Peer-assisted Learning Research Articles

Peer-Led Surgical Safety Learning Among Medical Students Using a Novel Story-Based Approach

IntroductionEven though medical students are important for the future of the overall healthcare system, they are often overlooked as valuable participants in safeguarding patient safety. Moreover, surgical safety is a critical topic that deserves to be addressed thoroughly during medical education, as part of the broader topic of patient safety. To maximize students’ engagement and to enhance their interest in patient safety and healthcare quality, it is imperative to explore and innovate stirring and interactive methods of learning. Through this paper, we present a unique narrative novel story-based, peer-led surgical safety teaching session organized by medical student representatives of Middle East's first student-led patient safety initiative and attended by medical students from various academic years.MethodsA 1-hour case-based interactive learning session on surgical safety was developed, based on the World Health Organization (WHO) patient safety curriculum for medical schools. The session was peer-led at Alfaisal University College of Medicine, Riyadh and participation was voluntary. Learning objectives included surgical safety checklist, human factors, complexity of healthcare, students’ critical role in safety and open disclosure. The session included a verbal “story-telling” segment, followed by a didactic segment where learning objectives were covered. Attendees were continuously engaged throughout the session with the help of verbal inquiries. Pre-test and post-test questionnaires were distributed to assess participants' knowledge, awareness and perceptions regarding surgical safety and other objectives covered in the session.ResultsA total of 75 students participated in the session, consisting of 57.3% females and 42.7% males. Responses to the pre-test and post-test were analyzed and compared. Most students who attended the session reported that it was of value to them - with more than 90% of students considering the session either valuable or highly valuable. After the session, more students (10.67%, p = 0.10) were correctly able to identify that the initial reaction in healthcare is often individual blame (Q.1). Additionally, more students (30.63%, p < 0.001) were able to correctly identify the implementation of the WHO surgical safety checklist as the major factor that has contributed to the reduction of errors in healthcare (Q.2). Students’ responses also indicated that after attending the session a higher number (16%, p = 0.01) correctly identified that most errors linked to surgery were potentially preventable (Q.3).ConclusionStudents are inherently willing to learn and engage in interactive learning. It was encouraging to see medical students show interest in this important patient safety topic, which also encourages similar future peer-learning initiatives. As reported, narrative story-based peer-assisted learning is an effective way to engage medical students in the cause of patient safety and should be utilized to further their knowledge and awareness regarding critical healthcare safety areas such as surgical safety, medication safety and infection control and instill a sense of responsibility in these future physicians.

The Effect of Peer-Assisted Mathematics Learning Opportunities in First Grade Classrooms: What Works for Whom?

To investigate whether child × instruction effects contribute to mathematics gains in first grade, we conducted a cluster randomized controlled trial with 454 (205 treatment; 249 control) students in 28 classrooms. Classrooms were randomly assigned to implement Math Peer Assisted Learning Strategies (Math PALS) to supplement Saxon Math or Saxon Math alone. Teachers received professional development on either Math PALS (treatment) or individualized reading instruction (control). Intent-to-treat and treatment-on-the-treated results revealed no significant difference between the Math PALS and control groups in student mathematics gains. However, Math PALS effectiveness varied with initial math skills. Based on modeled results of the continuous fall math score, students who scored at the 75th percentile of the sample demonstrated significantly stronger mathematics outcomes compared with the treated control group; there was no significant treatment effect for students at the 50th percentile. For students with lower initial math skills (modeled at the 25th percentile of the sample), the effect of the treatment was negative. Students with lower initial mathematics skills made greater gains in the control group (Saxon Math alone) versus the Math PALS group.

