Peer assessment of resuscitation skills

Can peer feedback substitute for faculty feedback in predoctoral dental education?

PURPOSE/OBJECTIVES

The ability to give and receive feedback is a key skill to develop during predoctoral dental education, and the use of peer feedback specifically offers distinct benefits including a different understanding of material due to peers' proximity of knowledge development and assisting with overburdened instructors. However, it is unclear if peer feedback offers similar quality to instructor feedback.

METHODS

Dental students in two different graduation years provided quantitative and qualitative peer feedback on a case-based oral and maxillofacial pathology simulation. The data from these exercises were aggregated and analyzed to compare the quality of qualitative feedback to course examination scores. Student perceptions of peer feedback were also recorded.

RESULTS

The mean quality of feedback was not correlated with course examination scores, though the number of times students gave high-quality feedback and received high-quality feedback was correlated with course examination scores. Student feedback overall had a lower quality than instructor feedback, though there was no significant difference between instructor feedback quality and the maximum student feedback quality received. Student perceptions of the utility of feedback were positive.

CONCLUSION

While instructor feedback is more reliable and consistent, our findings suggest that in most instances, at least one peer in moderate-sized groups is able to approximate the quality of instructor feedback on case-based assignments.

Effectiveness of peer teaching in health professions education: A systematic review and meta-analysis

BACKGROUND

The reform in health professions education requires the focus to shift from fact memorization to exploring, analyzing, assimilating, and synthesizing information to promote active and collaborative learning. Peer teaching is one of the educational strategies.

AIMS

This review aimed to explore and synthesize quantitative evidence to determine the overall effect of peer teaching in enhancing students' theoretical knowledge and practical skills (e.g., procedural skills and resuscitation) in health professions education.

METHODS

PubMed, ScienceDirect, CINAHL, ERIC, ProQuest, reference lists of relevant studies, and reviews were searched till November 2021. Results were pooled using random-effects meta-analysis or narrative synthesis.

RESULTS

A total of 44 RCTs were included. This review showed a significant effect of peer teaching on procedural skills improvement and a comparable effect on theoretical knowledge and resuscitation skills acquisition compared to the conventional teaching method. Near-peer teaching seemed to be the most effective method for skill improvement. Subgroup analysis showed no significant differences between peer teaching and conventional teaching groups (e.g., expert/faculty teaching, self-study or lectures).

CONCLUSIONS

Peer teaching seems to be a promising teaching and learning strategy in health professions education, positively affecting theoretical knowledge and procedural skills. Future research should explore the effect of peer teaching in developing countries to provide a comprehensive picture of peer teaching.

The role of training in student examiner rating performance in a student-led mock OSCE

INTRODUCTION

Peer assessments are increasingly prevalent in medical education, including student-led mock Objective Structured Clinical Examinations (OSCE). While there is some evidence to suggest that examiner training may improve OSCE assessments, few students undergo training before becoming examiners. We sought to evaluate an examiner training programme in the setting of a student-led mock OSCE.

METHODS

A year‑2 mock OSCE comprised of history taking (Hx) and physical examination (PE) stations was conducted involving 35 year‑3 (Y3) student examiners and 21 year‑5 (Y5) student examiners who acted as reference examiners. Twelve Y3 student-examiners attended an OSCE examiner training programme conducted by senior faculty. During the OSCE, Y3 and Y5 student examiners were randomly paired to grade the same candidates and scores were compared. Scores for checklist rating (CR) and global rating (GR) domains were assigned for both Hx and PE stations.

RESULTS

There was moderate to excellent correlation between Y3 and Y5 student examiners for both Hx (ICC 0.71-0.96) and PE stations (ICC 0.71-0.88) across all domains. For both Hx and PE stations, GR domain had poorer correlation than CR domains. Examiner training resulted in better correlations for PE but not Hx stations. Effect sizes were lower than the minimum detectible effect (MDE) sizes for all comparisons made.

