A systematic review of peer teaching and learning in clinical education

Unpacking the perceptions and experiences of student facilitators in interprofessional education: a qualitative study

Enhancing health professional students' effective learning and collaborative practice requires a deep understanding of strategies for facilitating interprofessional learning. While faculty members and clinical preceptors are recognized as facilitators in interprofessional education (IPE), there is limited knowledge about the impact of student facilitators' engagement in IPE. Accordingly, this study aims to explore the perceptions and experiences of student facilitators in IPE. Thirteen student facilitators were recruited to lead an interprofessional learning program, and they were subsequently invited to participate in one-on-one interviews. An interview guide was developed to explore their motivations, expectations, engagement, effectiveness, and achievements in IPE facilitation. Thematic analysis was conducted using MAXQDA software to analyze the student facilitators' experiences and perceptions. Eight interviewees from various disciplines, including Medicine, Nursing, Pharmacy, Speech and Hearing Sciences, and Social Work, took part in the study. The findings revealed that student facilitators highly valued their IPE facilitation experience, which aligned with their expectations and led to the creation of social networks, increased confidence, improved understanding of other professions, and the development of lifelong skills. Furthermore, the student facilitators demonstrated cognitive and social congruence by establishing a relaxed learning environment, displaying empathetic and supportive behaviors, and using inclusive language to engage IPE learners in group discussions. This study provides a comprehensive understanding of the role of student facilitators in IPE, contributing to the evolving literature on IPE. A conceptual framework was developed to explore the entire facilitation experience, encompassing the motivations and expectations of student facilitators, their engagement and effectiveness, and the observed achievements. These findings can inform the development of peer teaching training in IPE and stimulate further research in identifying relevant facilitator competencies for optimal delivery of IPE.

How does training format and clinical education model impact fidelity and confidence in a speech-language pathology rotation?

Clinical education rotations typically involve an initial training phase followed by supervised clinical practice. However, little research has explored the separate contributions of each component to the development of student confidence and treatment fidelity. The dual purpose of this study was to compare the impact of clinical training format (synchronous vs. asynchronous) and education model (traditional vs. collaborative) on student confidence and treatment fidelity. Thirty-six speech-language pathology graduate students completed this two-phase study during a one-term clinical rotation. Phase 1 investigated the impact of training condition (synchronous, asynchronous guided, asynchronous unguided) on student confidence and treatment fidelity. Phase 2 explored the impact of education model (traditional vs. collaborative) on student confidence and treatment fidelity. Treatment fidelity was measured at the conclusion of Phases 1 and 2. Students rated their confidence at six-time points throughout the study. Our results indicate that training condition did not differentially impact student confidence or treatment fidelity; however, education model did: students in the collaborative education model reported increased confidence compared to students in the traditional education model. Students in the collaborative education model also trended towards having higher treatment fidelity than students in the traditional education model. These results demonstrate that pre-clinical trainings can be effective in several different formats provided they cover the discrete skills needed for the clinical rotation. While preliminary, our results further suggest that students may benefit from working with peers during their clinical rotations.

The effectiveness of interprofessional peer-led teaching and learning for therapeutic radiography students and Speech and Language Therapy students

BACKGROUND

Therapeutic Radiographers (RT) and Speech and Language Therapists (SLT) work closely together in caring for people with head and neck cancer and need a strong understanding of each others' roles. Peer teaching has been shown to be one of the most effective methods of teaching; however, no studies to date, have involved RT and SLT students. This research aims to establish the effectiveness and perceptions of peer-led teaching between undergraduate RT and SLT students in Ulster University.

METHODS

Twenty SLT students and 14 RT students participated. Knowledge tests were taken online before the peer-led teaching session (T1), after the session (T2) and 3 months later (T3). Students' perceptions of the experience were collected at the end of the session. Wilcoxon signed-rank tests were used to analyse the impact of the intervention on knowledge scores. Qualitative content analysis was used for open text response data.

RESULTS

RT students' own professional knowledge score at T2 was statistically significantly higher than the score at T1; the score at T3 was not deemed to be statistically significantly higher. RT students' SLT knowledge score at T2 and T3 was found to be statistically significantly higher than the score at T1. SLT students' own professional knowledge score was not statistically significantly higher at T2 or T3 than T1. They did have a statistically significantly higher score at T2 on the RT test, but score at T3 was not deemed to be statistically significantly higher. The majority of students across both professions agreed or strongly agreed that the peer-led teaching experience had a positive impact on their learning.

CONCLUSION

This investigation highlights the benefits of an interprofessional peer-led teaching intervention for RT and SLT students and the findings add to the evidence of more objective study of knowledge gain as a result of interprofessional peer teaching.

Student Perceptions of Simulation to Enhance Clinical Readiness for Assessment and Management of Adults With Voice Disorders

BACKGROUND

Simulation is a safe, supported, and accessible learning method for students to gain skills and experience, especially in difficult to access range of practice areas such as voice.

OBJECTIVE

The study aimed to explore change in students' perceptions of knowledge, confidence, anxiety, and clinical readiness for assessment and management of an adult with a voice disorder after participation in simulation-based learning activities.

METHODS

Participants (N = 113) were students enrolled in a mandatory course dedicated to the voice and voice disorders. Students completed 32 hours of academic coursework which included lectures and tutorials and two 30-minute simulation-based learning activities with a standardized patient playing the role of an adult with a voice disorder. The impact of the simulation-based learning activities on student perceptions of their knowledge, confidence, anxiety, and clinical readiness for work within the area of voice were surveyed at three time points: (1) pre lectures, (2) post lectures but pre simulation, and (3) post simulation. Change across time was analyzed using repeated measures analysis of variance with post hoc Bonferroni adjustment.

RESULTS

All students perceived significant (P ≤ 0.001) positive changes in knowledge and confidence across time points for all activities, except for writing an assessment report. Anxiety related to the management of a client with a voice disorder fluctuated significantly (P ≤ 0.001) throughout the program. Overall, the majority (>90%) of students agreed or strongly agreed that the simulation-based learning activities were useful and helped them to develop clinical skills, apply content taught in lectures, and gain confidence and interest in voice.

CONCLUSION

This study supports incorporation of simulation-based learning as part of students' clinical preparation for the assessment and management of voice disorders.

The Student Grand Round: A Peer Teaching Initiative

Introduction Oral presentation and public speaking skills are poorly emphasised in the medical school curriculum. The student grand round was created to tackle this deficiency by changing the way in which students are taught, from traditional lecture-based learning to interactive small-group peer-to-peer teaching. This approach encourages students to become responsible for their own learning, develop their public speaking and teaching skills, as well as identify and address gaps in their knowledge. Aims The primary aims of this study were to determine the understanding of students before and after peer teaching, including retention of concepts via quiz scores and confidence of students in giving SBAR (Situation, Background, Assessment, Recommendation) handovers. The secondary aim is to determine the place of student-led grand round teaching in the medical curriculum as a means of developing teaching skills and encouraging active learning. Methods A cohort of 21 third-year medical students from Leicester University attended a weekly peer teaching programme where students presented a case they had encountered during their clinical attachment. Peer teachers were required to research some background and pathophysiology regarding the topic and teach in an interactive manner and create discussion regarding the topic. The students then summarised the case and practised the skill of concise handovers using the SBAR format. Knowledge and understanding were assessed with an interactive quiz, and feedback via a survey was gathered before and after sessions. Each student engaged in case discussion and received input from a specialty registrar regarding their presentation skills, case knowledge, and SBAR handover. Results Individual and combined session analysis demonstrated a significant improvement in scores across understanding the topic and confidence in SBAR. Student recommendation for the session cumulatively was significant (p=0.02); however, comparison of medical student recommendations of individual sessions did not yield statistically significant results. There was a significant improvement in the overall quiz score (p=0.045), and average scores improved from 51% to 70% (p=0.043). There was a significant increase in the mean quiz result after the first two sessions (28-55% (p=0.002) and 56-85% (p=0.0001), respectively). Summary The student grand round is a promising teaching initiative that capitalises on peer teaching, a valuable learning theory that centres around students taking on the role of teachers to instruct their peers. Results from this study have shown that this method of collaborative teaching is effective in improving the understanding of medical topics, increases confidence in public speaking and precise handover skills, and therefore better prepares medical students for their career as future clinicians.

