Use Of Peer-assisted Learning Research Articles

A peer-led kinesthetic forearm and wrist anatomy workshop: A multiple cohort study.

An understanding of forearm and wrist anatomy is necessary for the diagnosis and treatment of various injuries. Evidence supports the use of peer-assisted learning (PAL) as an effective resource for teaching basic science courses. First-year medical students across three class years participated in an optional PAL kinesthetic workshop wherein participants created anatomically accurate paper models of forearm and wrist muscles. Participants completed pre- and post-workshop surveys. Participant and nonparticipant exam performances were compared. Participation ranged from 17.3% to 33.2% of each class; participants were more likely to identify as women than men (p< 0.001). Participants in cohorts 2 and 3 reported increased comfort with relevant content after the workshop (p< 0.001). Survey responses for cohort 1 were omitted due to low response rates; however, exam performances were assessed for all three cohorts. Cohort 2 participants scored higher than nonparticipants on forearm and wrist questions on the cumulative course exam (p= 0.010), while the opposite was found for cohort 3 (p= 0.051). No other statistically significant differences were observed. This is the first study to examine quantitative and qualitative results for a PAL intervention repeated for three separate cohorts. Although academic performance varied, two cohorts reported increased comfort with relevant course material after the workshop. Results of this study support the need for further exploration of PAL workshops as an instructional method in teaching anatomy and highlight the challenges associated with repeating interventions over multiple years. As more studies attempt replication across multiple years, these challenges may be addressed, thereby informing PAL best practices.

Teaching of AETCOM modules in Physiology using Peer assisted learning: Feasibility assessment study

Introduction and Background: Attitude Ethics and communication (AETCOM) teaching learning methodology needs to be innovative, informal and realistic. Internalization and actualization is important for having a long term impact on their interactions with patients, relatives as well as professional interactions with colleagues. Peer Assisted Learning (PAL) is an effective teaching and learning tool used extensively for various curricular components in medical education worldwide. Objective: the purpose of study was to find feasibility of use of PAL as teaching and learning modality to administer AETCOM module in Physiology. Method: After approval from IEC, in this study first year MBBS students practiced peer assisted learning for AETCOM module in Physiology by 5 peer tutors and 45 peer tutees. Teachers role was to facilitate the PAL methodology learning and preparing the Peer tutors for smooth conduct of PAL sessions. Study participants were evaluated using pre-validated five point Likert scale, structured short answer questions for PAL and AETCOM based case scenario and feedback questionnaire. Results: 42 MBBS students participated in the study. It was observed that peer tutees perceived PAL as interesting and innovative method for teaching and learning AETCOM module in Physiology. Open ended assessment showed that they had achieved desired score about understanding of the AETCOM module and PAL methodology. The feedback from facilitators also echoed the same with improvement in team learning behaviour and use of PAL technique not only for AETCOM but also for learning other curricular topics. Conclusion: PAL can be used as novel teaching learning tool for AETCOM module in Physiology.

An educational initiative to support the development of communities of practice in older people’s care home settings

Background: It is predicted that care home provision for older people will need to increase significantly over the next 30 years, requiring a skilled workforce that expands to meet this growing need. Innovative practice development strategies are required to support the existing workforce and provide incentives to help recruit new staff. Aim: This article aims to explore the use of the peer-assisted learning model to support the development of communities of practice in care home settings in an area of England. Method: Care home teams were invited to university-based workshops and their experiences of using peer-assisted learning were elicited through narrative telephone interviews undertaken with care home managers. Findings: Three overarching themes were identified relating to practice development: context, process and impact. Through peer-assisted learning, staff were empowered to share their expertise and knowledge with colleagues, resulting in enhanced communication, respect and person-centred resident care. Managers viewed peer-assisted learning as a sustainable, low-cost investment in staff development. Conclusion: This article contributes to practice development by presenting reflections on an innovative initiative to facilitate the use of peer-assisted learning in educational practices in the care home workforce. Combining the philosophies of community of practice and peer-assisted learning provides a model that can foster practice development in the care home setting. Further, this work can support the development of communities of practice that operate across care homes on a national/international basis. Implications for practice: This article describes a sustainable practice development model that can be used in the care home setting Grounding practice development in the philosophies of peer support and communities of practice can promote a climate of mutual respect and enhanced communication Improved communication and sharing of expertise within care home teams offers the potential for improved resident-centred care provision

Validating the Use of Peer-Assisted Learning Laparoscopic Simulation Training for Medical Students.