DISCUSSION

Y3 student examiners are effective substitutes for Y5 student examiners in a Y2 mock OSCE. Our findings suggest that examiner training may further improve marking behaviour especially for PE stations. Further studies with larger sample sizes are required to further evaluate the effects of dedicated examiner training.

Peer Assessment in Medical Student Education: A Study of Feasibility, Benefit, and Worth

BACKGROUND

Direct experience with medical procedures is an important component of medical school training, yet opportunities for medical students have dwindled for various reasons. To offset this, simulated procedures are being integrated into training. However, this comes with additional time commitments required of teaching surgeons regarding assessment of simulation. A solution to this could be peer assessment. We hypothesize that there will be no significant difference between peer assessment when compared to that of a teaching surgeon.

METHODS

Third-year medical students were shown 3 simulated procedures by teaching surgeon and provided a grading rubric. Student performances were independently graded by peer assessment and by teaching surgeons. All peer assessment grades and surgeon grades were compared.

RESULTS

Four hundred fifty-nine medical students completed the simulation procedures. Comparisons between the teaching surgeons and peer assessment evaluations demonstrated a 99% interobserver agreement for pass-fail designation and 98% agreement for individual data points (kappa = .78). Survey results demonstrated a significant increase in confidence in performing the tested items and comfort with peer assessment.

DISCUSSION

This analysis demonstrates that the inclusion of peer assessment within medical school is highly comparable to teaching surgeon assessments.

Agreement between medical students' peer assessments and faculty assessments in advanced resuscitation skills examinations in South Korea

PURPOSE

In medical education, peer assessment is considered to be an effective learning strategy. Although several studies have examined agreement between peer and faculty assessments regarding basic life support (BLS), few studies have done so for advanced resuscitation skills (ARS) such as intubation and defibrillation. Therefore, this study aimed to determine the degree of agreement between medical students' and faculty assessments of ARS examinations.

METHODS

This retrospective explorative study was conducted during the emergency medicine (EM) clinical clerkship of fourth-year medical students from April to July 2020. A faculty assessor (FA) and a peer assessor (PA) assessed each examinee's resuscitation skills (including BLS, intubation, and defibrillation) using a checklist that consisted of 20 binary items (performed or not performed) and 1 global proficiency rating using a 5-point Likert scale. The prior examinee assessed the next examinee after feedback and training as a PA. All 54 students participated in peer assessment. The assessments of 44 FA/PA pairs were analyzed using the intraclass correlation coefficient (ICC) and Gwet's first-order agreement coefficient.

RESULTS

The PA scores were higher than the FA scores (mean±standard deviation, 20.2±2.5 [FA] vs. 22.3±2.4 [PA]; P<0.001). The agreement was poor to moderate for the overall checklist (ICC, 0.55; 95% confidence interval [CI], 0.31 to 0.73; P<0.01), BLS (ICC, 0.19; 95% CI, -0.11 to 0.46; P<0.10), intubation (ICC, 0.51; 95% CI, 0.26 to 0.70; P<0.01), and defibrillation (ICC, 0.49; 95% CI, 0.23 to 0.68; P<0.01).

CONCLUSION

Senior medical students showed unreliable agreement in ARS assessments compared to faculty assessments. If a peer assessment is planned in skills education, comprehensive preparation and sufficient assessor training should be provided in advance.

Certified Basic Life Support Instructors Identify Improper Cardiopulmonary Resuscitation Skills Poorly: Instructor Assessments Versus Resuscitation Manikin Data

INTRODUCTION

During basic life support (BLS) training, instructors assess learners' cardiopulmonary resuscitation (CPR) skills and correct errors to ensure high-quality performance. This study aimed to investigate certified BLS instructors' assessments of CPR skills.