Peer Assessment of Student Presentations: Key Takeaways and Lessons Learned

Background Students' presentations are a teaching-learning tool where students not only study and understand a topic but also teach their peers, thereby learning the art and skill of effective presentation. Aims The study aimed to evaluate peer assessments in students' presentations and find their role and application in improving presentation skills among students through feedback and course correction. Methods A group of students every week from a class of 125 was assigned a topic to present to the rest of their batch students who evaluated their presentation on a rubric shared via a Google Form link. The number of students who gave responses was noted. The responses were also shared with the presenters. The evaluator faculty moderated and discussed the areas for possible improvement and course correction. The students also filled out a feedback form on the entire exercise after presentations from the entire batch. Results The quality of students' presentation skills improved with subsequent students over the period. The students learned about their areas of improvement. Through the feedback form, students shared their reasons not to give a presentation. However, most of them found the exercise beneficial. Conclusions Peer assessment can be a credible mode for improving presentation skills with the active participation of other students and provide a learning method based on others' performances. Peer responses provide for self-evaluation and self-reflection. This type of survey among different institutions will identify students' flaws, help them improve and self-evaluate, and add to the current literature.

Redesigning nurse practitioner clinical education with a Dyad/POD model: A feasibility study

ABSTRACT

Clinical education for nurse practitioner (NP) students is increasingly challenging. With fewer preceptors, lack of resources and time burden, finding clinical placements is a burdensome responsibility. Also, when students have multiple preceptors, there may be inconsistencies when evaluating students. With the change to competency-based education, consistency is crucial when evaluating NP students. Typical preceptorship with students is a 1:1:1 ratio: one student with one preceptor for one semester. The Dyad/Precepting to Optimize Development (POD) model has potential to improve clinical precepting. Precepting to optimize development refers to a consistent team of students, preceptors, and faculty over the course of the students' education. Dyad refers to two students with one preceptor. Students rotate in dyad pairs every 4-8 weeks with a consistent group of preceptors, and see these same preceptors again over the course of their educational journey. Preceptors met monthly to collaborate, discuss, and learn. This article reports on the outcomes of a mixed-methods feasibility study that occurred over a year. The students, preceptors, and faculty report satisfaction with the model. Several themes arose during analysis of focus group sessions. Those themes were as follows: safe learning environment; everyone teaches, everyone learns; growth mindset; teaming culture and the POD structure is essential to the dyad. In conclusion, developing a different approach to precepting is essential to meet national provider needs. The Dyad/POD model provides consistency for development and evaluation of the NP student.

MUSIG: An Example Highlighting the Value of Student Led POCUS Education, Influenced by the COVID-19 Pandemic

There has been a recent push for more formal ultrasound teaching in medical school curricula. Faculty availability, however, presents a significant barrier to its implementation. Medical student interest groups such as the McGill Ultrasound Interest Group (MUSIG), aimed to address this barrier by using near-peer instruction (NPI) to teach ultrasound to other students. MUSIG has helped teach hundreds of students about the fundamentals of ultrasound and its applicability in clinical practice by creating ultrasound conferences, friendly ultrasound competitions, virtual lectures, and educational resources. This paper aims to use MUSIG as an example to highlight the important role students can play in changing the landscape of medical education.

Gathering Trainee Feedback to Improve Programs With Low Annual ACGME Survey Content Area Compliance: A Pilot Study

PROBLEM

Systematically investigating annual Accreditation Council for Graduate Medical Education (ACGME) Resident/Fellow Survey results by directly gathering trainee feedback could uncover training program problems and clarify misunderstandings as they arise, leading to faster corrective actions and program improvement.

APPROACH

The Focus Group Forum (FGF) was created based on the utilization-focused evaluation approach to systematically gather comprehensive, high-quality, actionable trainee feedback on specific annual ACGME survey results and involve trainees in program improvement (Henry Ford Hospital, 2021). Trainees from programs with survey results indicating <80% compliance within several content areas were invited to attend FGF sessions. During FGF sessions, neutral moderators experienced in conducting focus groups and creating psychologically safe spaces and neutral scribes gathered trainee feedback on survey results through structured, iterative discussions and an anonymous electronic polling system. Summaries of FGF findings were created, combined with actual annual ACGME survey data, and used to develop recommended corrective actions and monitoring plans.

OUTCOMES

In 2021, 6 training programs had survey results below the institution's compliance threshold for 4-8 of the 9 content areas. Of the 180 trainees (from the 6 programs) invited to attend an FGF session, 79 (44%) participated. Five key issues were identified: misinterpretation of several survey questions, lack of knowledge of institutional policies and procedures, perceived inability to share feedback with faculty, feelings of being overwhelmed with administrative duties, and lack of sufficient protected time for educational activities and requirements.

NEXT STEPS

The authors are developing an FGF process for faculty so that all stakeholders have a voice regarding annual ACGME survey results. They are also improving scheduling processes so that feedback from experienced trainees who are leaving the institution will not be missed and developing longer-term processes for tracking outcomes since time for implementing corrective actions before the next ACGME survey is limited.

Regional determinants of quality of care for sick children: A multilevel analysis in four countries

Background

The limited impact of increased access to care on improvements in health outcomes during the Millennium Development Goal era has been attributed, in part, to inadequate quality of care. We identified regional factors associated with health service quality for sick child care in low-income countries and examined whether provider factors interact with regional factors to affect the quality of care.

Methods

We conducted cross-sectional random intercept four-level linear regression using the most recent Service Provision Assessment and Demographic Health Survey data from four countries (467 from the Democratic Republic of Congo 2018, 2425 from Afghanistan 2018, 2072 from Nepal 2015, and 813 from Senegal 2017). The outcome variable was the service quality score for sick child care, which was measured as the percentage of clinically recommended tasks completed in the integrated management of childhood illness (ranging from 0 to 100). Regional factors were selected based on the High-Quality Health System Framework.

Results

The service quality score was found to be positively associated with the proportion of large facilities (β = 8.61; P = 0.004) and the proportion of providers ranked in the top fifth for service quality score (β = 30.15; P < 0.001) in the region. We identified significant cross-level interactions between provider qualifications (β = -16.6; P < 0.001) or job descriptions (β = 12.01; P = 0.002) and the proportion of providers in the top fifth for service quality scores within the region. As the proportion of top-performing providers in a region increased, the increase in the service quality score was more pronounced among providers who were nonmedical doctors or did not have job descriptions than among their counterparts.

Conclusions

Our findings indicate that the quality of care for sick children in a region improves with a greater proportion of high-performing providers or larger facilities. Providers who are not medical doctors, or those who have specific job descriptions, tend to benefit more from the presence of these top-performing providers.

Near-peer teaching in a psychomotor skills course: Benefits, challenges and solutions

INTRODUCTION

This study evaluates the perceptions and experiences of students in the role of near-peer teachers in a psychomotor skills course.

MATERIALS AND METHODS

Final year BDS students were invited to participate as near-peer teachers in a 4th-year conventional bridges course. Near-peer teachers attended eight sessions (3 h) of simulation laboratory teaching relating to conventional bridge tooth preparations and provided feedback on near-peer tooth preparations and answered their questions. Interviews were conducted with all near-peer teachers to evaluate their perceptions of this novel teaching and learning experience and a thematic analysis was performed to analyse the data.

RESULTS

Near-peer teachers reported this to be a rewarding, enjoyable and challenging experience. They benefited from learning and revising content-related materials as well as gained insights and teaching skills through the peer teaching process. Students felt supported and learned from peers and teaching staff and some used dyad teaching as a strategy to overcome perceived challenges. Students also reported the benefits of social and cognitive congruence in interacting with junior peers. However, students reported the feeling of inadequacy or lack of confidence and suggested the need for a training to prepare them better for the course.

CONCLUSION

This paper reports on the benefits as well as challenges perceived by near-peer teachers during simulation laboratory teaching experience. We provide solutions into how to better prepare students for such teaching experience.

Effectiveness of peer-assisted teaching of medical English skills to non-native English-speaking medical students

Background

Peer-assisted learning has been shown to be constructive in numerous aspects of undergraduate medical education. The purpose of this study was to evaluate the effectiveness of peer-assisted teaching of medical English skills to non-native English-speaking students.

Methods

A medical English conversation course was conducted at Damascus University by a group of students. Targeted participants were intermediate level fellow students from the same program. A longitudinal study was carried out between 1 st to 31 st March 2019 to assess changes in self-assessment of English language skills among course participants. Pre- and post-course appraisal involved a review of previous experience with medical English language, a self-assessment of five English language skills, and an objective measurement of medical English knowledge. In addition, participants were requested to respond to a set of statements related to the importance and the usefulness of peer-assisted teaching of medical English skills. Paired-sample Student t-test was used to compare pre- and post-course appraisal results.