Medical students are often passive observers in laparoscopic theatres due to their lack of basic laparoscopic skill competence, which negatively impacts their education. This study aims to (1) validate the use of peer-assisted learning (PAL) to teach medical students basic laparoscopic skills on low-cost simulators and (2) compare the efficacy of PAL training between pre-clinical and clinical medical students to ascertain when this training should be introduced. Our results demonstrate significant training efficacy at both levels, suggesting that PAL simulation may be implemented at either stage of training, but may garner better retention of confidence and knowledge in the clinical medical students.

16055 Medical student survey of use of peer-assisted learning in dermatology medical education and confidence in meeting curriculum objectives before and after clinical placements in a UK medical school

The use of peer-assisted learning (PAL) and its associated cognitive, pedagogical, attitudinal and socioeconomic benefits in education are well described. PAL can assist an institution to meet external expectations for medical graduates to achieve competencies in both teaching and assessment and instil a lifelong culture of teaching. We surveyed a group of 28 third-year medical students regarding confidence in meeting curriculum objectives before and after a week’s clinical placement in dermatology using PAL as a learning technique.

Preparing students for the future through developing evaluative judgement.

In today's environment, health students need to be prepared for an ever changing workplace and workforce. They need to understand what demonstrates good quality work and how to assess their standard of work. Evaluative judgement can contribute to student and graduate self-regulation and autonomy in their learning. This toolbox article describes how to implement strategies for developing evaluative judgement in allied health placements. These strategies were developed as part of an occupational therapy program in rural Western Australia, where experiential education is provided through service-learning with both direct and indirect supervision. Practical advice is provided on the use of peer-assisted learning, rubrics, self-assessment and feedback. Challenges and opportunities in implementing strategies to develop evaluative judgement, such as how to achieve effective feedback, are also discussed. The suggested toolbox may be adapted to various clinical placement contexts. Developing evaluative judgement can help to prepare our students to be lifelong learners. This article empowers educators to promote this capability in their students to create work ready graduates, who are able to operate independently and in rapidly evolving, technologically enabled environments.

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.

Differences in The Effects of Core Nursing Skills Education According to the Use of Peer-Assisted Learning (PAL) Among Nursing Students

Differences in The Effects of Core Nursing Skills Education According to the Use of Peer-Assisted Learning (PAL) Among Nursing Students

Improving Medical Student Confidence in Clinical Skills through a Peer-Facilitated Workshop

University of Maryland, School of Maryland’s (UMSOM) curriculum does not provide training in physical exam skills to first year medical students (MS1s). A peer assisted learning model offered a unique way to address this deficiency. We aimed to design, implement, and evaluate a clinical skills workshop facilitated by upper-level medical students (upper MSs) that could be replicated by other medical schools. Faculty provided a one-hour training session to upper MSs. These students then facilitated a two-hour workshop for MS1s providing instruction on select elements of the physical exam. We theorized that upper MSs would have increased confidence in their abilities to perform the physical exam by learning to teach these skills. Additionally, we hypothesized that MS1s would have increased confidence in their abilities to perform the same skills after participating in the peer-facilitated workshop. We tested these hypotheses using a paired pre- and post-survey model and used paired sample t test analyses to determine statistical significance. We used thematic analyses to analyze free response answers. After training, upper MSs (n = 43) reported a significant improvement (p < .01) in self-reported confidence for each item: measure radial pulse, respiratory rate, and blood pressure, and auscultate lung fields and heart valves. There was a significant improvement (p < .01) in self-reported confidence by MS1s (n = 47) for the same items after the workshop. Students reported positive feedback regarding the use of peer assisted learning. Implementing a peer-facilitated workshop led to increased self-confidence in performing clinical skills by MS1s and upper MSs with minimal faculty demand. Similar models could be feasibly implemented at other institutions.