METHODS

Data were collected at BLS courses for medical students at Aarhus University, Aarhus, Denmark. Two certified BLS instructors evaluated each learner with a cardiac arrest test scenario, where learners demonstrated CPR on a resuscitation manikin for 3.5 minutes. Instructors' assessments were compared with manikin data as reference for correct performance. The first 3 CPR cycles were analyzed. Correct chest compressions were defined as 2 or more of 3 CPR cycles with 30 ± 2 chest compressions, 50 to 60 mm depth, and 100 to 120 min rate. Correct rescue breaths were defined as 50% or more efficient breaths with visible, but not excessive manikin chest inflation (for instructors) or 500 to 600mL air (manikin data).

RESULTS

Overall, 90 CPR assessments were performed by 16 instructor pairs. Instructors passed 81 (90%) learners, whereas manikin pass rate was 2%. Instructors identified correct chest compressions with a sensitivity of 0.96 [95% confidence interval (CI) = 0.79-1) and a specificity of 0.05 (95% CI = 0.01-0.14), as well as correct rescue breaths with a sensitivity of 1 (95% CI = 0.40-1) and a specificity of 0.07 (95% CI = 0.03-0.15). Instructors mistakenly failed 1 learner with adequate chest compression depth, while passing 53 (59%) learners with improper depth. Moreover, 80 (89%) improper rescue breath performances were not identified.

CONCLUSIONS

Certified BLS instructors assess CPR skills poorly. Particularly, improper chest compression depth and rescue breaths are not identified.

Comparison of peer assessment and faculty assessment in an interprofessional simulation-based team training program

Challenges related to limited clinical sites and shortage of clinical instructors may reduce the quality of clinical experiences, leading to increased demand for the establishment of simulation-based training programs in the curricula of educational institutions. However, simulation-based training programs in health education place great demands on faculty resources. It is interesting, therefore, to investigate peers contributions in formal assessment, and how this compares to faculty assessment. This paper report the results from the comparison of direct observation by peer observers who had received short rater training, and post-hoc video-based assessment by trained facilitators. An observation form with six learning outcomes was used to rate team performance. Altogether 262 postgraduate nursing students, bachelor of nursing students and medical students participated, organized into 44 interprofessional teams. A total of 84 peers and two facilitators rated team performance. The sum score of all six learning outcomes showed that facilitators were more lenient than peer observers (p = .014). The inter-rater reliability varied considerably when comparing scores from peer observers from the three different professions with those of the facilitators. The results indicate that peer assessment may support, but not replace, faculty assessment.

Peer teacher training for health professional students: a systematic review of formal programs

BACKGROUND

Skills in peer teaching, assessment and feedback are documented internationally as required graduate attributes for health professional students, placing emphasis on universities to prepare health professional graduates with teaching skills. The aim of this systematic review was to determine the rational, design, content and evaluation of student peer teacher training skills programs across the health professions.

METHODS

In October 2017, a search was conducted of five databases (Pubmed, Embase, CINAHL, ERIC and Cochrane Collection) using combinations of key search terms: 'Student as teacher', 'near-peer teaching', 'student teacher', 'peer teacher', 'peer-to-peer', 'undergraduate', 'medical education', 'curriculum', 'program', 'training', 'allied health', 'health science', 'pharmacy', 'nurse', and 'medicine', with results restricted to articles published in English within the decade. Articles were excluded if they were not original research, focused on a teaching approach other than peer assisted learning or teaching, did not adequately describe a student teacher training component of at least 3 hrs duration, or addressed only clinical skills training and not teaching skills training.

RESULTS

The two authors independently assessed 42 full-text articles for eligibility, with 19 articles satisfying criteria for inclusion. Dominating results were uni-disciplinary, faculty-led, non-mandated programs, targeting participants in senior years of training. Medicine was the dominant profession, with an obvious underrepresentation of the other health professions. Common program content included the foundations of education theory, teaching methods and techniques, and providing feedback. Summary and comparison of program design is restricted by gaps and inconsistencies in reporting, while the evaluation of programs remains largely subjective.