Results

42 students attended the course and completed pre- and post-course appraisals in full. Data analyses showed a statistically significant increase in participants' confidence in speaking medical English in public ( p<0.001) and using English in various medical settings (presenting and discussing cases, writing clinical reports, interviewing patients and reading English medical texts). Objective measurements of medical English knowledge confirmed a significant increase in participants' knowledge of methods of administration of therapeutics, knowledge of human body parts in English and familiarity with English medical abbreviations. Most participants agreed that peer-education was effective in teaching medical English skills to non-native English-speaking students and in increasing their confidence when using English in real-life medical scenarios.

Conclusions

The present study highlights the effectiveness of peer-assisted teaching of medical English skills to non-native English-speaking medical students. Further validation is required and should compare the effectiveness of traditional versus peer-assisted teaching approaches.

Near-Peer Teaching Opportunities Influence Professional Identity Formation as Educators in Future Clinicians

Teaching is a key role of a physician. Despite this, medical students are rarely exposed to the necessary skills and techniques throughout the duration of their education to prepare them for this component of their training. The gross anatomy lab provides a safe environment for students serving as near-peer educators to teach and learn to manage unexpected and uncomfortable situations. Students acting in near-peer teaching roles see a range of benefits from addressing personal weaknesses to improving communication skills and enhancing their anatomy and clinical knowledge, but there remains a lack of insight on how these experiences shape students' professional identity. This study examined how the professional identities of second-year medical students are shaped by serving as peer educators (PEs) in a gross anatomy laboratory. Gross anatomy PEs from the 2022 and 2025 cohorts recorded audio diary reflections at the end of each week they served as a PE highlighting how this role impacted how they view themselves as future physicians. Audio diary recordings were transcribed verbatim and analyzed using the framework method which includes familiarization, code application, and interpretation. A total of 26 audio diaries averaging 4 min in length were recorded across 11 PEs. Themes included Balancing Workload, Role of a Near Peer, Learning to Communicate, Learning to Collaborate, and Learning through Teaching. Students recognized that in addition to reinforcing their didactic training, serving as a peer educator in the gross anatomy lab helped them build skills necessary to fulfil their future role as a physician educator.

Interprofessional peer assisted learning: Paramedic students learning falls assessments from Occupational Therapy students

Peer-assisted learning (PAL) describes a program in which students learn from students from the same health discipline. This teaching method has gained significant momentum over the past decade as an effective learning strategy for undergraduate healthcare students. Paramedic programs are increasingly utilizing PAL, however there is a scarcity of literature about interprofessional PAL, particularly between Paramedics and allied health students. This project was an evaluation of a pilot educational intervention involving final year undergraduate paramedic students. Occupational Therapy (OT) peer instructors facilitated a session on falls' risk assessments during a scheduled undergraduate Paramedic practical class. The OT peer instructors discussed pertinent considerations for Paramedics attending to elderly patients who have fallen, and then provided direct feedback to the Paramedic students during a case simulation. At the conclusion of the session, Paramedic students completed a survey evaluating their reaction to and learning from the teaching session. Results indicated that interprofessional PAL can improve undergraduate paramedic students' knowledge and confidence in performing a new skill that is well understood by another allied health profession. This adds to the body of empirical research on interprofessional PAL and supports its inclusion as a teaching modality into undergraduate healthcare programs such as Paramedicine.

Peer education model in Trakya university faculty of medicine

BACKGROUND

Peer education is an education model applied to change knowledge, behavior, and attitude in groups equal to each other regarding age, education, and status. This model is preferred in universities to improve teaching skills and reduce the stress level of students. This study aims to apply the peer education model at Trakya University Faculty of Medicine to receive feedback from students and to examine its effect on exam results.

METHODS

This cross-sectional, descriptive, and analytical study was conducted with second-year medical students in parasitology laboratory lessons. Eighteen out of a total of 264 students were selected as peer educators. Peer educators have reached the level of providing education to students by taking the training before the laboratory lessons. At the end of the study, questionnaires were applied to peer educators and students. The students' of 2021-2022 exam results were compared with the 2018-2019 academic year results.

RESULTS

A total of 233 students were surveyed, and 78.5% (183/233) of them believe peer education is helpful, 69.9% (163/233) think it can help them reinforce what they have learned in theoretical lessons, 54.5% (127/233) think it should be used in other practical lessons, and 64.3% think it should be used in the coming years. While there was no significant difference between the exam results of the students in 2021-2022 and the 2018-2019 period (p: 0.462), a significant difference was found between the exam results of peer educators and students (p < 0.05).

CONCLUSIONS

It is known that with the peer education model, student stress will decrease, and interest and participation in the lesson will increase. Continuing this education model in the coming years and expanding it to other laboratory courses will benefit medical education.

Methods to teach schoolchildren how to perform and retain cardiopulmonary resuscitation (CPR) skills: A systematic review and meta-analysis

Background

Worldwide, bystander CPR rates are low; one effective way to increase these rates is to train schoolchildren; however, the most effective way to train them is currently unknown.

Methods

This systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies, evaluated whether CPR training for schoolchildren, using innovative teaching modalities (nonpractical, self, or peer-training) versus standard instructor-led training, resulted in higher quality CPR, self-confidence and short-term (≤3 months post-training) or long-term (>3 months post-training) retention of CPR skills.

Results

From 9793 citations, 96 studies published between 1975 and 2022 (44 RCTs and 52 before/after studies) were included. There were 43,754 students, average age of 11.5 ± 0.9 (range 5.9-17.6) and 49.2% male. Only 13 RCTs compared practical vs. nonpractical training (n = 5), self- vs. instructor-led training (n = 7) or peer- vs. instructor-led training (n = 5). The observed statistically significant differences in mean depth and rate of compressions between children with hands-on practical training and those without were not clinically relevant. Regardless of training modality, compression depth was consistently suboptimal. No differences were observed in CPR skills immediately or ≤ 3 months post-training, between children who were self- or peer-trained vs. instructor-led. Due to lack of data, we were unable to evaluate the impact of these novel training modalities on student self-confidence.

Conclusion

Although innovative training modalities are equally effective to instructor-led training when teaching schoolchildren CPR, compression depth was frequently suboptimal. Recommendations on standardized training and evaluation methods are necessary to understand the best ways to train children.

How radiography educators teach the concept of caring to undergraduate radiography students

INTRODUCTION

Caring is a key part of a radiographers work and the education of student radiographers. Despite recent literature highlighting the importance of putting the patient at the centre of care and being caring, research describing the educational approaches used by radiography educators to facilitate the teaching of caring is lacking. The aim of this paper is to explore the teaching and learning strategies used by radiography educators to facilitate the development of caring in students.

METHODS

A qualitative, exploratory research design was used. Purposive sampling was used to select radiography educators (n = 9). This was followed by quota sampling to ensure all four radiography disciplines, namely diagnostic radiography, diagnostic ultrasound, nuclear medicine technology and radiation therapy were represented in the sample. Data was analysed thematically and themes were identified.

RESULTS

The findings indicated that radiography educators use teaching strategies such as peer role play, learning through observation and role modelling to facilitate teaching and learning of caring.

CONCLUSION

The study suggested that although radiography educators know the teaching strategies that facilitate caring, aspects such as clarification of professional values and the refinement of reflection seems to be lacking.

IMPLICATIONS FOR PRACTICE

The teaching and learning approaches that can assist students in developing as caring radiographers can add to the evidence-based pedagogies that shape the teaching of caring in the profession.

Shadow Coaching Improves Patient Experience for English-Preferring Patients but not for Spanish-Preferring Patients

BACKGROUND

Shadow coaching, a type of one-on-one provider counseling by trained peers, is an effective strategy for improving provider behaviors and patient interactions, but its effects on improving patient experience for English- and Spanish-preferring patients is unknown.

OBJECTIVE

Assess effects of shadow coaching on patient experience for English- and for Spanish-preferring patients.

DESIGN

We analyzed 2012-2019 Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) data (n=46,089) from an urban Federally Qualified Health Center with 44 primary care practices and 320 providers. One-third (n=14,631) were Spanish-preferring patients. We fit mixed-effects regression models with random effects for provider (the level of treatment assignment) and fixed effects for time (a linear spline for time with a knot and "jump" at coaching date), patient characteristics, and site indicators, stratified by preferred language.

PARTICIPANTS

The 74 providers who had a 6-month average top-box score on the CAHPS overall provider rating below 90 (on a 100-point scale) were shadow coached. Similar percentages of English-preferring (45%) and Spanish-preferring patients (43%) were seen by coached providers.