A novel instrument of cognitive and social congruence within peer-assisted learning in medical training: construction of a questionnaire by factor analyses

BackgroundPeer-assisted learning is effective due to cognitive and social congruence. Cognitive congruence is created by sharing a similar knowledge base between students and student tutors. Social congruence is defined as having similar social roles. A questionnaire of these concepts was newly constructed, and this study explored the factor analysis of the instrument.MethodsIn a cross-sectional method design cognitive and social congruence were operationalised by exploratory and confirmatory factor analyses. Cognitive and social congruence were assessed by validated questionnaires and through self-developed items that were collected through semi-structured interviews.. The questionnaire consisted of 26 items that were rated on a five-point Likert scale, from 0 = I strongly disagree to 4 = I strongly agree.Results676 medical students participated in the study. Exploratory factor analysis for students resulted in a two-factor solution with cognitive and social congruence as confirming factors. New findings showed that the items “non-judgmental learning atmosphere” and “informal communication” were associated to cognitive congruence, “effectiveness” and “comprehensible explanations” belonged to social congruence. Confirmatory factor analysis for student tutors confirmed the resulting two-factor solution.ConclusionsAs one of the largest investigation of cognitive and social congruence, this study investigated the underlying mechanisms of effective PAL using factor analysis. Cognitive congruence was created by sharing the same knowledge. Knowledge transfer might play a relevant role in cognitive congruence. Social congruence focused on the relationship between student tutors and students, which might impact the content level. Practical recommended actions (using the same language) could be implemented.

Effectiveness of Peer-Assisted Learning in Nursing Student Knowledge and Compliance in The Application of Standard Precautions

The learning process in higher nursing education develops student competences, such as applying standard precautions, in providing professional nursing care. To improve student knowledge and compliance related to standard precautions requires innovation from lecturers in providing appropriate learning methods. Peer-assisted learning (PAL) can enhance the active role of students and improve achievement. The PAL method involves senior students as peer teachers who help junior students. Using a questionnaire as an assessment instrument, this study aimed to determine the effectiveness of PAL on knowledge and compliance in the application of standard precautions in student nurses. This study design was quasi experimental with pre and post assessment and a control group design approach. This research was conducted at the D Hospital in Padang, Indonesia, a hospital where students practice. This study was conducted in June–September 2017 with a sample size of 45. Data analysis using paired t-test showed that the average values of the level of knowledge and skills of students in the application of standard precautions before and after PAL methods differed significantly in the intervention group (p = 0.001). In conclusion, PAL can be applied in the learning process of nursing students to increase student achievement. Abstrak Efektifitas Metode Peer-Assisted Learning (PAL) Terhadap Tingkat Pengetahuan dan Kepatuhan Mahasiswa Dalam Penerapan Kewaspadaan Standar. Proses pembelajaran pada pendidikan tinggi keperawatan mengembangkan kompetensi mahasiswa dalam memberikan asuhan keperawatan profesional. Salah satu kompentensi mahasiswa adalah menerapkan kewaspadaan standar. Untuk meningkatkan pengetahuan dan kepatuhan mahasiswa terkait kewaspadaan standar membutuhkan inovasi dari dosen dalam memberikan metode pembelajaran yang sesuai. Metode peer-assisted learning (PAL) merupakan metode pembelajaran yang dapat meningkatkan peran aktif mahasiswa serta meningkatkan pencapaian kompetensi mahasiswa. Metode PAL melibatkan mahasiswa senior sebagai peer-teacher yang membantu juniornya dalam belajar. Tujuan penelitian ini adalah mengetahui efektifitas metode PAL terhadap tingkat pengetahuan dan kepatuhan dalam penerapan kewaspadaan standar pada mahasiswa keperawatan. Intrumen penelitian ini menggunakan kuesioner. Desain penelitian ini adalah quasi experiment dengan pendekatan pre dan post with control group design. Penelitian ini dilakukan di Rumah Sakit D di Padang, Indonesia, sebagai salah satu rumah sakit yang menjadi tempat praktik mahasiswa. Penelitian ini dilakukan pada Juni – September 2017. Jumlah sampel dalam penelitian ini adalah 45 orang. Hasil analisis data menggunakan paired t test menunjukkan nilai rerata tingkat pengetahuan dan keterampilan mahasiswa dalam penerapan kewaspadaan standar sebelum dan sesudah dilakukan metode PAL berbeda secara signifikan pada kelompok intervensi (p= 0,001). Metode PAL dapat diterapkan dalam proses pembelajaran mahasiswa keperawatan karena dapat meningkatkan pencapaian kompetensi mahasiswa. Kata kunci: kewaspadaan standar, mahasiswa keperawatan, peer-assisted learning (PAL)