CONCLUSIONS

Teaching is increasingly recognised as a core professional skill across the health workforce, with expectations to teach peers and colleagues, within and across professional disciplines, as well as to educate patients. Students, faculty and institutes may benefit from training programs being designed for implementation in any health profession; and further to this, implemented within an interprofessionally context. Consistent reporting of teacher training programs, and objective methods of evaluation would enable more in-depth investigation.

Peer Feedback on Collaborative Learning Activities in Veterinary Education

Collaborative learning activities are an increasingly prominent feature of veterinary curricula that have been redesigned to achieve competency-based graduate learning outcomes. This evolution challenges the traditional individualistic approach to veterinary education and necessitates revisions to assessment and feedback practices to ensure constructive alignment. Peer feedback has been widely reported in the medical education literature as a teaching intervention in collaborative learning settings, with learning gains reported for students who receive and provide peer feedback. In this setting, peer feedback has been demonstrated to provide valuable formative feedback on professional behaviors and skills. However, there are very few such reports in the veterinary education literature to date. Barriers to the introduction of this approach can include teacher and student perceptions, and concerns around validity and reliability. This review aimed to provide an overview of current evidence regarding peer feedback on collaborative learning activities in higher education, and to explore opportunities and challenges for the introduction of peer feedback in the context of veterinary education. We contend that early and repeated provision of formative peer feedback can provide an opportunity to scaffold the development of crucial core competencies within veterinary education, including the self-regulated learning skills required to work in collaborative teams, and interpret and act on feedback.

Basic life support and external defibrillation competences after instruction and at 6 months comparing face-to-face and blended training. Randomised trial

AIM OF THE STUDY

The objective of this study was to compare the immediate and 6-month efficacy of basic life support (BLS) and automatic external defibrillation (AED) training using standard or blended methods.

METHODS

First-year students of medicine and nursing (n = 129) were randomly assigned to a control group (face-to-face training based on the European Resuscitation Council [ERC] Guidelines) or to an experimental group that trained with a self-training video, a new website, a Moodle platform, an intelligent manikin, and 45 min of instructor presence. Both groups were homogeneous and were evaluated identically. Theoretical knowledge was evaluated using a multi-choice questionnaire (MCQ). Skill performance was evaluated by the instructor's rubric and on a high-fidelity Resusci Anne QCPR manikin.

RESULTS

Immediately after the course, there were no statistically significant differences in knowledge between the two groups. The median score of practical evaluation assessed by the instructor was significantly better in the experimental group (8.15, SD 0.93 vs 7.7, SD 1.18; P = 0.02). No differences between groups were found when using a high-fidelity manikin to evaluate chest compressions and lung inflations. At six months, the scores in knowledge and skill performance were significantly lower compared to the evaluations at the end of the instruction, but they remained still higher compared to baseline. The experimental group had higher scores in practical skills evaluated by the instructor than the control group (7.44, SD 1.85 vs 6.10, SD 2.6; P = 0.01).

CONCLUSIONS

The blended method provides the same or even higher levels of knowledge and skills than standard instruction both immediately after the course and six months later.

Peer-assisted learning (PAL) in undergraduate medical education: An overview

Peer-assisted learning (PAL) has a long tradition and is nowadays implemented in the curricula of most medical faculties. Besides traditional areas of application like problem-based learning, anatomy, or CPR, more and more departments and institutes have established PAL as part of their everyday teaching. This narrative review provides some background information and basic definitions of PAL. It offers an overview on features and determinants as well as underlying learning theories and developments in PAL. In addition, motives for implementation are highlighted followed by a comparison of advantages and disadvantages. After outlining aspects of quality management including the training of tutors and the evaluation and acceptance of PAL formats, this review concludes with an outlook on how PAL can proceed into the future and where further research is necessary.