INTERVENTION

Trained providers observed patient care by colleagues and provided suggestions for improvement. Verbal feedback was provided immediately after the observation and the participant received a written report summarizing the comments and recommendations from the coaching session.

MAIN MEASURES

CG-CAHPS Visit Survey 2.0 provider communication composite and overall provider rating (0-100 scoring).

KEY RESULTS

We found a statistically significant 2-point (small) jump in CAHPS provider communication and overall provider rating among English-preferring patients of coached providers. There was no evidence of a coaching effect on patient experience for Spanish-preferring patients.

CONCLUSIONS

Coaching improved care experiences for English-preferring patients but may not have improved patient experience for Spanish-preferring patients. Selection and training of providers to communicate effectively with Spanish-preferring patients is needed to extend the benefits of shadow coaching to Spanish-preferring patients.

What does high value care for musculoskeletal conditions mean and how do you apply it in practice? A consensus statement from a research network of physiotherapists in New South Wales, Australia

OBJECTIVES

To develop a physiotherapist-led consensus statement on the definition and provision of high-value care for people with musculoskeletal conditions.

DESIGN

We performed a three-stage study using Research And Development/University of California Los Angeles Appropriateness Method methodology. We reviewed evidence about current definitions through a rapid literature review and then performed a survey and interviews with network members to gather consensus. Consensus was finalised in a face-to-face meeting.

SETTING

Australian primary care.

PARTICIPANTS

Registered physiotherapists who are members of a practice-based research network (n=31).

RESULTS

The rapid review revealed two definitions, four domains of high value care and seven themes of high-quality care. Online survey responses (n=26) and interviews (n=9) generated two additional high-quality care themes, a definition of low-value care, and 21 statements on the application of high value care. Consensus was reached for three working definitions (high value, high-quality and low value care), a final model of four high value care domains (high-quality care, patient values, cost-effectiveness, reducing waste), nine high-quality care themes and 15 statements on application.

CONCLUSION

High value care for musculoskeletal conditions delivers most value for the patient, and the clinical benefits outweigh the costs to the individual or system providing the care. High-quality care is evidence based, effective and safe care that is patient-centred, consistent, accountable, timely, equitable and allows easy interaction with healthcare providers and healthcare systems.

Virtual Clinics: A Student-Led, Problem-Based Learning Approach to Supplement Veterinary Clinical Experiences

The COVID-19 pandemic created an abrupt need for effective remote clinical experiences for senior clinical veterinary students. Subsequently, the authors created virtual clinics. This activity was derived from a problem-based learning (PBL) model wherein students designed clinical cases and participated through virtual role play as clients and clinicians. The purpose of this article is to describe virtual clinics and to report data from focus groups of participating students and faculty facilitators from two institutions regarding the positive and negative aspects of the shift in practice. A few common emerging themes included that case rounds were fun and engaging, students could learn at their own pace, and peer-to-peer learning opportunities had perceived value. Themes are reflected against the pedagogical literature to draw out areas that resonated. Students felt this activity was more engaging than listening to a discussion of a case they had no ownership of, and facilitators agreed that the peer-to-peer interactions added to student engagement. Additionally, students developed deeper knowledge about the underlying disease process and clinical presentation of their case, which required independent and self-directed learning, enabling students to think about a case from a client's perspective. By participating in these activities, students developed skills of classroom-to-clinic transitional value. While virtual clinics should not replace in-person clinical experiences, this activity might be useful to facilitate students' transition from a structured classroom setting to a less-structured clinical experience.

Impact of a near-peer teaching program within a college of pharmacy on interest in mentoring roles

BACKGROUND AND PURPOSE

Near-peer teaching within healthcare education has numerous benefits, but there is limited literature to assess the impact that these experiences have on skill development and future teaching roles. This study describes the impact of serving as a near-peer teaching assistant on both former and current pharmacy students.

EDUCATIONAL ACTIVITY AND SETTING

The University of Texas at Austin College of Pharmacy implemented the Academic Assistant (AA) program in 2009 to provide an opportunity for students to participate as near-peer educators in a variety of courses. To determine the impact of these AA positions on current and former students, participants from five years of the program were surveyed regarding the impact of the program on skill development and current or future interest in teaching/mentoring.

FINDINGS

Current students in the AA program reported that participation increased the likelihood of pursuing a career with teaching/mentoring roles. A majority (65%) of alumni who participated in the program reported being in a current teaching/mentoring role with 42% responding that the AA program was impactful to their career choice. The qualitative analysis showed that direct impact to respondents included validating career goals and increasing interests in teaching/mentoring roles. Those who reported no direct impact on their career still gained valuable professional skills that included: public speaking, time management, broadened perspectives, and increased understanding of academia career expectations.

SUMMARY

Providing opportunities for pharmacy students to serve in near-peer teaching roles increased students' interest in pursuing teaching/mentoring roles and offered valuable professional experiences.

Peer teachers taking the lead in classroom instruction: program creation and challenges faced

Purpose

This paper discusses a program to train undergraduate students as near peer teachers delivering course-embedded information literacy instruction to undergraduate students.

Design/methodology/approach

The approach involved the development and delivery of a curriculum combining information literacy concepts and teaching pedagogy. Significant student feedback was gathered which determined the final program structure.

Findings

While the curriculum was successful in developing students' information literacy competencies and pedagogical skills, stakeholder buy-in and the COVID-19 pandemic hindered the program. Additionally, the goal of the program – solo student teaching, was not realized.

Originality/value

Peer teaching is widely implemented in many disciplines; however, its application in academic libraries has focused more on peer reference, rather than peer teaching. This case study adds to the body of literature on this topic related to student peer teaching in academic libraries.

An online case-based teaching and assessment program on clinical history-taking skills and reasoning using simulated patients in response to the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has created unprecedented challenges for medical students and educators worldwide. Groups 1, 2 and 3 of year 3, semester 2 medical students at the Royal College of Surgeons in Ireland (n = 275) had only completed 2, 5 and 7 weeks, respectively, of their scheduled 10-week clinical medicine and surgery attachments, prior to the Irish shutdown of all in-person non-essential activities, including medical student education.

METHODS

We developed and delivered an online case-based program, focused on history-taking skills and clinical reasoning, using simulated patients and video technologies. 12 tutorials were delivered over 6 weeks to 35 subgroups of 8 students in line with program learning outcomes. Both simulated patients (n = 36), and tutors (n = 45, from retired clinical professors to newly graduated physicians), were rapidly upskilled in Blackboard Collaborate and Microsoft Teams, and also in the provision of constructive feedback. We evaluated this newly developed program by the following three criteria: student attendance, achieved grades, and student feedback.

RESULTS

Attendance at the 12 tutorials was higher amongst group 1 and 2 students (75 and 73%) by comparison with group 3 students (60%) (p = < 0.001). Of the 273 students that sat the Year 3 Semester 2 online long case assessment, 93% were successful. Despite group 1 students having the least prior clinical experience, results were similar to those of groups 2 and 3 (1st honors, 2nd honors, pass, and fail grades for group 1, 39%, 33%, 23% and 6%; group 2, 34%, 41%, 17% and 8%; group 3, 39%, 25%, 28% and 7%) (p = 0.48). An increased attendance rate at tutorials was associated with higher numbers of honors grades (p = < 0.001). Anonymous feedback from the students demonstrated considerable satisfaction with program: > 85% agreed that the online program was interactive and very educational.

CONCLUSIONS

Use of online video technology, tutors of varied experience, and simulated patients were demonstrated to replicate patient encounters, and to facilitate the development of clinical skills remotely during the COVID-19 pandemic.

Follow-Up Shadow Coaching Improves Primary Care Provider-Patient Interactions and Maintains Improvements When Conducted Regularly: A Spline Model Analysis

INTRODUCTION

Shadow coaching improves provider-patient interactions, as measured by CG-CAHPS® overall provider rating (OPR) and provider communication (PC). However, these improvements erode over time.

AIM

Examine whether a second coaching session (re-coaching) improves and sustains patient experience.

SETTING

Large, urban Federally Qualified Health Center PROGRAM: Trained providers observed patient care by colleagues and provided suggestions for improvement. Providers with OPRs<90 (0-100-point scale) were eligible.

EVALUATION

We used stratified randomization based on provider type and OPR to assign half of the 40 eligible providers to re-coaching. For OPR and PC, we fit mixed-effects regression models with random-effects for provider (level of treatment assignment) and fixed-effects for time (linear spline with knots and possible "jump" at initial coaching and re-coaching), previous OPR, patient characteristics, and sites. We observed a statistically significant medium jump among re-coached providers after re-coaching on OPR (3.7 points) and PC (3.5 points); differences of 1, 3, and ≥5-points for CAHPS measures are considered small, medium, and large. Improvements from re-coaching persisted for 12 months for OPR and 8 months for PC.