The benefits of a peer-assisted mock PACES.

Peer-assisted learning (PAL) and mock examinations have been credited as effective teaching tools; however, there is a lack of research into their effectiveness in PACES (practical assessment of clinical examination skills). This study demonstrates an effective model and the benefits of PAL after its implementation in a mock PACES at Imperial College London. There is a lack of research into the effectiveness of PAL and mock examinations in PACES METHODS: A mock PACES was designed for fifth-year medical students. Examiners were recruited from the final year and from the foundation year doctor (intern) cohort. A Likert scale (1, strongly disagree; 5, strongly agree) questionnaire given before and after the exam was used to investigate its effectiveness. A total of 41 pre-mock exam surveys (57% completion rate) and 57 post-mock exam surveys (79% completion rate) were completed. Students felt significantly more confident after the mock PACES (mean 3.54 post-mock exam versus 2.68 pre-mock exam), with 90.64percent of students agreeing that this mock PACES was more useful than a lecture-based format, bedside teaching and small group teaching in order to prepare for this exam. Twenty-eight tutor surveys were completed (87.5% completion rate). Tutors agreed that the mock PACES had improved their confidence in their teaching ability (mean 4.07) and enhanced their clinical knowledge (mean 4.18). The mock PACES demonstrated benefits to confidence levels and knowledge both for tutees and tutors. The results demonstrate an effective model in examination preparation for PACES. This reinforces the holistic positive attributes gained from the use of PAL and mock examinations, whilst encouraging its use within the undergraduate syllabus.

Peer-assisted learning for foundation doctors.

Peer-assisted learning (PAL) is a widely accepted learner-led educational model encouraging cooperative active learning. Whereas attention has historically focussed on the use of PAL in undergraduate contexts, less is known about the benefits and challenges of using PAL for postgraduate clinical trainees. This study describes the implementation and evaluation of a PAL scheme for UK foundation-year trainees (newly qualified doctors). Following a needs assessment, a peer-led component was introduced into the weekly foundation teaching programme at the hospital. Each week a peer tutor presented a topic relevant to the foundation curriculum, and peer participants provided written feedback. Questionnaire-based evaluation of the scheme was conducted 7months after implementation. Ninety-eight percent of trainees completed the evaluation. Eighty-eight percent were satisfied with the PAL scheme. Crucially, PAL was seen to address historic barriers to effective learning. Educational content seemed to be better matched to the learning needs and experience of learners, with particular value placed on case-based peer discussions. Furthermore, PAL seemed to promote a learning environment in which questions and conjectures could be safely shared. Although some peer tutors found presenting to peers anxiety-provoking, the majority agreed that PAL not only helped develop their teaching ability but also positively impacted on their everyday clinical work. Less is known about the benefits and challenges of using PAL for postgraduate clinical trainees DISCUSSION: The PAL scheme was well received by participants and supports its use outside of its traditional undergraduate focus. Trainees identified a number of pedagogical benefits through serving as both tutor and tutee. Delivering teaching skills and feedback skills training were identified as future developments to further maximise the educational benefits of PAL.

Same-level peer-assisted learning in medical clinical placements: a narrative systematic review.