Interprofessional peer teaching: The value of a pharmacy student-led pharmacology course for physical therapy students

BackgroundThis report describes the creation, implementation, and evaluation of an interprofessional pharmacy student-led pharmacology course for physical therapy students. The course was designed using a flipped classroom model and a peer-assisted learning framework. Interprofessional education activityWe describe the development, design, assessment, and evaluation of a pharmacy student-led pharmacology course for physical therapy students. This report focuses specifically on the interprofessional aspect of the course, which was measured using the student perceptions of physician-pharmacist interprofessional clinical education (SPICE) instrument. DiscussionThe SPICE instrument was measured across two cohorts in 2015 and 2016. Each cohort consisted of approximately 50 physical therapy students. After implementation of the course, there were significant improvements across all three domains of the SPICE instrument: interprofessional teamwork, roles/responsibilities for collaborative practice, and patient outcomes from collaborative practice (P < .01). Qualitative feedback from the physical therapy students and pharmacy student teaching assistants was positive and emphasized the benefits of interprofessional peer teaching. ImplicationsOverall, this interprofessional peer teaching model effectively improved interprofessional attitudes while accomplishing didactic needs. This innovative course may serve as a model for interprofessional education in different subject areas or across other health professions programs.

Differential Effects of Self-graphing on Self-monitoring of Early Literacy Outcomes in Kindergarten Students

The purpose of this study was to examine how an early literacy intervention, Kindergarten Peer-Assisted Learning Strategies (K-PALS; Mathes et al. Kindergarten peer-assisted literacy strategies (K-PALS): Sopris West, 2001), can be intensified to extend the positive outcomes to students who do not initially demonstrate an adequate response to intervention. K-PALS was intensified by incorporating a self-monitoring package that included self-graphing. An alternating treatment design was used to compare the effectiveness of K-PALS with self-graphing alone and K-PALS with a self-monitoring package to baseline/K-PALS for the purpose of increasing student performance on the early literacy measure of phonemic awareness. The results of the study indicate that while the self-monitoring package was the more effective intervention for two of the three student participants, the self-graphing alone intervention also resulted in positive outcomes for both of these participants. There was no change in the phonemic awareness performance for the third participant throughout the alternating treatment phase. Implications for intensifying academic interventions within the context of a Response to Intervention framework are discussed.

A Quasiexperimental Evaluation of Two Versions of First-Grade PALS: One With and One Without Repeated Reading

We attempted to strengthen an evidence-based, peer-mediated, first-grade reading program (First Grade Peer-Assisted Learning Strategies [PALS]) by modestly revising its content and adding a repeated-reading (RR) component. In a cluster-randomized trial, we conducted a component analysis of the revised program by creating two versions of it. “PALS+Fluency” represented the modified program with an RR component, whereas “PALS-Only” represented the same program without RR. We tested the efficacy of the two PALS versions together against controls and against each other to determine if peer-mediated RR had “value added.” With moderator analyses, we further explored whether the PALS programs benefited weaker and stronger readers alike. Thirty-three first-grade classroom teachers (and 491 students) from eight urban schools were randomly assigned to the three study groups within their schools. The PALS-Only and PALS+Fluency programs ran for 22 weeks. Multilevel modeling showed that the combined effects of the two PALS programs on phonological awareness (PA), word reading, and reading fluency were superior to those of controls. Students’ pretreatment PA moderated combined program effects on PA and word reading, indicating stronger effects for students with weaker PA. PALS-Only students improved PA skills (over PALS+Fluency students) with stronger effects for those with weaker pretreatment PA.

Evidence-based teaching practices: A road less traveled in Pakistan?