DISCUSSION

Re-coaching improved patient experience more than initial coaching, suggesting the reactivation of knowledge from initial coaching. However, re-coaching gains also eroded. Coaching should occur every 6 to 12 months to maintain behaviors and scores.

Nurse anesthetist students' experiences of peer learning in clinical education - A qualitative study

BACKGROUND

As part of an interprofessional operating team, nurse anesthetists need to be skilled in collaboration, problem solving, attentiveness, independent decision-making and knowledge of anesthesiology nursing. Factors that are vital for nurse anesthetist students' future profession. The educational model peer learning, characterized by collaboration and learning through social interaction between individuals, may support nurse anesthetist students' development in such skills.

AIM

The aim of the study was to explore nurse anesthetist students' perceptions of their experiences of peer learning as an educational model during their clinical education in a Swedish context.

METHODS

The approach was a qualitative descriptive design. Seven nurse anesthetist students from four different universities were interviewed individually using a semi-structured interview guide. The data were analyzed with content analysis.

RESULTS

Three generic categories revealed a description of the phenomenon: Increased independence, Holistic view and Expansive learning process. A main category brought together the content of the generic categories and shows the overall finding of the study: Peer learning promotes nurse anesthetist students' personal and professional development.

CONCLUSION

Peer learning as an educational model during nurse anesthetist students' clinical education might facilitate preparation for their coming profession.

Interprofessional peer-assisted learning and tutor training practices in health professions education-A snapshot of Germany

Peer-assisted learning (PAL)-especially peer tutorials-are gaining momentum in health professions education, particularly in interprofessional education. As little is known about the use of peer tutorials or the preparation of tutors in this context in Germany and in other countries, this study aims to provide an overview of these interventions. A cross-sectional study with a descriptive-exploratory design was conducted. German institutions for health professions education were contacted, and individuals with pedagogical responsibilities were invited to participate in an online survey. The survey was informed by two studies in which seven domains were identified as important. These included facts about the institution, the offer of PAL, the use of tutorials, and the design of tutor training. The survey used mostly closed-ended questions. The questionnaire was completed by n = 100 participants. Overall, n = 46 participants indicated that PAL was offered at their institution. Of these 46 participants, 32 (70%) indicated that uniprofessional PAL was offered, 2 (4%) indicated that interprofessional PAL was offered, and 12 (26%) indicated that both forms of PAL were offered. Peer tutoring was the most common format in both cases (73% for uniprofessional and 64% for interprofessional PAL), and mandatory interventions were mostly used to prepare the tutors. These interventions were held by educators or lecturers and were offered mostly face-to-face as workshops or as discussions. Deepening the tutors' social competencies through training was given high relevance. Regarding content, focus was placed on communication, (self-)reflection, and group management. Eighty-eight participants expressed recommendations for future directions in terms of preparing tutors for interprofessional PAL. Minor differences between the use of uniprofessional and interprofessional PAL and tutor training were found. Nevertheless, implementation strategies varied. In future, preparatory measures for tutors should be more uniformly designed and geared to the specific requirements of uniprofessional and interprofessional learning, and that at best on an empirical basis.

Peer mentoring programs for nursing students: A mixed methods systematic review

BACKGROUND

Peer mentoring in nursing is imperative to both mentors' and mentees' personal and professional development. Yet, there is a dearth of reviews appraising the relevant qualitative and quantitative studies reported in the literature.

OBJECTIVES

To synthesize the best evidence exploring the impacts of peer mentoring programs on nursing students.

DESIGN

A mixed-method systematic review.

DATA SOURCES

Published and unpublished literature written in English between January 2011 and May 2022 were identified from nine databases, including PubMed, CINAHL, Cochrane Library, Embase, and PsycINFO.

REVIEW METHODS

A systematic search strategy was applied in June 2021. Two reviewers independently screened and selected the eligible studies focusing on nursing students in higher education institutions who participated in peer mentoring programs. We included studies of quantitative, qualitative, or mixed methods and explored the main outcomes of peer mentoring programs. Eligible studies were appraised independently using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists. Two independent reviewers extracted relevant data using a standardized form. A meta-analysis, narrative synthesis, and meta-aggregation were then conducted, followed by a convergent segregated approach to integrate the findings.

RESULTS

Thirty-one studies were selected for analysis. We aggregated four sets of synthesized findings from fourteen categories. A meta-analysis of the data showed that the intervention group experienced significant improvement in stress levels. In addition, the integrated results revealed peer mentors, with the support of academia, served as rich resources and support for peer mentees.

CONCLUSION

This review highlights the importance of providing support to peer mentors to help them achieve the desired outcomes of peer mentoring while they cater to the needs of nursing student mentees.

A structured multimodal teaching approach enhancing musculoskeletal physical examination skills among undergraduate medical students

Current evidence indicates that undergraduate medical students display deficits in musculoskeletal physical examination skills (MPES). While various instructional methods are recommended for teaching clinical skills, effective methods for teaching MPES have not been established. This study compared the effectiveness of a multimodal teaching approach incorporating video-based learning, interactive small-group teaching, hands-on practicing, peer-assisted learning, formative assessment, and constructive feedback with traditional bedside teaching in developing undergraduate orthopedic MPES. Participants were 151 fifth-year medical students divided into two groups. One group received multimodal teaching, and the other received traditional bedside teaching. In both groups, the participants learned how to physically examine the knee and shoulder. The primary outcome was objective structured clinical examination (OSCE) scores, while the secondary outcomes included teaching sessions' total durations, facilitator's demonstration time, participants' practice time, and proportion of students with passing checklist scores and global ratings-based assessments for the two teaching approaches. The multimodal teaching group had significantly higher OSCE scores (checklist scores, global ratings, and passing rates; p = 0.02, 0.02, 0.01, respectively) than the comparison group. Individual OSCE component assessments showed significant improvements in the special musculoskeletal physical examination test. The overall duration and amount of participants' hands-on time were significantly longer for the multimodal than for the traditional bedside teaching group (p = 0.01 and 0.01, respectively), and the facilitator's demonstration time was significantly shorter (p = 0.01). The multimodal learner-centered teaching approach evaluated in this study was effective for teaching MPES. It appeared to maximize learner engagement through enhancing interactions and providing increased time to engage in hands-on practice. This teaching approach improved MPES levels, maximized teaching efficiency for scenarios with limited instruction time and resources, and enhanced competency of undergraduate medical students in performing special musculoskeletal physical examinations compared to traditional bedside teaching.

Does the clinical experience of a tutor influence how students learn extended focused assessment with sonography for trauma: A randomized controlled trial

BACKGROUND

Extended focused assessment with sonography for trauma (eFAST) is now an essential part of the primary survey of an emergency patient. The discrepancy between an increasing number of medical students and growing clinical commitments of lecturers is a major challenge in student teaching that needs to be resolved. The practice of using peers in the clinical education of medical students is a well-established tradition and commonly practiced but lacks definition in its implementation. Therefore, we aimed to investigate whether the level of experience of the tutor affects the effectiveness of learning among students using eFAST during a clinical scenario.

METHODS

A prospective randomized single-blinded controlled trial, where 168 medical students in the eighth semester were randomized into control and intervention groups. The control group received the 4-h standard ultrasound (US) tutorial from various resident doctors. All residents were at least stage-1-certified in ultrasound. The intervention group received the tutorial from trained peer teachers (TPTs). These TPTs were medical students who were qualified to teach the procedure. All students received an initial tutorial on basic ultrasound principles and a final lecture on recognizing pathological images. Students completed basic questionnaires requesting pre-existing US experience, theoretical and clinical application questions based on eFAST one day later and at the end of the semester. Students also completed a 6-min OSCE (Objective-Structured-Clinical-Exam) station involving clinical emergency scenarios.

RESULTS

Eighty-five percent of participants had no previous eFAST experience. Early and later evaluation of the participants show no significant differences between both groups regarding the theoretical and the clinical application examinations, except the early phase OSCE results, which was not repeated in the late-stage results.

CONCLUSIONS

Peer-teaching can be utilized to teach practical skills such as eFAST without a loss of clinical application skills. This relieves the burden of removing doctors from patient care situations and maintains teaching standards.