Peer-assisted learning (PAL) is increasingly used in medical education, and the benefits of this approach have been reported. Previous reviews have focused on the benefits of peer tutoring of junior students by senior students. Forms of PAL such as discussion groups and role-playing have been neglected, as have alternative teacher-learner configurations (e.g. same-level PAL) and the effects on other stakeholders, including clinician educators and patients. This review examines the benefits of same-level PAL for students, clinician educators and patients in pre-registration clinical medical education. Medline, PsycINFO, CINAHL and ERIC were searched in March 2014. A total of 1228 abstracts were retrieved for review; 64 full-text papers were assessed. Data were extracted from empirical studies describing a same-level PAL initiative in a clinical setting, focusing on effects beyond academic performance and student satisfaction. Qualitative thematic analysis was employed to identify types of PAL and to cluster the reported PAL effects. Forty-three studies were included in the review. PAL activities were categorised into role-play, discussion, teaching and assessment. Only 50% of studies reported information beyond self-report and satisfaction with the PAL intervention. Benefits for students (including development of communication and professional skills) and clinician educators (developing less-used facilitation skills) were reported. Direct patient outcomes were not identified. Caveats to the use of PAL emerged, and guidelines for the use of PAL were perceived as useful. Many student-related benefits of PAL were identified. PAL contributes to the development of crucial skills required for a doctor in the workplace. Vertical integration of learning and teaching skills across the curriculum and tools such as feedback checklists may be required for successful PAL in the clinical environment. Benefits for patients and educators were poorly characterised within the included studies. Future work should evaluate the use of PAL with regards to student, clinician educator and patient outcomes.

Peer-led Stress Prevention Seminars in the First Year of Medical School--A Project Report.

Introduction: From the beginning of the first year of medical studies, increased psychological stress and elevated burnout prevalence rates can be registered compared to sample populations. Characterized by learning “on an equal footing”, the principle of peer-assisted learning (PAL) is widely used in medical education. This report aims to showcase the development and evaluation of peer-led stress prevention seminars for first year medical students after one year of implementation.Project description: With each of the three sessions lasting 90 min., the stress prevention seminars took place in small groups (6-10 students) in the period from November 2013 to January 2014 and from November 2014 to December 2014 at the Medical Faculty of Heidelberg. Led by trained peers, the seminar content ranged from psycho-educational elements, i.e. time management strategy development and test anxiety assistance, to relaxation techniques. All seminar sessions were evaluated via questionnaire. All questions were answered on a Likert scale ranging from 1 to 7 (1=strongly agree; 7=strongly disagree).Results: 75 students consented to participate in seminars (65% female; aged 20.5±3.3 years). The series of seminars was averagely given the school grade of 1.2±0.4 (1=very good to 6=unsatisfactory) in WS 2013/14 and 1.5±0.5 in the following year and the peer tutors’ competence was evaluated as very high (1.4 to 1.5 approval rate on the Likert scale).Discussion: The seminar sessions’ importance to the students is underlined by their very positive evaluations. This offer seems to have benefited students especially during the demanding transitional phase at the start of their studies. Both the implementation of the preventive measure at an early stage as well as the use of PAL seem to have proven effective.Conclusion: PAL seems to be effective in the field of stress prevention. However, specific efficacy studies are still lacking.

Peer-assisted learning to train high-school students to perform basic life-support.

The inclusion of cardiopulmonary resuscitation (CPR) in formal education has been a useful approach to providing basic life support (BLS) services. However, because not all students have been able to learn directly from certified instructors, we studied the educational efficacy of the use of peer-assisted learning (PAL) to train high-school students to perform BLS services. This study consisted of 187 high-school students: 68 participants served as a control group and received a 1-hour BLS training from a school nurse, and 119 were included in a PAL group and received a 1-hour CPR training from a PAL leader. Participants' BLS training was preceded by the completion of questionnaires regarding their background. Three months after the training, the participants were asked to respond to questionnaires about their willingness to perform CPR on bystander CPR and their retention of knowledge of BLS. We found no statistically significant difference between the control and PAL groups in their willingness to perform CPR on bystanders (control: 55.2%, PAL: 64.7%, P=0.202). The PAL group was not significantly different from the control group (control: 60.78±39.77, PAL: 61.76±17.80, P=0.848) in retention of knowledge about BLS services. In educating high school students about BLS, there was no significant difference between PAL and traditional education in increasing the willingness to provide CPR to bystanders or the ability to retain knowledge about BLS.

