Perceived Benefits of Peer Leadership as Described by Junior Baccalaureate Nursing Students

Investigating the fundamental levels of a signature pedagogy in nursing education: A scoping review

BACKGROUND

A signature pedagogy is a unique approach that provides a blueprint for curricular decision-making, as it reflects how we teach (surface structures), why we teach (deep structures), and what we believe are vital concepts or values all learners should embody (implicit structures).

OBJECTIVE

To investigate what is known from the existing literature about a signature pedagogy to support undergraduate nursing education.

DESIGN

This scoping review adopted Arksey and O'Malley's framework to guide the analysis of data. Two electronic databases were used to explore studies on educational strategies, content, and values published in Arabic, English, Filipino, French, Portuguese, and Spanish between 1972 and 2022.

RESULTS

A total of 258 articles were included in this review. The analysis revealed that the majority of articles were at the surface (n = 189), followed by the deep (n = 123), with the least number examining the implicit level (n = 90) associated with signature pedagogy levels. Results reflect a limited focus on implicit level; the core concepts and values that all learners should understand and grasp for their future practice to construct their professional identity and engage in healthcare transformation.

CONCLUSIONS

The findings from this scoping review, should not be an isolated movement within nursing education. The first step is to engage in discourse amongst all stakeholders, educational and healthcare nurse leaders, regarding the state of the profession. As a profession we need to understand what is the preferred future of nursing and what are the necessary educational processes to ensure the profession is actualizing their mandate. A call to action to develop a unique signature pedagogy should provide synergy between education and practice to enhance learner's competencies as a future professional.

Perspective of students in the Global Citizenship in Dentistry as an international peer learning experience

OBJECTIVE

To explore the achievement and perception of dental students in an international peer learning setting via the Global Citizenship in Dentistry (GCD) program.

METHODS

In the GCD program, year-2 dental students from universities in Egypt, Hong Kong, Malaysia, UK, and the United States developed a portfolio of a restorative procedure in simulation laboratory and uploaded to an online platform (https://gcd.hku.hk/). Through the platform, the students left comments on each other's portfolios to share and discuss their knowledge and experiences on restorative dentistry. This study invited students from Hong Kong in 2018-2019 to complete an open-ended questionnaire to explore their experience on the GCD program. The feedback was compiled and analyzed.

RESULTS

All 71 year-2 students completed the questionnaire. Their most dominant comments were positive feelings about learning different clinical principles and methods from universities abroad. The students also enjoyed the cultural exchange from the comfort of their own devices. Other recurrent comments included the improvement of the skills of communication and comments on the peers' work in a professional manner. The students were enthusiastic about being able to apply their critical thinking in evaluating their work. They shared their learning barriers, including the extra time needed for the program, some unenthusiastic responses from groupmates, and delayed replies from peers. They made suggestions to remove the barriers in the learning process of the GCD program.

CONCLUSION

Students generally welcomed the GCD program and benefitted from the global academic exchange, development of critical thinking, enhancing professional communication skills, as well as opportunities of cultural exchange.

Implementing a New Capstone Leadership Clinical Course

BACKGROUND

Nurse educators are challenged to ensure clinical education meets the changing health care environments and needs.

PROBLEM

New nurses remain unprepared for practice, have insufficient foundational leadership capacities, and lack systems-thinking awareness.

APPROACH

Responding to educational gaps, increased enrollment, and scarce clinical placements, faculty used an eclectic education model to develop a new capstone leadership clinical course that included 5 types of experiences. The total acute care clinical hours were reduced, while adding leadership-focused experiences and simulated learning.

OUTCOMES

Stakeholders' evaluations indicate the pilot provided opportunities to strengthen students' leadership capacity, systems thinking, and professional identity while still providing sufficient practice managing care of multiple patients, engaging in teamwork, and applying evidence.

CONCLUSION

The new clinical course addressed students' transition into practice needs and enrollment capacity issues. Thoughtful planning by invested stakeholders, communication among faculty, and clear expectations are necessary to implement eclectic clinical models.