Teaching Tip: Integrating Same-Level Peer-Assisted Learning in a Simulation-Based Emergency Dystocia Module for Final-Year Veterinary Students

Due to faculty shortages, time restraints, and unpredictability of emergency cases, teaching emergency veterinary care is associated with a range of challenges. A novel simulation-based emergency veterinary care (EVC) module was introduced at the Department of Veterinary Medicine, Freie Universität Berlin. The module was mandatory for all final-year veterinary students (n = 155) and consisted of a 5-hour online workshop series on communication skills, a series of interactive, virtual emergency cases, and a weeklong block event covering practical skills at different simulation-based learning stations. A same-level peer-assisted learning (PAL) approach was trialed at two learning stations. Sixteen students volunteered to act as student tutors for their peers. The student tutors received specific training and each tutored six groups of three to four tutees in one topic of their choice. Evaluation forms were filled out by both tutors and tutees with response rates of 100% and 89.7%, respectively. Most student tutors felt well prepared and comfortable in their role as tutor. They indicated exceptionally high levels of motivation and felt useful and competent during the exercise. The tutees reciprocated these opinions and specifically enjoyed the fun and positive learning environment that the tutors were able to create. Responses in the evaluation forms also indicated that the ratio of faculty member to tutors to tutees (1:3:9-12) was a good fit for the exercise. Reciprocal same-level PAL shows promise as an effective teaching tool for final-year veterinary students receiving EVC training.

Academic, clinical and personal experiences of undergraduate healthcare students during the COVID-19 pandemic: A prospective cohort study

Background

Coronavirus disease 2019 has impacted upon the role and safety of healthcare workers, with the potential to have a lasting effect on their wellbeing. Limited research has been conducted during previous pandemics exploring how student healthcare workers are impacted as they study and train for their professional careers.

Objective

The aim of the current study was to examine the specific impact of COVID-19 on the academic, clinical and personal experiences of healthcare students.

Method

Undergraduate students across three year groups within the School of Health Sciences at Ulster University completed online Qualtrics surveys at three timepoints during one academic year (2020/2021). Quantitative survey data was downloaded from Qualtrics into SPSS Version 25 for descriptive analysis of each cross-sectional sample. Qualitative survey data was downloaded into text format, which was thematically analysed using content analysis.

Results

412 students completed the survey at Time 1 (October 2020), n = 309 at Time 2 (December 2020) and n = 259 at Time 3 (April 2021). Academically, the pandemic had mostly a negative impact on the learning environment, the development of practical skills, the assessment process and opportunities for peer learning and support. Students reported increased stress and challenges managing their workload and maintaining a sense of motivation and routine. Clinically, they felt unprepared by the university for placement where the pandemic had an increasingly negative impact over time on learning and skill development. In terms of personal experiences, despite the majority of students taking steps to keep physically and mentally well, negative impacts on friendships, mental wellbeing and concerns for family were reported. The pandemic had not impacted upon career choice for most students.

Conclusion

Consideration must be given to the development of practical skills so students feel prepared for their professional careers given the practical nature of their roles. Programme coordinators should adopt a holistic approach to student wellbeing.

What factors motivate male and female Generation Z students to become engaged as peer teachers? A mixed-method study among medical and dental students in the gross anatomy course

Peer-teaching is widely established in anatomy teaching and offers well-described advantages. Nevertheless, at Ulm University, Germany, a reduction in the number of peer teacher applicants for the dissection course was observed. This study examined factors related to the attractiveness of a position as a peer teacher for Generation Z students. Participants of the gross anatomy course were asked to evaluate factors influencing the attractiveness of a peer teacher position using a six-point Likert scale. Additionally, open-ended questions were analyzed qualitatively. Sex-specific subgroup analysis was performed comparing students of low and high motivation to apply for a tutorship. Of the 374 students who participated in this study (response rate 53%), 38% stated that they were intending to apply as peer teachers. Data indicated that students displayed intrinsic motivation to apply for a tutorship because of the opportunity to improve their anatomy knowledge and/or their pleasure in teaching. In contrast, extrinsic factors like remuneration of the tutorship and its relevance for their curriculum vitae were least important. Anatomy educators underestimated the demotivating factor of the workload associated with the tutorship and encouraged students less frequently to apply than peer teachers. Only minor sex-specific differences could be identified. Nevertheless, female students were encouraged less frequently to apply than their male peers. In summary, Generation Z students apply as peer teachers because they are enthusiastic about the task. To motivate students to commit to extracurricular activities like a tutorship, anatomy educators should actively encourage students-particularly females-more frequently to apply.

Critical Faculty and Peer Instructor Development: Core Components for Building Inclusive STEM Programs in Higher Education

First-generation college students and those from ethnic groups such as African Americans, Latinx, Native Americans, or Indigenous Peoples in the United States are less likely to pursue STEM-related professions. How might we develop conceptual and methodological approaches to understand instructional differences between various undergraduate STEM programs that contribute to racial and social class disparities in psychological indicators of academic success such as learning orientations and engagement? Within social psychology, research has focused mainly on student-level mechanisms surrounding threat, motivation, and identity. A largely parallel literature in sociology, meanwhile, has taken a more institutional and critical approach to inequalities in STEM education, pointing to the macro level historical, cultural, and structural roots of those inequalities. In this paper, we bridge these two perspectives by focusing on critical faculty and peer instructor development as targets for inclusive STEM education. These practices, especially when deployed together, have the potential to disrupt the unseen but powerful historical forces that perpetuate STEM inequalities, while also positively affecting student-level proximate factors, especially for historically marginalized students.

Impact of the peer education model on nursing students' anxiety and psychomotor skill performance: A quasi-experimental study

Background

Peer-assisted education (PAE) is a collaborative and active learning strategy in which another student or another student group teaches one group of students. This model is quite widely used in social and health science vocational education.

Aim

This study was carried out to determine the effect of peer education on clinical skill learning and anxiety in nursing students. A quasi-experimental and a single-blinded design were used.

Subjects and Methods

This study was conducted using experimental (n = 45) and control groups (n = 47) in a university in the Central Anatolia Region, Turkey. A total of 92 students were included. The experimental group received peer education nursing skills. The control group also received education in the traditional model. An Objective Structured Clinical Examination (OSCE) pretest and posttest were used to assess student performance.

Results

It was found that the total scores of posttraining exam success in both experimental and control groups increased (35.20 ± 4.63; 36.70 ± 5.36, respectively) and there was no statistically significant difference between the two groups (P > 0.264). The posttest scores of anxiety in the experimental group were less than the control group (30.18 ± 2.25; 41.21 ± 4.20, respectively).

Conclusions

The use of the peer education model in nursing education has been found to reduce the level of learning anxiety and positively affect psycho-motor skill acquisition. It is proposed to be used as an alternative method in vocational skills training within this context in this area.

Blended (online and in-person) Women's Health Interprofessional Learning by Simulation (WHIPLS) for medical and midwifery students

BACKGROUND

Blended teaching combines traditional in-person components (simulation-based training and clinical-based placement) with online resources. Due to the COVID-19 pandemic, we modified our Women's Health Interprofessional Learning through Simulation (WHIPLS) program - to develop core obstetric and gynaecological skills - into a blended teaching program. There is limited literature reporting the observations of blended teaching on learning.

AIMS

To qualitatively evaluate the blended teaching program and explore how it contributes to learning.

MATERIALS AND METHODS

This study was performed at Monash University in Melbourne, Australia. A total of 98 medical students and 39 midwifery students participated. Data were collected by written survey and analysed by authors using a thematic analysis framework.

RESULTS

Students reported that in-person teaching remains a vital aspect of their curriculum, contributing an averaged 63.2% toward an individual's learning, compared with online. Five substantial themes demonstrate how students learnt and maximised education opportunities using a blended teaching program: 'low-pressure simulation environments', 'peer-assisted learning', 'haptic learning', 'scaffolded learning' and 'the impact of online discourse'.

DISCUSSION

In-person teaching remains a cornerstone of obstetric and gynaecological clinical skills education, of which interprofessional simulation and clinical-based placement are key components. Teaching via online discourse alone, is not sufficient to completely replace and provide comparable learning outcomes, but certainly plays an important role to prime students' learning and to maximise in-person opportunities and resources. Our study reveals key pedagogies of a blended (online and in-person) learning program, providing further evidence to support its ongoing utility as a feasible and warranted approach to learning.

Learning on the periphery: a modified Delphi study of a nursing student communities of practice model

OBJECTIVES

To develop a contemporary student placement model to address current placement challenges, impact student learning, and alleviate supervisor burden.

METHODS

A modified Delphi technique was used to seek opinions, insights, and creative solutions.

RESULTS

A draft Communities of Practice placement model, based on a systematic literature review, was introduced to a heterogenous expert panel (n=12). A contemporary placement model was developed and refined via video conference and email over three rounds.