Analyses of inter-rater reliability between professionals, medical students and trained school children as assessors of basic life support skills

BACKGROUND

Training of lay-rescuers is essential to improve survival-rates after cardiac arrest. Multiple campaigns emphasise the importance of basic life support (BLS) training for school children. Trainings require a valid assessment to give feedback to school children and to compare the outcomes of different training formats. Considering these requirements, we developed an assessment of BLS skills using MiniAnne and tested the inter-rater reliability between professionals, medical students and trained school children as assessors.

METHODS

Fifteen professional assessors, 10 medical students and 111-trained school children (peers) assessed 1087 school children at the end of a CPR-training event using the new assessment format. Analyses of inter-rater reliability (intraclass correlation coefficient; ICC) were performed.

RESULTS

Overall inter-rater reliability of the summative assessment was high (ICC = 0.84, 95 %-CI: 0.84 to 0.86, n = 889). The number of comparisons between peer-peer assessors (n = 303), peer-professional assessors (n = 339), and peer-student assessors (n = 191) was adequate to demonstrate high inter-rater reliability between peer- and professional-assessors (ICC: 0.76), peer- and student-assessors (ICC: 0.88) and peer- and other peer-assessors (ICC: 0.91). Systematic variation in rating of specific items was observed for three items between professional- and peer-assessors.

CONCLUSION

Using this assessment and integrating peers and medical students as assessors gives the opportunity to assess hands-on skills of school children with high reliability.

Incorporating Peer Assessments within a Clinical Practicum Course: Insights from a Clinical Faculty Initiative

INTRODUCTION

Peer assessments have been used within health professional programs to provide some degree of judgment of professional behavior and to facilitate feedback among peers. In an attempt to further support the clinical learning of our students, the clinical education team at the Odette Cancer Centre initiated a pilot to introduce peer assessments as a part of strategies for learning and engagement within laboratory sessions. The aim of our work was to retrospectively review peer assessments completed during these sessions in an attempt to identify professional behaviors, both positive and negative, and subsequently correlate the assessments with observed behaviors noted, both formally and anecdotally, within clinical faculty assessments. Further to this, our team attempted to explore student perceptions on the impact of peer assessments to their own learning.

METHODS

Students in the final year of a 3-year undergraduate medical radiation sciences program were asked to assess their peers during laboratory sessions using a modified version of an assessment tool previously known to the students, the Assessment of Readiness for Clinical tool. Students (N = 14) were required to evaluate each of their peers who participated in the same session and provide supporting comments for their rating. For each student, responses from peer assessors were anonymized and collated. Comments and numerical ratings on the peer assessments were compared. The student assessments were subsequently compared with similar measures extracted from faculty assessments. Students also participated in a debriefing session to provide feedback regarding the integration of these assessments within the learning sessions and the potential impact they had on their own professional behaviors.

RESULTS

The majority of students rated their peers in all criteria at a score of 2 (performed or surpassed expectations). There was some correlation between numerical ratings and comments written in the assessments. Comments on peer assessments were in concordance with observations extracted from previous assessments by clinical faculty and teachers for 71% of the students. Students expressed a favorable attitude toward the use of the peer assessments but did not find the numerical ratings useful and instead valued supporting constructive comments that cited specific examples for improvement.

CONCLUSIONS

Peer assessments were found to be of some benefit to the learning of our students, particularly the anecdotal supporting comments that accompanied the ratings. However, their use must be accompanied by formalized training and guidelines to teachers and learners as well as a careful consideration of the tool chosen to ensure the most purposeful impact on behavior change.

Medical students as peer tutors: a systematic review

BACKGROUND

While Peer Assisted Learning (PAL) has long occurred informally in medical education, in the past ten years, there has been increasing international interest in formally organised PAL, with many benefits for both the students and institutions. We conducted a systematic review of the literature to establish why and how PAL has been implemented, focussing on the recruitment and training process for peer tutors, the benefits for peer tutors, and the competency of peer tutors.