Improving undergraduate education in surgical paediatrics using near-peer assisted learning tutorials

INTRODUCTION

Near-peer assisted learning (NPAL) has been welcomed in recent years as a favourable method for teaching medical students. It has proven advantages for both the educator and the learner. As such it was identified as an ideal approach for delivering the local curriculum within a paediatric surgical setting. Short duration of placements further suggests that structured tutorials would best guarantee coverage of the student curriculum. Our hypothesis was that the introduction of a structured programme such as this could lead to reduced dependence on senior staff for teaching, increased exposure of junior staff as educators, and increased coverage of the curriculum.

METHODS

Curriculum outcomes were identified, and a series of tutorials developed for delivery by juniors within the department. Pre and post intervention questionnaires were given to students rotating through the department.

RESULTS

70 responses were analysed (23 pre; 47 post intervention). Reliance on Consultant teaching dropped 29% and engagement of surgical, GP and foundation trainees in teaching increased by 29%, 43% and 9% respectively. Overall curriculum coverage increased by 12%.

CONCLUSION

A near-peer assisted tutorial programme is an effective way of increasing coverage of the medical curriculum with benefits for tutors and learners, whilst increasing junior engagement in teaching and reducing burden on Consultants.

Interprofessional Peer Teaching of Pharmacy and Physical Therapy Students

OBJECTIVE

To evaluate an interprofessional peer-teaching activity during which physical therapy students instructed undergraduate pharmacy students on 3 ambulatory devices (canes, crutches, walkers).

DESIGN

The pre/post evaluation of 2 pharmacy undergraduate classes included 220 students, 110 per year. After pharmacy students completed a 10-point, knowledge-based pretest, they participated in a hands-on activity with physical therapy students teaching them about sizing, use, and safety of canes, crutches, and walkers. A 10-point posttest was completed immediately afterward.

ASSESSMENT

The mean difference of pre/post scores was 3.5 (SD 1.9) for the peer-led teaching, and 3.8 (SD 2.2) for the peer learning group. Students had positive responses regarding the learning exercise and recommended further peer teaching.

CONCLUSION

The peer-learning activity involving physical therapy students teaching pharmacy students was an effective method of improving knowledge and skills regarding basic ambulatory devices.

Near-peer-assisted learning (NPAL) in undergraduate medical students and their perception of having medical interns as their near peer teacher

INTRODUCTION

A near-peer-assisted learning term (NPAL) is "a trainee one or more years senior to another trainee". The current study is aiming to determine the pattern of NPAL activities, to compare its effect on student's course achievement score and to determine the perception of students regarding having near-peer clinical teaching from their fellow medical interns.

METHODS

A total of 189 third year medical students participated in the study. The study questionnaire contains three sections. The first is the focus group section, self-administered questions and lastly quality control section. Trained staff helped in conducting the data collection.

RESULTS

Clinical teaching with mentoring was experienced by 116 students (61.4%) from their assigned interns in the early clinical experience course. The results of the study showed higher course achievement grades for students who experienced mentoring with clinical teaching compared to those students who experienced mentoring only, but it did not reach statistical significance. The study also found that most medical students acknowledged and agree that their near peers medical interns could provide unique input in helping them mastering clinical and communication skills competencies, the average percent for the seven opinion questions of the response agree combined with strongly agree was 62%.

CONCLUSION

In conclusion, third year medical students recognize the unique and important role of near peer teaching in under graduate medical education and its importance for their professional development. NPAL strategy should be encouraged and used in other medical schools. The benefits of NPAL to peer teacher and in late clinical medical years needed to be investigated in future studies.

Pairing as an instructional strategy to promote soft skills amongst clinical dental students

Training dentists today is challenging as they are expected to provide a wide range of dental care. In the provision of good dental care, soft skills are equally important as clinical skills. Therefore in dental education the development of soft skills are of prime concern. This study sought to identify the development of soft skills when dental students are paired in their clinical training. In this perception study, four open-ended items were used to elicit students' feedback on the appropriateness of using clinical pairing as an instructional strategy to promote soft skills. The most frequently cited soft skills were teamwork (70%) and communication (25%) skills. However, both negative and positive behaviours were reported. As for critical thinking and problem solving skills, more positive behaviours were reported for abilities such as to explain, analyze, find ideas and alternative solutions, and make decisions. Leadership among peers was not evident as leading without legitimate authority could be a hindrance to its development. If clinical pairing is to be used as an effective instructional strategy to promote soft skills amongst students, clear guidelines need to be developed to prepare students to work in a dental team and the use of appropriate assessment tools can facilitate the development of these soft skills.