It is no secret that most health professionals, after postgraduation, aim to secure an academic position in a teaching institute due to various personal and/or professional preferences. Personal interest in teaching, inspirational figure/ role model-driven career selection, fixed working hours, financial rewards, societal respect, and relatively easier career path are some of the prominent motives for health professionals to join academia (Huda &amp; Yousuf, 2006). Indeed, it is a personal choice of a health professional should he/she opt for an academic career path. However, a serious question to ask oneself is: Am I prepared and ready for this challenging role?

IMPROVING ACQUISITION OF LEARNING THROUGH PEER-MEDIATED SUPPORT STRATEGIES IN TEACHING RESEARCH

The conduct of an action research enabled teachers to assess the research capabilities of the students specifically in writing the different parts of the paper. The aim of the study is to improve the learning acquisition of students through peer-mediated support strategies in teaching research. The participants of this study were the Senior High School students taking Research Project as a subject. A pre-writing activity was administered to identify the needs of the students in writing the different parts of the research. A learning plan integrating the use of the Peer-mediated Support Strategies (PMSS) such as classroom-wide peer tutoring, peer support arrangement and lunch bunches as interventions, was developed to improve the performance of the students-participants in writing research. A post-writing activity was given as well to the participants to find out if there were significant improvements in their writing capability. The study used methodological triangulation. Descriptive and inferential statistics were used to analyse and compare the results of the pre-writing and post-writing scores. A focus group discussion and teachers’ observation were conducted to support the result of the analysis made. The result was found to be significant proving PMSS to be an effective strategy in improving acquisition of learning. KEYWORDS: Research writing, acquisition of learning, peer-mediated support strategies, peer assisted learning, classroom-wide tutoring, peer-support arrangement, lunch bunches

Learning Mole Concept with PALS: An Intervention for Working Students in a Night School

A quasi-experimental study was done in order to investigate the effectiveness of Peer-Assisted Learning Strategy (PALS) as an intervention in learning Mole Concept for the ninth grade-working students in a night school in Cebu City, Philippines. Study findings revealed that students exposed to conventional lecture method (CLM) (N=15) had Below Average performance in the pre/posttests, and those exposed to PALS (N=15) had Below Average performance in the pretest and Average performance in the posttest. Both groups had significant mean improvement before and after exposure to CLM (t=5.07, p=.000) and PALS (t=10.37, p=.000), indicating that both lectures and peer tutoring are essential in teaching-learning process. The study also found out that those exposed to PALS (t=4.24, p=.000) had significantly greater improvement than those exposed to CLM. Moreover, sex, age, civil status and number of people in the house were not associated with their performance in Chemistry, implying that these profiles do not affect the tutor-tutee relationship. The study concluded that PALS manifested a more enhanced performance among the working students in Chemistry.

A systematic review of peer-assisted learning in fully online higher education distance learning programmes

ABSTRACTPeer-assisted learning (PAL) involves a student peer providing some form of support to a student mentee, usually participating at an earlier point in the same programme of study. PAL has been shown to have benefits for on-campus students. However, differences in on-campus and online programme delivery make it difficult to generalise these benefits to fully online distance learners (ODL). Of concern to providers of these types of programmes in higher education, are reports of increased student isolation, reduced motivation and early drop-out from their studies. Thus, providing PAL through an online environment may be one way to reduce these concerns. A systematic review of the published literature was performed to identify evidence of the potential benefits of formalised peer-assisted learning for students enrolled on a fully online, distance learning programme in higher education. A recognised methodology was used to search for relevant literature, and to synthesise results. Of the initial 2,225 individual studies identified from the search, only four met the full inclusion criteria for this review. The results of the four studies were inconclusive; differences between types of academic programmes, the design of the peer-support and the way in which they had been examined and reported were found. As a result, there was little more than a suggestion that in higher education, formal online peer-support might benefit fully online distance learners in some way.

