The influence of near-peer teaching on undergraduate health professional students' self-efficacy beliefs: A systematic integrative review

BACKGROUND

Near-peer teaching, a type of peer teaching traditionally used in medical education, has gained popularity as a way of enhancing students' learning in undergraduate health disciplines such as nursing, physiotherapy and paramedicine. Research has established the positive impact of near-peer teaching on health professional students' cognitive and psychomotor outcomes; however, little is known about its influence on students' self-efficacy beliefs, which are important predictors of future clinical performance.

AIM

To determine the influence, if any, of near-peer teaching participation on undergraduate health professional students' self-efficacy beliefs.

DESIGN

Whittemore and Knafl's integrative review framework was used as a guide to synthesise diverse literature including quantitative, qualitative, and mixed methods peer-reviewed studies and grey literature.

REVIEW METHODS AND DATA SOURCES

A search was conducted of published literature prior to October 2023 using the MEDLINE, Embase, SCOPUS, ERIC, PsycINFO and CINAHL databases; 1376 non-duplicate studies were identified. Following independent screening by two authors, nine studies were included in the review. Critical appraisal of studies was performed using the Mixed Methods Appraisal Tool. Data were extracted and compared to generate themes related to students' self-efficacy outcomes.

RESULTS

Seven included studies were quantitative survey-based; five were from medicine. Two studies met all methodological quality criteria. In seven studies, near-peer teaching participation positively influenced junior (i.e., first- and second-year) health professional students' self-efficacy in three domains - psychomotor skills, interprofessional skills and critical thinking. In four studies, near-peer teaching participation enhanced senior (i.e., final- or penultimate-year) health professional students' self-efficacy in teaching.

CONCLUSIONS

Few high-quality studies with a focus on near-peer teaching's influence on health professional students' self-efficacy beliefs were found. Available evidence suggests that near-peer teaching may positively impact health professional students' self-efficacy beliefs across several domains. More rigorous, multi-perspective investigations are needed from various health disciplines to build upon this evidence.

Mapping the Terrain of Faculty Development for Simulation: A Scoping Review

ABSTRACT

Understanding what interventions and approaches are currently being used to improve the knowledge, skills, and effectiveness of instructors in simulation-based education is an integral step for carving out the future of simulation. The current study is a scoping review on the topic, to uncover what is known about faculty development for simulation-based education.We screened 3259 abstracts and included 35 studies in this scoping review. Our findings reveal a clear image that the landscape of faculty development in simulation is widely diverse, revealing an array of foundations, terrains, and peaks even within the same zone of focus. As the field of faculty development in simulation continues to mature, we would hope that greater continuity and cohesiveness across the literature would continue to grow as well. Recommendations provided here may help provide the pathway toward that aim.

Dissemination of a long-term care planning tool, PlanYourLifespan.org, through community-based stakeholder leaders

BACKGROUND

Geriatrics research generally cumulates in academic journal publications, with variable diffusion to patients and communities. PlanYourLifespan.org is a free, evidence-based tool that assists older adults, and their loved ones, to better understand and plan for their long-term support needs. There is a need to effectively disseminate geriatrics research, such as PlanYourLifespan.org, to communities that may directly benefit from this research.

OBJECTIVE

To leverage community-based stakeholder leaders, utilizing a train-the-trainer program, to disseminate PlanYourLifespan.org and evaluate the extent of the dissemination.

METHODS

Using a train-the-trainer strategy, community stakeholder leaders from the original study paired up with newly recruited community stakeholder leaders. New community stakeholder leaders were trained on dissemination, using a "how-to-disseminate" web-based toolkit-developed as part of this project. Newly trained community stakeholder leaders subsequently trained additional community stakeholder leaders who conducted and tracked dissemination activities in their communities. Google Analytics tracked newly created PlanYourLifespan.org accounts, login sessions, and daily website visitors.

RESULTS

Five newly trained community stakeholder leaders disseminated PlanYourLifespan.org over a three-month period. Cumulatively, on the day of the dissemination activity, there were 11,361 PlanYourLifespan.org log-ins (average: 378.7 log-ins/activity day), 89,068 log-ins (average: 2969 log-ins/activity week) one-week after the activity, and 319,154 log-ins (average: 10,638 log-ins/activity month) one month after the dissemination activity. Approximately 9.4 new PlanYourLifespan.org accounts were created one-week post dissemination activity and over 1100 new accounts in the one-month period thereafter.