The use of peer-assisted learning for review presentations in heterogeneous classes

Peer Assisted Learning benefits both higher and lower level students, either from the act of teaching, or by learning from more capable classmates. With this in mind the author devised a presentation task, for a heterogeneous (mixed ability) ESL class in Japan, to review units from the course textbook. Students were placed in groups consisting of two pairs, each pair with a high and low level student, and were asked to prepare presentations within a limited timeframe. The objective was to see whether students could cooperate, learn from each other, and complete the task while under time constraints. Aided by the use of L1 in the planning stages, one pair explained in English, key speaking/listening strategies from the textbook, the other illustrated them using dialog. In anonymous questionnaires, the class agreed that they had either helped or been helped by their peers and that the task had been beneficial to them. ピアアシスト（生徒相互補助）学習は、教えるという行為や、より能力の高い仲間から学ぶことによって、高いレベルの学生にも低いレベルの学生にも有益である。これを踏まえて筆者は、能力の異なる学生からなる日本のESLクラスのために、テキストの単元を復習するためにプレゼンテーションを行うという課題を考案した。高いレベルの学生と低いレベルの学生で1組になり、2組で1グループを構成した。学生たちは限られた時間内にプレゼンテーションを準備することになった。目的は、学生たちが協力しあえるか、互いから学べるか、時間的に制約された中で作業をやり遂げられるかを見ることであった。立案段階ではL1（日本語）の使用に助けられ、グループ内の1組は、教科書の重要なスピーキング／リスニングのストラテジーを英語で説明し、もう1組は対話により説明した。 無記名アンケートで学生たちは、お互いに助けたり助けられたりして、この課題は自分にとって有益だったと回答した。

How is peer-teaching perceived by first year paramedic students? Results from three years

Background: Peer Assisted Learning (PAL) can create a cooperative learning environment, providing benefits to all students involved. While there is a large pool of research exploring PAL amongst medical students it is worth considering the use of PAL amongst students of different health disciplines. The objective of this study was to examine the perceptions of first year paramedic peer learners being taught by peer teachers over a three-year period. Methods: A cross-sectional study using the modified Clinical Teaching Preference Questionnaire (CTPQ) was administered to first year paramedic peer learners at a large Australian university during October 2011-2013. Results: Over a three year period, 361 peer learners participated in this study. The mean item-level result for each item was highest in the 2013 cohort compared to the earlier two years. Item 1 “Teaching is an important role for paramedics” reflected the highest mean score of the eleven items (4.46 in 2011; 4.52 in 2012; 4.60 in 2013) while item 2 “I feel freer to approach my instructor for help than I do my peers” reflected the lowest mean score (2011: 3.61; 2012: 2.99; 2013: 3.72). Conclusions: First year paramedic students over a three year period reported item-level results on the modified CTPQ which indicate that PAL is a valuable teaching method. This is consistent with previous research on PAL using students from other health disciplines. Results suggest peer learners believe teaching is an important role for paramedics, and communication between peer learners and teachers was slightly better compared with their tutors. Further mixed methodology work is required to explore other facets of paramedic PAL.

Peer-Assisted Communication Training: Veterinary Students as Simulated Clients and Communication Skills Trainers

Mounting research supports the use of peer-assisted learning (PAL) as a teaching method in human and veterinary medicine. PAL can be a cost-efficient educational tool, saving both financial resources and faculty time. This article reviews a PAL model for teaching communication skills to veterinary medical students. In this model, junior veterinary students served as simulated clients for sophomore veterinary students. Details regarding methods of program delivery as well as evaluation data are presented. Differences between two student cohorts who participated in the PAL educational model and their subsequent evaluation results are discussed. Overall, veterinary medical students reported that this approach was beneficial and that the topic was critical to their success as veterinarians. Students also showed improvement in communication knowledge and reported that peer feedback was a strength of the program. Finally, future directions to assess and strengthen the use of PAL for communication training in veterinary medical education are proposed.

