied with both the course structure and its PAL approach and considered disaster medicine to be highly relevant for their future professional career. By presenting this nationwide program and its outcomes, the authors hope to strengthen the case for including disaster medicine education in the standard medical curriculum. Because the course relies on medical students and PAL, the authors trust that it could be adapted to other countries worldwide.

Peer assisted learning model to support students’ success in a complex science course

The application of peer learning models, including Peer Assisted Learning (PAL), has been primarily in the clinical and simulation settings with the focus on readiness for clinical and professional practice. We present a single center experience with the design, structure and implementation of an in-house PAL tutorial in a Pathophysiology; a complex mandatory 12 weeks science course taken by 2nd-year students. This experience represents a phase and progression towards a more coherent model. In phase I, a short survey was conducted to gauge the students’ interest and assess the feasibility of a tutorial model. In Phase II and III, PAL tutorials were introduced and implemented over the course of two semesters for two cohorts of students. Phase I provided sufficient evidence to proceed with tutorial development, and provided guidance for tutorial planning and implementation. Phase II and III showed tutorial participation gradually increased over time. We have integrated complexity science as a theoretical basis that guided the study and unified the findings throughout the study. The tutorials helped students to integrate concepts from related courses, encouraged them to find similarities, and enhanced overall understanding of course content, while providing a support system to reduce anxiety and stress. The use of online material and a concept mapping approach received the most significant positive feedback as learning tools. We believe the PAL approach is important to tutorial development and, when implemented within the theoretical model of complexity science, may carry potential in developing nursing or other curricula. Further research into the application of tutorial models more broadly in nursing education curriculum is necessary to determine more coherently the unique design characteristics required.

A Peer Assisted Learning (PAL) approach to pre-service teacher professional experiences in Australia: organisational friendships

ABSTRACTThis study explored how students (pre-service teachers) benefit from the support of having a peer with them during their first professional experience in preschool contexts, utilising a PAL (Peer Assisted Learning) approach. International students at a large Australian University were interviewed as part of this qualitative study. We found that peer engagement facilitated the development of friendships and social support among participants. Discussion is situated within a sociological framework of organisational friendship. This study extends conceptions of organisational friendships beyond managerial imperatives and peer relationships are highlighted as supportive, not competitive, engagements. The PAL approach highlights the benefit of collaborative professional learning.

Peer-assisted learning combined with micro-teaching for international undergraduates during anesthesia internship

Objective To explore the peer assisted learning approach combined with micro-teaching in anesthesia internship for oversea students. Methods 60 international medical students were randomly divided into two groups. Students in the control group have peer guidance before routine theatre observation, while students in experimental group discuss micro-teaching of anesthetic skills with each other by watching real time videos from smart phone. Students' subjective attitudes to new approach were evaluated and their final exam score were analyzed. SPSS 11.0 was used for data processing and the data was made descriptive analysis, t test and analysis of variance. Results Students in experimental group did better in both theory exam(46.8±4.03)vs.(35.7±6.12)and practice exam(35.2±3.20)vs.(27.6±4.71)than those in control group, and the total scores of two groups were(80.5±7.40)and(63.1±6.81)respectively. These scores all had significant difference between two groups. More students from experimental group than those from control group feel interested in anesthesiology(P<0.01)and feel confident about exams(P<0.05); There was no dif-ference between two groups in understanding clinical guideline(P=0.57). Conclusion Peer assisted learning combined with micro-teaching is proved to enhance the quality of anesthesia teaching during internship for oversea undergraduates. Key words: Peer-assisted learning; Micro-teaching; Anesthesiology

Student conceptions of peer-assisted learning

This article reports on a programme in which peer-assisted learning (PAL) was combined with case-based learning (CBL) in a second-year radiologic biology unit of study. Our aim is to explore evidence of whether PAL supported the development of qualitative conceptions of learning. The programme involved students in small PAL groups preparing and offering a tutorial based on a case study for the class (large PAL group). The small PAL group assessed the learning of the large PAL group, while the large group gave feedback to the small group. Small groups attended a debriefing session following the tutorial. A six-category framework related to conceptions of learning was developed to guide qualitative analysis of data derived from a student questionnaire, the debriefing sessions and a final focus group. Data analysis indicated some evidence of quantitative conceptions of learning (particularly early in the programme), and showed that PAL played a role in developing students’ qualitative conceptions of learning, particularly through the social and affective processes involved and opportunities for developing metacognitive knowledge. The programme contributed to ‘deep’ processing as students learnt from and with each other. Concurrently, students’ feelings of responsibility to their peers increased their responsibility for their own learning. The PAL approach that was used provides a basis for further exploration of the role of peers in developing students’ conceptions of learning.