Can student-peers teach using simulated-based learning as well as faculty: A non-equivalent posttest-only study

BackgroundPeer-assisted learning has an important place in the delivery of health care education with benefits for both the learners and the peer teachers. Simulation-based learning (SBL) is evolving in healthcare professions training and academic programs as a modality that conveys realism and fidelity through immersion. ObjectivesThe primary aim was to compare physiotherapy student's motivation to learn between a conventional faculty-led SBL activity and the same SBL activity delivered by trained final year physiotherapy peer tutors. MethodsPhysiotherapy students from two Universities (n = 226) undertook a SBL learning activity (either faculty led or peer led) and completed the Instructional Materials Motivation Scale questionnaire to assess motivation to learn. ResultsThere was a high level of learner motivation in all learning groups, with significantly higher learner satisfaction (p < 0.001) and lower attention (p < 0.001) in student-led SBL than faculty-led SBL. ConclusionsThis study has highlighted the potential to incorporate peer-assisted and simulation-based learning together in the development of future educational activities in health care training.

Strategies to optimize implementation of novel preceptorship models: Peer-assisted learning and near-peer teaching

IntroductionHospital experiential placements have traditionally used a 1:1 (student to preceptor) ratio. Two models, peer-assisted learning (PAL) and near-peer teaching (NPT), have been described in the literature for education of health professions. This research explored the use of PAL and NPT, as well as advantages, challenges, and strategies to address challenges for implementation. MethodsThis study used an anonymous survey to solicit feedback from staff pharmacists and pharmacy leaders about their use of PAL and NPT models in hospital settings in Alberta, Canada. Using closed and open-ended questions, experience with each model and implementation considerations were explored. ResultsThe survey was completed by 115 hospital pharmacists (11% response rate). PAL and NPT were utilized by 25% and 8% of respondents, respectively, and 10% had experience with both models. Advantages of these models include promoting teamwork and clinical independence, learners supporting each other, and fostering active learning. The highest ranked challenges were space/technology/computer access limitations and additional time to complete learner assessments. Many strategies were provided to address challenges, and facilitate implementation and utilization. ConclusionIn the hospital setting, pharmacists used PAL more commonly than NPT. Feedback from pharmacists and leaders affirmed the advantages and challenges associated with use of these precepting models. Strategies to facilitate and optimize use were provided, which will guide faculty, pharmacy leaders, and preceptors in efforts to support implementation to increase capacity and expand the practice of precepting.

Peer Assisted Learning Experience as an Extracurricular Activity during a Gross Anatomy course.

Multiple medical schools have modified classical teaching methods introducing new tools to improve learning processes 1. Amongst these, extra academic activities defined as out of the curriculum, of voluntary participation 2, and without grading, have been described as activities requiring auto discipline, teamwork, commitment and knowledge 3 as these are mostly carried out by an academic peer. These and other group activities in and out of campus should not be overlooked, as they also influence student performance in medical school. Additionally, peer assisted learning has many benefits, which include preparing students as future educators, improving their communication skills and reducing staff workload.The aim of this study is to describe the effect of a peer assisted learning based extracurricular activity on student performance during a Gross Anatomy course in an integrated curriculum medical school and the students’ perception on their own learning process.Quantitative and qualitative data acquisition tools were used to determine the existence or not of an association between the activity and students summative performance. Grades from two groups without the activities n=162 and two with these n=127 were considered with a total of 22 interventions. Additionally, quantitative data was triangulated with qualitative data obtained from a focal group with the student’s perception on their own learning process.No positive association (p &gt; 0.05) between the grades of each group were found. However, as each exam is composed by a theoretical and a practical component, a decrease in the difference between theoretical and practical grades when peer assisted extracurricular activities were applied was evident. When qualitative data was analyzed, there was a general perception by students that they had less stress levels during the practical component after the activity.Peer‐assisted extracurricular activities show to be beneficial for both: those who attend and peers. Students consider this activity as helpful in reducing other factors such as stress and anxiety that may also be influencing their performance on the exam. However, not finding an association may occur because the students who are more academically able tend to seek out teaching and/or research opportunities and participated at these activities 2. This and other factors need to be addressed and evaluated in order to restructure this tool, so it can be improved in a way it can be implemented and fully analyzed in the future.Support or Funding InformationAnatomy Laboratory, Universidad de los Andes School of Medicine