METHOD

A literature search was conducted in three electronic databases. Selection of titles and abstracts were made based on pre-determined eligibility criteria. We utilized the 'AMEE Peer assisted learning: a planning and implementation framework: AMEE Guide no. 30' to assist us in establishing the review aims in a systematic review of the literature between 2002 and 2012. Six key questions were developed and used in our analysis of particular aspects of PAL programs within medical degree programs.

RESULTS

We found nineteen articles that satisfied our inclusion criteria. The PAL activities fell into three broad categories of teacher training, peer teaching and peer assessment. Variability was found in the reporting of tutor recruitment and training processes, tutor outcomes, and tutor competencies.

CONCLUSION

Results from this review suggest that there are many perceived learning benefits for student tutors. However, there were mixed results regarding the accuracy of peer assessment and feedback, and no substantial evidence to conclude that participation as a peer tutor improves one's own examination performance. Further research into PAL in medicine is required if we are to better understand the relative impact and benefits for student tutors.

Comparison of the quality of basic life support provided by rescuers trained using the 2005 or 2010 ERC guidelines

INTRODUCTION

Effective delivery of cardiopulmonary resuscitation (CPR) and prompt defibrillation following sudden cardiac arrest (SCA) is vital. Updated guidelines for adult basic life support (BLS) were published in 2010 by the European Resuscitation Council (ERC) in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines.

METHODS

We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course.

RESULTS

We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p < 0.05), reflecting a significantly greater proportion of lay-rescuers performing chest compressions at too fast a rate when trained and assessed with the 2010 rather than 2005 guidelines (6.04% vs. 2.67%; p < 0.05). Error rates for other skills did not differ between guideline groups.

CONCLUSIONS

The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate.

Peer-led training and assessment in basic life support for healthcare students: synthesis of literature review and fifteen years practical experience

BACKGROUND

In 1995, the University of Birmingham, UK, School of Medicine and Dentistry replaced lecture-based basic life support (BLS) teaching with a peer-led, practical programme. We present our 15-yr experience of peer-led healthcare undergraduate training and examination with a literature review.

METHODS

A literature review of healthcare undergraduate peer-led practical skills teaching was performed though Pubmed. The development of the Birmingham course is described, from its inception in 1995-2011. Training methods include peer-led training and assessment by senior students who complete an European Resuscitation Council-endorsed instructor course. Student assessors additionally undergo training in assessment and communication skills. The course has been developed by parallel research evaluation and peer-reviewed publication. Course administration is by an experienced student committee with senior clinician support. Anonymous feedback from the most recent courses and the current annual pass rates are reported.

RESULTS

The literature review identified 369 publications of which 28 met our criteria for inclusion. Largely descriptive, these are highly positive about peer involvement in practical skills teaching using similar, albeit smaller, courses to that described below. Currently approximately 600 first year healthcare undergraduates complete the Birmingham course; participant numbers increase annually. Successful completion is mandatory for students to proceed to the second year of studies. First attempt pass rate is 86%, and close to 100% (565/566 students, 99.8%) following re-assessment the same day. 97% of participants enjoyed the course, 99% preferred peer-tutors to clinicians, 99% perceived teaching quality as "good" or "excellent", and felt they had sufficient practice. Course organisation was rated "good" or "excellent" by 91%. Each year 3-4 student projects have been published or presented internationally. The annual cost of providing the course is currently £15,594.70 (Eur 18,410), or approximately £26 (Eur 30) per student.

CONCLUSIONS

This large scale, peer-led BLS course demonstrates that such programmes can have excellent outcomes with outstanding participant satisfaction. Peer-tutors and assessors are competent, more available and less costly than clinical staff. Student instructors develop skills in teaching, assessment and appraisal, organisation and research. Sustainability is possible given succession-planning and consistent leadership.