Understanding the Peer Assisted Learning Model: Student Study Groups in Challenging College Courses

The Peer Assisted Learning (PAL) program at the University of Minnesota is a primary academic support program for historically difficult, introductory college courses that serve as gatekeepers to academic degree programs. Based upon operating principles of other academic support programs and educational theories, PAL is integrated into the courses it serves. The PAL groups review essential course content, model cognitive learning strategies to deepen understanding, and promote metacognitive awareness so students are autonomous learners in courses without academic support services. The PAL approach operates at the confluence of collaborative learning, cooperative learning groups, and learning communities. This article provides a detailed overview of the PAL model, educational theories upon which it is based, and how variations of it are implemented at the institution. Quantitative and qualitative studies reveal academic and personal benefits for participating students and those serving as PAL facilitators. The studies validate the role of PAL with closing the achievement gap between students of different ethnicities and levels of academic preparedness for rigorous college courses in mathematics and science.

Improving Residents’ Performance on the PRITE: Is There a Role for Peer-Assisted Learning?

The authors implemented a peer-assisted learning approach to prepare residents for the Psychiatry Resident-In-Training Examination (PRITE), with the goal of increasing test performance. The authors developed a PRITE review curriculum utilizing a peer-assisted learning approach. The residents were randomly assigned to teams and instructed to teach assigned topic(s). The participants' PRITE scores before and after the intervention were compared with the PRITE scores of the previous residents. PGY-2 residents achieved the highest psychiatry percentile increase, and PGY-3 residents achieved the highest psychiatry percentile in the past 7 years. PGY-4 residents' psychiatry percentile decreased, although two residents from the previous year left for a fellowship, and the program accepted one PGY-4 transfer. All of the groups' neurology percentile increased, but were not substantially different from the previous years. Our preliminary study has shown that implementing a peer-learning strategy to prepare residents for the PRITE is feasible and may lead to promising results.

Strategies for Using Peer‐assisted Learning Effectively in an Undergraduate Bioinformatics Course

This study used a mixed methods approach to evaluate hybrid peer-assisted learning approaches incorporated into a bioinformatics tutorial for a genome annotation research project. Quantitative and qualitative data were collected from undergraduates who enrolled in a research-based laboratory course during two different academic terms at UCLA. Findings indicate that a critical feature of the peer-assisted learning approach is to have near-peer leaders with genome annotation experience, allowing them to communicate technical and conceptual aspects of the process in the context of a research project (a.k.a., the "big picture"). These characteristics are important for creating connections between the wet lab experiments and the computer lab activities, engendering excitement about the research project and fostering engagement in bioinformatics as a discipline. Likewise, it is essential to couple tutorial training in genome annotation with appropriate instructional materials, providing detailed, step-by-step instructions for database navigation. Finally, the assessment results support this hybrid peer-assisted learning approach as a model for undergraduates to successfully learn bioinformatics in a course setting.

Efficacy of Peer-Assisted Learning Across Residencies for Procedural Training in Dermatology

With new care models such as the medical home, there is an expanding need for primary care providers to be trained in dermatologic procedures. Yet, many internal medicine residency program graduates feel unprepared to perform these procedures. The aim of this study was to evaluate the effect of a structured peer-assisted learning approach to improve residents' knowledge and skills related to common dermatologic assessment techniques. Eight medicine-dermatology resident educators, with a faculty member, facilitated dermatologic procedure workshops for 28 internal medicine and medicine-pediatrics resident learners. Learners completed preworkshop and postworkshop surveys, assessing their knowledge and skill levels as well as the efficacy of the resident educators and the educational value of the workshop as a whole. All learners were able to properly demonstrate the techniques at the workshop's conclusion. The median sum score of self-reported knowledge increased from 3 to 9.5 (scale, 0-10; P < .001). The median sum score of self-reported skills increased from 10 to 16 (scale, 4-20; P < .001). Resident educators were favorably evaluated by their peers, and 96% of participants rated the experience as being of high educational value. Peer-assisted learning is effective in teaching dermatologic procedures in graduate medical education. Resident learners found peer-assisted learning to be beneficial and rated their peer teachers highly. Further studies should focus on outcomes in practice, looking at the number of dermatologic procedures performed by learners, as well as the effects on resident educators.

Course‐specific learning in Peer Assisted Learning schemes: a case study of creative media production courses

The purpose of this paper is to consider the specific role of Peer Assisted Learning (PAL) in creative media production courses. We present a review of the pedagogical approaches that inform our ‘generic’ understanding of PAL. We then consider both quantitative and qualitative data from students, leaders and tutors to gain insights into PAL. Overall, the findings suggest a need to address the disparity between a generic PAL approach and the specific needs of creative production students, including the tensions leaders experience negotiating their role. Recommendations for future practice are provided as, when planned correctly, it seems that PAL may complement tutor skills by providing an important authentic space for the development of confidence and core skills in media production.