Peer-assisted learning in the prehospital educational setting in South Africa

Background. Clinical learning is an important component of health professions training. Peer-assisted learning (PAL) involves students who work in the clinical learning domain, often with their peers. There is a paucity of literature related to PAL in the South African (SA) context. Objectives. To explore the perspectives of SA prehospital emergency care personnel regarding PAL. Methods. A cross-sectional design used a purpose-designed online survey to gather data from qualified prehospital emergency care personnel. Participation was invited by emailing persons registered on a privately managed database. The questionnaire was available for 2 months after the initial email had been sent. The questionnaire used Likert-type scales to measure participant perceptions of specific aspects related to PAL. An open-ended question gathered data on participant perceptions of PAL. Results. Participants recognised PAL as a contributor to improved theoretical and practical academic performance, increased confidence, better debriefing and creating a platform for future relationships, both professionally and socially. Most participants reported a positive relationship with their PAL partners. The presence of a PAL partner made participants more comfortable during hostile or unsafe situations. Conclusions. PAL was positively viewed by participants and the environment created by PAL was perceived to enhance learning, debriefing and confidence and to improve theoretical and practical assessment results. We recommend that students are included in the PAL partner allocation process. Further research should include PAL in a larger spread of health professions in the African setting.

Insight into strategies adopted by the residents who passed exit fellowship examination in first few attempts

Background: The residents who pass exit fellowship examination in few attempts adopt certain strategies for early success. The lived experiences of residents passing FCPS final examination in few attempts, barriers to success and strategies to overcome those barriers were studied.&#x0D; Participants and methodology: This phenomenological research study was conducted at Services Hospital, Lahore, Pakistan from June 2015 to May 2017. Purposeful snowball sampling was done. Eleven residents who passed their Final FCPS examination in few attempts, in the last 15 years were included in the study. Semi-structured open-ended interview of the residents was audio-recorded and transcribed. Three themes of helpful factors, barriers encountered and suggestions to overcome those barriers to get through the final FCPS examination and the emerging sub-themes were analyzed and textural and structural description were assigned.&#x0D; Results: Three themes were based on the aim of study and their related emerging sub-themes were found. The helpful factors included self-directed learning, peer assisted learning, interactive educational environment, rehearsal and self-determination. Barriers encountered were related to learning difficulties, competing responsibilities and physical and emotional burnout. Lastly, suggestions to overcome the barriers were use of multiple technology based learning strategies, developing self-confidence and self-efficacy together with prioritization of emotional and physical wellbeing.&#x0D; Conclusions: This study found that self-regulation and internal motivation were important strategies for success in the FCPS exit examination. Barriers can be overcome through technology based learning and increased self-efficacy and prioritizing physical and emotional wellbeing.

Assessing Advanced Communication Skills via Objective Structured Clinical Examination: A Comparison of Faculty Versus Self, Peer, and Standardized Patient Assessors

Construct: The construct addressed in this study is assessment of advanced communication skills among senior medical students. Background: The question of who should assess participants during objective structured clinical examinations (OSCEs) has been debated, and options discussed in the literature have included peer, self, standardized patient, and faculty assessment models. What is not known is whether same-level peer assisted learning can be utilized for formative assessment of advanced communication skills when no faculty, standardized patients, or other trained assessors are involved in providing feedback. If successful, such an educational model would optimize resource utilization and broaden the scope of topics that could be covered in formative OSCEs. Approach: The investigators developed a 4-station formative OSCE focused on advanced communication skills for senior medical students, and evaluated the concordance of assessment done by same-level peers, self, standardized patients, and faculty for 45 students. After each station, examinees completed a self-assessment checklist and received checklist-based assessment and verbal feedback from same-level peers only. Standardized patients completed checklist-based assessments outside the room, and faculty did so after the OSCE via video review; neither group provided direct feedback to examinees. The investigators assessed inter-rater agreement and mean difference scores on the checklists using faculty score as the gold standard. Findings: There was fair to good overall agreement among self, same-level peer, standardized patient, and faculty-assessment of advanced communication skills. Relative to faculty, peer and standardized patient assessors overestimated advanced communication skills, while self-assessments underestimated skills. Conclusions: Self and same-level peer-assessment may be a viable alternative to faculty assessment for a formative OSCE on advanced communication skills for senior medical students.