Impact of peer teaching on nursing students: perceptions of learning environment, self-efficacy, and knowledge

BACKGROUND

Peer teaching has been shown to enhance student learning and levels of self efficacy.

OBJECTIVES

The purpose of the current study was to examine the impact of peer-teaching learning experiences on nursing students in roles of tutee and tutor in a clinical lab environment.

SETTINGS

This study was conducted over a three-semester period at a South Central University that provides baccalaureate nursing education.

PARTICIPANTS

Over three semesters, 179 first year nursing students and 51 third year nursing students participated in the study.

METHODS

This mixed methods study, through concurrent use of a quantitative intervention design and qualitative survey data, examined differences during three semesters in perceptions of a clinical lab experience, self-efficacy beliefs, and clinical knowledge for two groups: those who received peer teaching-learning in addition to faculty instruction (intervention group) and those who received faculty instruction only (control group). Additionally, peer teachers' perceptions of the peer teaching learning experience were examined.

RESULTS

Results indicated positive response from the peer tutors with no statistically significant differences for knowledge acquisition and self-efficacy beliefs between the tutee intervention and control groups. In contrast to previous research, students receiving peer tutoring in conjunction with faculty instruction were statistically more anxious about performing lab skills with their peer tutor than with their instructors. Additionally, some students found instructors' feedback moderately more helpful than their peers and increased gains in knowledge and responsibility for preparation and practice with instructors than with peer tutors.

CONCLUSIONS

The findings in this study differ from previous research in that the use of peer tutors did not decrease anxiety in first year students, and no differences were found between the intervention and control groups related to self efficacy or cognitive improvement. These findings may indicate the need to better prepare peer tutors, and research should be conducted using more complex skills.

Collaborative Learning Using Nursing Student Dyads in the Clinical Setting

Formal pairing of student nurses to work collaboratively on one patient assignment is a strategy for improving the quality and efficiency of clinical instruction while better utilizing the limited resources at clinical agencies. The aim of this qualitative study was to explore the student nurse and patient experiences of collaborative learning when peer dyads are used in clinical nursing education. Interviews were conducted with 11 students and 9 patients. Students described the process of collaborative learning as information sharing, cross-checking when making clinical decisions, and group processing when assessing the outcomes of nursing interventions. Positive outcomes reported by students and patients included reduced student anxiety, increased confidence and task efficiency. Students’ primary concern was reduced opportunity to perform hands-on skills which had to be negotiated within each dyad. Meeting the present and future challenges of educating nurses will require innovative models of clinical instruction such as collaborative learning using student peer dyads.

Perceived frequency of peer-assisted learning in the laboratory and collegiate clinical settings

CONTEXT

Peer-assisted learning (PAL) has been recommended as an educational strategy to improve students' skill acquisition and supplement the role of the clinical instructor (CI). How frequently students actually engage in PAL in different settings is unknown.

OBJECTIVE

To determine the perceived frequency of planned and unplanned PAL (peer modeling, peer feedback and assessment, peer mentoring) in different settings.

DESIGN

Cross-sectional study.

SETTING

Laboratory and collegiate clinical settings.

PATIENTS OR OTHER PARTICIPANTS

A total of 933 students, 84 administrators, and 208 CIs representing 52 (15%) accredited athletic training education programs.

INTERVENTION(S)

Three versions (student, CI, administrator) of the Athletic Training Peer Assisted Learning Survey (AT-PALS) were administered. Cronbach α values ranged from .80 to .90.

MAIN OUTCOME MEASURE(S)

Administrators' and CIs' perceived frequency of 3 PAL categories under 2 conditions (planned, unplanned) and in 2 settings (instructional laboratory, collegiate clinical). Self-reported frequency of students' engagement in 3 categories of PAL in 2 settings.