CONCLUSIONS

Despite initial reluctance concerning a new model, participants became conversant with the concept of peer-to-peer learning, where incidental, albeit essential, learning and support occurs between students, which also supports supervising staff. Greater flexibly and student screening were also incorporated to enable greater learning, confidence building, and reflection. The model's success is contingent upon students working within their scope of practice and provides a contemporary approach to best responds to student, education provider, and health service needs.

Observational Study Exploring the Efficacy and Effectiveness of a New Model of Peer-Assisted Simulation-Based Learning Clinical Placement

(1) Background: Immersive simulation-based learning is relevant and effective in health care professional pre-licensure training. Peer-assisted learning has reciprocal benefit for the learner and the teacher. A fully simulated model of fieldwork placement has been utilised at Curtin University since 2014, historically employing full-time faculty supervisors. Due to the COVID-19 pandemic in 2020, traditional clinical placement availability diminished. (2) Methods: This mixed-methods prospective observational study aimed to translate the existing faculty-led placement for penultimate-year physiotherapy students to a peer-taught model, thereby creating new teaching placements for final-year students. Final- and penultimate-year physiotherapy students undertook the fully simulated fieldwork placement either as peer learners or peer teachers. The placement was then evaluated using four outcome measures: The ‘measure of quality of giving feedback scale’ (MQF) was used to assess peer learner satisfaction with peer-teacher supervision; plus/delta reflections were provided by peer teachers and faculty supervisors; student pass/fail rates for the penultimate-year physiotherapy students. (3) Results: For 10 weeks during November and December 2020, 195 students and 19 faculty participated in the placement. Mean MQF scores ranged from 6.4 (SD 0.86) to 6.8 (SD) out of 7; qualitative data reflected positive and negative aspects of the experience. There was a 4% fail rate for penultimate-year students for the placement. Results suggested that peer learners perceived peer-led feedback was of a high quality; there were both positives and challenges experienced using the model. (4) Conclusions: Physiotherapy students effectively adopted a peer-taught fully simulated fieldwork placement model with minimal faculty supervision, and comparable clinical competency outcomes.

Opening up a tailored tutor qualification program for medical students to other healthcare students - a mixed-method study

BACKGROUND

Peer-led tutorials are widely used in medical education to promote practical skills acquisition and support faculty staff. Typically, student tutors are custom trained for this specific task. We investigated whether opening up an existing medical tutor qualification program to other degree programs is successful in terms of acceptance among students, acquisition of tutor-specific and interprofessional competencies, and which factors contribute to success or failure.

METHODS

We developed a two-day tutor qualification program and conducted it annually from 2016 to 2020 with medical and other healthcare students. At the end of each course, we administered a written survey in which the participants rated the following items: their attitudes towards interprofessional learning (using the UWE-IP-D Interprofessional Learning Scale), the interprofessional learning setting, the teaching approach, and their competency acquisition (each on a five-point Likert scale; 1 = strongly agree, 5 = strongly disagree). Furthermore, we assessed participants' qualitative feedback in free-text fields and performed inductive content analyses.

RESULTS

The study participation rate was high (response rate 97%; medical students: n = 75; healthcare students: n = 22). Participants stated high levels of competency acquisition (total M = 1.59, individual items' M's ranging from 1.20 to 2.05) and even higher satisfaction with the teaching approach (total M = 1.28, individual items' M's ranging from 1.43 to 1.05). Overall satisfaction with the training was M = 1.22; SD = 0.58. No significant differences in ratings were found between the student groups. The qualitative results showed that students appreciated the interprofessional setting and experienced it as enriching. The most positive feedback was found in didactics/teaching methods on role-plays and group work; most suggestions for improvement were found in the area of structure and organisation on breaks and time management.

CONCLUSIONS

Opening up an existing medical tutor qualification program to other student groups can be seen as fruitful to teach not only tutor-related aspects but also interprofessional competencies. The results demonstrate the importance of detailed planning that considers group composition and contextual conditions and provides interactive teaching methods to promote interprofessional experiences. This study offers important information about prerequisites and methodological implementation that could be important for the interprofessional redesign of existing training programs.

Peer-assisted learning in medical education: A systematic review and meta-analysis

OBJECTIVES

The prevalence of peer-assisted learning (PAL) featuring alongside the core medical curriculum is increasing; however, the evidence base for PAL's efficacy on academic performance is limited. This systematic review of randomised studies of PAL in medical school sets out to assess the impact of PAL on academic outcomes in medical school and evaluate whether PAL confers a benefit in specific educational contexts.

METHODS

A literature search was conducted across MEDLINE, Ovid Embase, Web of Science and Education Research Complete. Titles and abstracts were screened, and records were selected following strict eligibility criteria. Following full-text assessment for eligibility, two reviewers independently extracted data from the final selection of records and a meta-analysis was performed. Studies were classified using a modified version of Kirkpatrick's levels of learning. Student test scores were standardised by calculating the standardised mean difference (SMD).

RESULTS

Twenty-seven randomised controlled trials were eligible for inclusion, and twenty-one provided sufficient and complete data to enable meta-analysis. There was a significant improvement in the academic performance of medical students who received PAL compared with those in the control group (SMD = 0.52 [95% confidence interval 0.18-0.85]; p = .003). The impact of PAL was greater amongst clinical medical students (SMD = 0.63; p = .02) than preclinical medical students (SMD = 0.39; p = .08) and when used for teaching practical skills (SMD = 0.69; p = .001) compared with theory (SMD = -0.11; p = .21). Students taught by PAL also achieved better results in assessments conducted more than four weeks after course completion (SMD = 1.20; p = .04). [Correction added on 8 November 2020 after first publication. The data values in the Results section have been corrected in this version.] CONCLUSIONS: Medical students experiencing PAL benefit in terms of academic performance, relative to those not receiving PAL. PAL is of greatest value in the clinical stages of training and for practical skills. The long-term outcomes of PAL remain a priority for future research.

Exploring peer tutoring from the peer tutor's perspective

INTRODUCTION

Changing working practices, student numbers, workforce demands, and deficits, have created a need to consider new ways of radiography student training. One suggestion could be to implement Peer Assisted Learning (PAL) during clinical placements. PAL utilises social constructivist theories, where peer tutors teach lower or same level tutees, reinforcing and practicing material formally taught. The aim of this study was to trial an intervention of PAL, co-designed between the university and students and evaluated to identify opportunities and challenges.

METHODS

Using participatory action research 8 final year student volunteers trialled a 3-week intervention, where they delivered PAL to first years, tutoring on first year radiographic clinical practice. Focus groups were held pre and post intervention to gather qualitative data.

RESULTS

Focus group discussions were transcribed and collectively thematically analysed. Two students and the primary researcher took part in the analysis.

CONCLUSION

Students identified benefits and challenges to PAL. Issue around preparing for and being a peer tutor are also discussed. Further study involving experiences of first year students and clinical colleagues is required.

IMPLICATIONS FOR PRACTICE

Peer-tutoring has potential benefits to students to facilitate the development of skills related to image analysis and critique as well as radiographic anatomy and patient positioning.

A Course-Based Teaching Experience for STEM Undergraduates Improves Student Perceptions of Teaching Self-Efficacy and Attitudes Toward Teaching Careers

There is a national need to recruit more science teachers. Enhancing pathways to teaching for science, technology, engineering, and mathematics (STEM) majors could help to address this need. The Learn By Doing Lab is a course in which STEM undergraduates teach hands-on life science and physical science to local third- through eighth-grade schoolchildren visiting the campus. To measure the impacts of this teaching experience on the undergraduate participants, we administered a version of the Science Teaching Efficacy Belief Instrument-Preservice survey at the start and end of the course. Significant gains were observed in the students' belief in their personal ability to effectively teach science (self-efficacy). Furthermore, qualitative and quantitative analysis of student reflections revealed that they perceived the Learn By Doing Lab experience to have helped them develop 21st-century competencies, particularly in the areas of collaboration, communication, and adaptability. Finally, the students' overall awareness and positive perception of science teaching careers increased. This indicates that providing a low-barrier course-based teaching experience for STEM undergraduates is a promising strategy to help recruit pre-service teachers, and a step toward alleviating the national STEM teacher shortage.