Peer-Assisted Learning in Dental Students' Patient Case Evaluations: An Assessment of Reciprocal Learning.

Little research exists on reciprocal learning, a type of peer-assisted learning in which students act concurrently as both teacher and learner in small groups. The aims of this pilot study were to assess the feasibility of using case-based reciprocal learning with dental students and to assess its impact on students' satisfaction and perceived clinical reasoning, educational value, and use of evidence-based dentistry. In this quasi-experimental mixed methods study conducted in 2018, small-group sessions led by a third-year dental student were designed to expose second-year students to clinical portfolios prior to clinical rotations, promote evidence-based dentistry, and improve students' clinical critical thinking skills by having them work in small groups to teach and learn from each other. After the intervention, all 76 students in the sessions were invited to complete a survey with 11 Likert-scale items and six open-response questions assessing their engagement in learning, perceived educational value, and perceived quality of facilitation associated with reciprocal learning. Sixty-five students completed the surveys for a response rate of 86%. Among the survey respondents, 87.7% agreed/strongly agreed that the small groups facilitated enhanced learning, and 66.2% agreed/strongly agreed that they learned the material better because they had to teach it to their peers. Also, 74.6% agreed/strongly agreed that their clinical critical thinking improved, and 92.3% agreed/strongly agreed that they felt better prepared to complete a patient portfolio once they reach clinic. This study found that reciprocal learning had favorable outcomes in terms of students' perceptions of learning. The students reported that the small groups enhanced their learning, improved their comfort in asking questions in small groups, and exposed them to a variety of clinical situations.

Peer-Assisted Learning: A New Look at the Good Old Monitoring and Its Motivation from the Perspective of Student-Monitor

Peer-assisted learning (PAL), good old monitoring, has been used in medical schools and shown good results in professional development and in developing communication skills among students. This method provides mutual benefits for both monitors/near-peer teachers - NPT and monitored students; however, little is still known about the NPT’ perception about peer-assisted learning. To evaluate the real motivation of students to become NPT, and to investigate how NPT qualify their own teaching activities – such as productivity, performance and difficulties faced – seems to be a crucial step for implementing PAL in medical schools. The research instrument, a semi-structured questionnaire with 11 closed questions and 3 questions that allowed the answer “other” and further explanation, was answered by 26 medical students, NPT of basic disciplines. The results showed a positive effect of PAL on the teaching-learning process, and the real reasons of students to become NPT and the positive impacts of PAL on their academic life. The identification of these potential benefits should encourage medical schools to promote training so students can perform their role as NPT since PAL aids in the development of their clinical and pedagogical skills.

Peer-Assisted Learning of Procedural Skill in Basti Karma (Medicated Enema)- A Pilot Study

Background- Peer Assisted Learning (PAL) is learning style with informative, interactive, and interesting learning. In clinical setting, PAL has been modestly used for the purpose of training of physical examination and general clinical skills examination, gross anatomy, communication skills training and resuscitation training. PAL is instruction-based model which used for teaching and learning in few medical schools and it has a great importance in today’s scenario. So, one cannot ignore PAL implementation in undergraduate teaching for enhancement of skill. Objectives- To develop competency in Ayurveda graduate to offer standardized Basti treatment as a service to mankind. Materials &amp; methods- 20 potential undergraduate students were participated in the study and peer tutor role assigned to the rapid learner undergraduate students. Testing module (Erandamuladi Basti preparation and administration) was based on cognitive and psychomotor skill. Study was carried forward by introductory didactic lecture on Basti (medicated enema) preparation and its administration, introducing the concept of PAL, training session for peer tutors, PAL session with feedback and in last assessment of the participants through OSPE. Results- Near about95% students were in favor of PAL teaching method. And opined regarding good cooperative aspect, development of personal skills and keen study of subject by PAL method. Conclusion- PAL is one of way to develop competent Ayurveda graduate to provide standardized Basti treatment to mankind. Peer teaching is an easy effective way of equipping students with the procedural skill.&#x0D;