Knowledge transfer of spinal manipulation skills by student-teachers: a randomised controlled trial

To assess the use of peer-assisted learning (PAL) of complex manipulative motor skills with respect to gender in medical students. In 2007-2010, 292 students in their 3rd and 4th years of medical school were randomly assigned to two groups [Staff group (SG), PAL group (PG)] led by either staff tutors or student-teachers (ST). The students were taught bimanual practical and diagnostic skills (course education module of eight separate lessons) as well as a general introduction to the theory of spinal manipulative therapy. In addition to qualitative data collection (Likert scale), evaluation was performed using a multiple-choice questionnaire in addition to an objective structured clinical examination (OSCE). Complex motor skills as well as palpatory diagnostic competencies could in fact be better taught through professionals than through ST (manipulative OSCE grades/diagnostic OSCE score; SG vs. PG; male: P = 0.017/P < 0.001, female: P < 0.001/P < 0.001). The registration of theoretical knowledge showed equal results in students taught by staff or ST. In both teaching groups (SG: n = 147, PG: n = 145), no significant differences were observed between male and female students in matters of manipulative skills or theoretical knowledge. Diagnostic competencies were better in females than in males in the staff group (P = 0.041) Overall, students were more satisfied with the environment provided by professional teachers than by ST, though male students regarded the PAL system more suspiciously than their female counterparts. The peer-assisted learning system does not seem to be generally qualified to transfer such complex spatiotemporal demands as spinal manipulative procedures.

Introducing Peer-Assisted Learning into a Veterinary Curriculum: A Trial with a Simulator

Peer-assisted learning (PAL) was implemented in the context of delivering training with a simulator, the Haptic Cow. This project was undertaken as a way of increasing student access to the simulator and to investigate the possibility of using PAL more extensively in the curriculum. Peer tutors attended a workshop to learn basic teaching skills and were then trained to use the simulator. The tutors taught their peers the basic skills for bovine rectal palpation with the simulator. The PAL project was evaluated using questionnaires and a focus group to gather feedback from both tutors and learners. Sixteen peer tutors trained 99 fellow students with the simulator. Both tutors and learners thought that there were certain advantages in students, rather than veterinarians, delivering the training. Student tutors were less intimidating and could relate more closely to the difficulties of their peers. However, lack of knowledge was identified as a potential issue. Students reported certain benefits from their role as tutors, including improvements in communication skills, knowledge of the subject area, and confidence in performing bovine rectal palpation. Additionally, the skills developed, including learning to teach, were considered to be useful for their future careers as veterinarians. Tutors and learners supported the continued use of PAL both with the simulator and in other areas of the course. The trial of PAL proved a successful way of delivering simulator-based training and the project has provided a basis for the further use of PAL in our curriculum.

Peer Assisted Learning in Clinical Education: Literature Review

Objective: To examine the occurrence, benefits, and preferences for peer assisted learning (PAL) in medical and allied health clinical education, and to identify areas in athletic training which need further research. Data Sources: Using relevant terms, five databases were searched for the period 1980–2006 regarding literature on the use of PAL in medical and allied health education programs. Data Synthesis: We reviewed over 40 articles on the use of PAL in nursing, physical therapy, occupational therapy, medicine, athletic training, and higher education. It is apparent that PAL is a commonly used educational strategy that offers mutual benefits to participating students. Conclusions/Recommendations: Research is warranted regarding the preferences for and occurrence and benefits of planned and unplanned PAL from the perspective of program administrators, clinical instructors, and students. These multiple perspectives will allow for a more complete understanding of PAL in athletic training clinical education, laying the groundwork for future studies comparing student learning outcomes in ATEPs with planned PAL to those with unplanned PAL.