RESULTS

Administrators and CIs perceived that unplanned PAL (0.39 ± 0.22) occurred more frequently than planned PAL (0.29 ± 0.19) regardless of category or setting (F(1,282) = 83.48, P < .001). They perceived that PAL occurred more frequently in the collegiate clinical (0.46 ± 0.22) than laboratory (0.21 ± 0.24) setting regardless of condition or category (F(1,282) = 217.17, P < .001). Students reported engaging in PAL more frequently in the collegiate clinical (3.31 ± 0.56) than laboratory (3.26 ± 0.62) setting regardless of category (F(1,860) = 13.40, P < .001). We found a main effect for category (F(2,859) = 1318.02, P < .001), with students reporting they engaged in peer modeling (4.01 ± 0.60) more frequently than peer mentoring (2.99 ± 0.88) (P < .001) and peer assessment and feedback (2.86 ± 0.64) (P < .001).

CONCLUSIONS

Participants perceived that students engage in unplanned PAL in the collegiate clinical setting with a stronger inclination toward engagement in peer modeling. Educators should develop planned PAL activities to capitalize on the inherent desire of the students to collaborate with their peers.

Can criteria for identifying educational influentials in developed countries be applied to other countries? A study in Iran

INTRODUCTION

There are published criteria for identifying educational influentials (EIs). These criteria are based on studies that have been performed in developed countries. This study was performed to identify criteria and characteristics of EIs in Iran.

METHODS

The study was conducted on residents, interns, and clerks at a major educational hospital in Iran. This study had 3 stages: (1) preparation of an inclusive list of EI characteristics through 3 focus group discussions with 22 individuals, in which 30 primary characteristics of EIs were found; (2) reducing the number of characteristics by examining 154 individuals for exploratory factor analysis and internal consistency evaluation by Cronbach's alpha, after which the characteristics were reduced to 25; (3) finalizing the criteria through discriminant validity.

RESULTS

Fifteen characteristics were identified in 4 domains: (1) knowledge (high level of clinical knowledge, being up-to-date and an expert, high level of clinical skills); (2) communication skills (good communication with others, easily accessible, good public relations, and oratory); (3) taking into account the stakeholders (involving patients in decision making, allowing students to identify problems, delivering decisions to others, and interest in transfer of material); and (4) professional ethics (pursuing the patients' maximum benefit, observing ethics in education and research). Overall, they have a sensitivity and specificity of 87% and 74%, respectively.

DISCUSSION

Three of the four domains we found were already identified in other studies; however, the "taking into account the stakeholders" domain has not been previously reported. The other domains and criteria were similar to those found in developed countries.

A step ahead: teaching undergraduate students to be peer teachers

Nurses have a responsibility to share knowledge with others. However, many are reluctant to undertake teaching, feeling unprepared for the responsibility. With this in mind, a semester-long compulsory core unit was designed and implemented in 2009 to equip final year students with knowledge and skills to enable facilitation of teaching and learning in practice. As part of the summative assessment, third (final) year students taught vital signs in first year skills laboratories. To evaluate the strategy, the Peer Teaching Experience Questionnaire (adapted from Iwasiw and Goldenberg, 1993) was administered to third year students and Clinical Teaching Preference Questionnaire (Iwasiw and Goldenberg, 1993) to first years. Focus groups were conducted with third year volunteers to explore issues in greater detail. One hundred and five (75%) third year and 112 (52%) first year students completed questionnaires. In addition, 11 third year students participated in a focus group. Overall, third year students reported increased confidence in their knowledge and teaching abilities, reflected on their own learning and found the experience rewarding, acquiring skills they considered would be helpful in graduate years. Many suggested there should be more opportunities for such types of learning and interaction. First year students reported feeling comfortable learning skills with senior peers, as well as being able to learn from their experiences. Overall, both groups recognised strongly that teaching was part of nurses' roles.

Identifying opinion leaders to promote behavior change

This article reviews 10 techniques used to identify opinion leaders to promote behavior change. Opinion leaders can act as gatekeepers for interventions, help change social norms, and accelerate behavior change. Few studies document the manner in which opinion leaders are identified, recruited, and trained to promote health. The authors categorize close to 200 studies that have studied or used opinion leaders to promote behavior change into 10 different methods. They present the advantages and disadvantages of the 10 opinion leader identification methods and provide sample instruments for each. Factors that might influence programs to select one or another method are then discussed, and the article closes with a discussion of combining and comparing methods.