The analysis of self and tutor assessment in the skill of basic life support (BLS) and endotracheal intubation: focused on the discrepancy in assessment

INTRODUCTION

This paper reports the results of a study of fourth year medical students that assessed whether assessments of basic life support (BLS) and intubation performance differ when assessed by the students themselves or by tutors. This information should be helpful for designing the contents of a complementary education core.

METHODS

Tutor assessments and student-assessments were conducted using a checklist and a fivepoint rating scale, and then compared. For the two skill performance tests, Resusci(®) Anne SkillGuide™ and Laerdal(®) Airway Management Trainer (Laerdal, Norway) devices were used. The check-lists used to evaluate students were based on International Liasion Committee on Resuscitation (ILCOR) guidelines and Korean Emergency Airway Management Society (KEAMS) tutor guidelines.

RESULTS

A total of 83 medical students participated in the study, intra-class correlation coefficient between tutor and student assessment were 0.542 (95% CI 0.371-0.678) in BLS and 0.693 (0.538-0.802). There were also no significant differences between self-assessments and tutor assessments based on the five-point. In BLS skill session, we found out that "maintenance of airway" and "palpating a carotid pulse" were the mostly missed parts. In the intubation skill, omitting the parts of 'securing the airway' while preparing for intubation, proper positioning of blade tip in the valleculae, and appropriate insertion of endotracheal tube were demonstrated.

CONCLUSION

We observed correlations between student self-assessments and tutor assessments for both BLS and intubation. Analyzing the discrepancies between self-assessment and tutor assessment will be helpful in focusing training on the steps that were omitted by students or during which students demonstrated incompetence.

Reliability and validity of student peer assessment in medical education: a systematic review

BACKGROUND

Peer assessment has been demonstrated to be an effective educational intervention for health science students.

AIMS

This study aims to give an overview of all instruments or questionnaires for peer assessments used in medical and allied health professional educational settings and their psychometric characteristics as described in literature.

METHODS

A systematic literature search was carried out using the electronic databases Pubmed, Embase, ERIC, PsycINFO and Web of Science, including all available inclusion dates up to May 2010.

RESULTS

Out of 2899 hits, 28 studies were included, describing 22 different instruments for peer assessment in mainly medical educational settings. Although most studies considered professional behaviour as a main subject of assessment and described peer assessment usually as an assessment tool, great diversity was found in educational settings and application of peer assessment, dimensions or constructs as well as number of items and scoring system per questionnaire, and in psychometric characteristics.

CONCLUSIONS

Although quite a few instruments of peer assessment have been identified, many questionnaires did not provide sufficient psychometric data. Still, the final choice of an instrument for educational purposes can only be justified by its sufficient reliability and validity as well as the discriminative and evaluative purposes of the assessment.

Comparison of the errors in basic life support performance after training using the 2000 and 2005 ERC guidelines

The importance of immediate cardiopulmonary resuscitation (CPR) and defibrillation after cardiac arrest is established. The 2005 European Resuscitation Council (ERC) guidelines were altered to try to improve survival after cardiac arrest. This observational study compares the errors in basic life support (BLS) performance after training using the 2000 or 2005 guidelines. First-year healthcare students at the University of Birmingham, United Kingdom, were taught adult BLS in a standardised 8-h course: an historical group with previous ERC guidelines (Old), the other with 2005 ERC guidelines (New). 2537 (Old 1773; New 764) students were trained and assessed in BLS. There was no difference in overall error rate between Old and New (5.53% vs. 6.70% (p>0.05)) or adherence to the sequence of the respective BLS algorithm. The New group ("hands in centre of the chest") had significantly more erroneous hand positions compared to the Old group (5.23% vs. 1.64%, p<0.001). The 2005 ERC guidelines do not significantly improve correct BLS performance. Removal of hand placement measurement results in a significant increase in hand position errors. The clinical benefit of an increased number of compressions impaired by worsened hand positioning is unknown and requires further study.