"We know what they're struggling with": student peer mentors' embodied perceptions of teaching in a health professional education mentorship program

This paper reports on a study of student peer mentorship in the context of nursing education in a higher education program in Canada. The study used an embodied hermeneutic phenomenological methodology to investigate student peer mentors' perceptions of teaching during peer mentorship. The data were collected over one calendar year (2019) and involved analysis of 10 participants' interview data and their 'body maps,' produced in response to guided questions. Through the data analysis a core theme of 'commitment to mentee growth' was identified, along with seven interrelated themes: sharing responsibility for learning, moderating stress, mediating power relations, navigating unknown processes, valuing creative approaches, offering generous acceptance, and facilitating confidence. Student peer mentorship has the potential to contribute to health professions education in a number of unique ways including through embodied attunement, trusting intersubjective relations, and dialogic education. This study is innovative in its purposeful design and aim to investigate both cognitive and embodied perceptions of student peer mentors. The findings point to the promise of student peer mentorship for advancing health sciences education. Implications for peer mentorship program development in health professions education are discussed.

Insights on my future job: implementing near-peer shadowing program for operating room freshmen

BACKGROUND

As a main challenge in paramedical faculties of medical sciences, freshmen lose interest in their academic field of study and then job motivation. Lack of developed knowledge about their academic field and unfamiliarity with their future job's tasks and roles contribute to freshmen's job motivation loss. Various interventional programs have been implemented to improve students' job motivation by familiarizing them with their future job's duties and responsibilities.

METHODS

This was one-group pretest-posttest design study in 2019-2020. Students grouped into pairs of a freshman (shadowee) with a senior (shadower) in a clinical setting during shadowing program. This program helps freshmen to comprehend and discover realities of their academic field and can help them change their perspectives regarding their future job's duties and responsibilities. The shadowees' main task was reflective observation on operating room events and interactions and to be active in the program, several tasks e.g., how to wear gloves, guns, and disinfect equipment were assigned to them exclusively under the supervision of senior students. The Hackman and Oldham's Job Diagnostic Survey (JDS) questionnaire and a novel Job Motivation Survey (JMS) questionnaire were distributed among participants.

RESULTS

Fifty freshmen majoring in operating room participated in the shadowing program from November 2019 to January 2020. Before and after the program, they completed Hackman and Oldham's job diagnostic survey and researcher-made job motivation survey questionnaires. Results were indicative of a significant difference in job diagnostic survey questionnaire score, where overall pre-test and post-test scores before and after the intervention were 57.78 (±9.78) and 68.58 (±5.02), respectively; the score difference was statistically significant (P < 0.001). Moreover, the overall pre-test and post-test scores of the job motivation survey questionnaire were 25.16 (± 9.75) and 39.80 (±5.18), respectively; this score difference was statistically significant (P < 0.001).

CONCLUSION

Shadowing program improved freshmen's realistic perception of their future job's duties and responsibility, and hence enhancing their job motivation and job recognition. As future work, in various disciplines, further studies need to evaluate the impact of such interventional programs in providing early insights for freshmen as well as in providing guidance on their plans for education, and future job.

Near-Peer Teaching in Human Anatomy from a Tutors' Perspective: An Eighteen-Year-Old Experience at the University of Bologna

The University of Bologna School of Medicine in 2003 adopted a near-peer teaching (NPT) program with senior medical students teaching and assisting younger students in human anatomy laboratories. This study aimed to evaluate the effectiveness and outcomes of this program-unique on the Italian academic panorama-from the tutors' perspective. An anonymous online survey was administered to all those who acted as peer tutors in the period from 2003 to 2021; it evaluated tutors' perceptions regarding the influence of the tutoring experience on their skillset gains, academic performance, and professional career. Furthermore, tutors were asked to express their views on the value of cadaver dissection in medical education and professional development. The overall perception of the NPT program was overwhelmingly positive and the main reported benefits were improved long-term knowledge retention and academic performance, improved communication, team-working and time management skills, and enhanced self-confidence and motivation. Most tutors strongly believed that cadaver dissection was an invaluable learning tool in medical education, helped them to develop professionalism and human values, and positively influenced the caring of their future patients. Nearly all the participants highlighted the importance of voluntary body donation for medical education and research. The present results supported the thesis that tutors themselves benefited from the act of teaching peers; this impactful experience equipped them with a wide range of transferable skills that they could draw on as future educators and healthcare professionals.

A Systematic Review and Narrative Synthesis of the Effectiveness of Peer- versus Faculty-led Simulation for Clinical Skills Acquisition in Undergraduate Student Nurses. MSc Project Findings

Background:

Clinical skills learning is an integral part of undergraduate nursing programmes in United Kingdom nurse education. Faculty staff teach some elements of clinical skills, and some are taught by clinicians in practice. International evidence indicates that some students feel overly anxious when taught by faculty members but less so with their peers, meaning that peer-led clinical skills teaching and learning might reduce anxiety and facilitate the acquisition and retention of skills education.

Objective:

The objective of this systematic review was to explore the research relating to undergraduate student nurses’ acquisition of skills within the simulation setting, particularly the associations between peer-led and lecturer-led learning.

Methods:

A systematic review of the literature was used to find all available evidence. A search of nine healthcare databases using Boolean and MeSH search terms including ‘Peer-to-peer’, ‘Clinical Skill*’, ‘Simulat*’, and ‘Student Nurs*’ was undertaken. Due to the heterogeneity of the research found, statistical meta-analysis was not possible, and so a narrative synthesis based on thematic analysis was conducted, which involved three-person research team critically appraising nine articles for inclusion in the review.

Results:

Articles were located from worldwide sources.

Three main themes in the findings were: psychological factors, motor skills, and educational issues. The use of peers can help to increase students’ motor skills, improved the psychological impact of skills and learning, and offered students a chance to be active participants in their education.

Conclusion:

Having explored the literature, we conclude that peer-to-peer teaching and learning could have a place in undergraduate nursing education; however, it is not clear if student nurses’ skills acquisition is more effective if mediated by peer- or lecturer-led teaching. Further research is required in this area to quantify and compare outcomes.

Near-peer-assisted learning for training undergraduate medical students in clinical ophthalmology skills

Objective

Methods

Results

Conclusion

Shadow Coaching Improves Patient Experience With Care, But Gains Erode Later

BACKGROUND

Health care organizations strive to improve patient care experiences. Some use one-on-one provider counseling (shadow coaching) to identify and target modifiable provider behaviors.

OBJECTIVE

We examined whether shadow coaching improves patient experience across 44 primary care practices in a large urban Federally Qualified Health Center.

RESEARCH DESIGN

Seventy-four providers with "medium" (ie, slightly below average) overall provider ratings received coaching and were compared with 246 uncoached providers. We fit mixed-effects regression models with random effects for provider (level of treatment assignment) and fixed effects for time (linear spline with a knot and "jump" at coaching date), patient characteristics and site indicators. By design, coached providers performed worse at selection; models account for the very small (0.2 point) regression-to-the-mean effects. We assessed differential effects by coach.

SUBJECTS

A total of 46,452 patients (from 320 providers) who completed the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) Visit Survey 2.0.

MEASURES

CAHPS overall provider rating and provider communication composite (scaled 0-100).

RESULTS

Providers not chosen for coaching had a nonsignificant change in performance during the period when selected providers were coached. We observed a statistically significant 2-point (small-to-medium) jump among coached providers after coaching on the CAHPS overall provider rating and provider communication score. However, these gains disappeared after 2.5 years; effects differed by coach.

CONCLUSIONS

Shadow coaching improved providers' overall performance and communication immediately after being coached. Regularly planned shadow coaching "booster" sessions might maintain or even increase the improvement gained in patient experience scores, but research examining additional coaching and optimal implementation is needed.

Method 300: a complementary teaching methodology in Dentistry

This study evaluated Method 300, a complementary teaching methodology in Dentistry. Thirty participants were divided into 6 groups according to the scores obtained in a placement test ranging from 0 to 10. Students with scores lower than 6 were classified as having poor academic performance; students with scores equal to or greater than 6 were considered as having good academic performance. Each group included at least one student with good performance. Our methodology consisted of two application cycles, each including one different test; however, only students with low performance could undergo the second testing. Students held meetings twice a week for one hour and thirty minutes. Of the 54 students initially enrolled in the subject, 24 dropped out, leaving 30 students who completed all the proposed activities. In cycle 1, 24 (80%) students showed poor academic performance and 6 (20%) good. Students with poor performance in P1 significantly improved after P1 300 test application (P < 0.001). After cycle 1 activities, all 30 participants showed significant improvement. In cycle 2, the number of students with good performance tripled when compared to cycle 1, resulting in a decrease in the number of students with poor performance (P = 0.205). Results show that the Method 300 is an important teaching-learning resource in Dentistry, to be used as a complementary methodology to lectures.