CONCLUSIONS

Wide dissemination of PlanYourLifespan.org occurred by leveraging a train-the-trainer approach with community stakeholder leaders. Researchers should consider collaborating early on with community stakeholders to meaningfully disseminate results.

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

BACKGROUND

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

AIMS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

If You Mix Them, They Will Learn: Using Simulation to Foster Multilevel Peer-to-Peer Engagement Through an Innovative Clinical Make-Up Program

ABSTRACT

Clinical experiences are an essential component of nursing education. However, at times, students are unable to attend scheduled clinical experiences because of illness or personal issues. We describe how a baccalaureate program of nursing used an innovative approach to manage clinical absence. Simulation educators placed students from every level of the program in teams during clinical make-up simulation scenarios. Students participating in the multilevel simulations identified leadership, mentorship, reinforcement of nursing concepts, clinical skill improvement, and the opportunity to support one another as benefits of the program.

Impacts of peer tutoring on academic performance of first-year baccalaureate nursing students: A quasi-experimental study

BACKGROUND

Peer tutoring has multiple benefits for students and the nursing program. However, little is known about the impacts of a peer tutoring on students' academic success.

OBJECTIVES

This study aimed to examine the impacts of a peer tutoring program on the course failure rates and exam scores among first-year baccalaureate nursing students.

DESIGN

A quasi-experimental study was conducted at a public university in the USA. A formal peer tutoring program was offered to the Class of 2020 over their first three semesters (n = 317), and the Class of 2018 without peer tutoring served as a historical comparison group (n = 285). The peer tutoring program provided free, one-on-one assistance to any students who needed additional academic support.

RESULTS

The overall course failure rate was 3.47% for the class with peer tutoring compared to 7.02% without peer tutoring (χ2 = 3.87; p = 0.049). For the class with peer tutoring, about one half attended the sessions. The attendees had lower first exam scores compared to the non-attendees, but the final exam scores of attendees improved by 4 points out of 100 possible (p < 0.001). For the non-attendees, the exam scores did not change significantly. Students who attended two or more sessions per semester improved their scores by about 5 points. There was a positive association between the improvements in exam scores and the frequency of tutoring sessions attended per semester (p = 0.002).

CONCLUSIONS

It appears that the peer tutoring was effective in reducing course failure rates as well as improving exam scores among first-year baccalaureate-nursing students. Peer tutoring may be a useful and cost-effective strategy to help at-risk nursing students as they adjust to the challenges of academic demands in nursing programs.

Peer-assisted learning in simulation-based medical education: a mixed-methods exploratory study

Introduction

Peer-assisted learning (PAL) is well described in medical education but there has been little research on its application in simulation-based education (SBE). This exploratory study aimed to determine the perceptions of senior medical students at two universities to teaching and learning in SBE using PAL (PAL-SBE).

Methods

Ninety-seven medical students at two universities working in small groups with facilitator oversight wrote, ran and debriefed a simulation scenario for their peers.This was a mixed-methods study. Participants completed a written free-text and Likert survey instrument, and participated in a facilitated focus group immediately after the scenario. Thematic analysis was performed on the free-text and focus group transcripts.

Results

Student-led scenarios ran without major technical issues. Instructor presence was required throughout scenario delivery and debrief, making the exercise resource intensive. Participant responses were more positive regarding learning as peer teachers in simulation than they were regarding participation as a peer learner. Five themes were identified: learning in the simulated environment; teaching in the simulated environment; teaching peers and taking on an educator role; learning from peers; and time and effort expended. Perceived benefits included learning in depth through scenario writing, improved knowledge retention, understanding the patient's perspective and learning to give feedback through debriefing.

Conclusion

PAL in SBE is feasible and was perceived positively by students. Perceived benefits appear to be greater for the peer teachers than for peer learners.

Using meta-ethnography to develop a conceptual model of peer-assisted learning of nursing students in clinical practice

AIM

The study presents the findings of a meta-ethnographic study, developing a conceptual model for peer-assisted learning for undergraduate nurses in clinical practice.

DESIGN

Qualitative meta-ethnography.

METHODS

Meta-ethnography was used to synthesize the findings of two ethnographic studies and a qualitative review related to the influence of peer-assisted learning on student nurses in clinical practice.

RESULTS

Four key themes were identified underpinned by six sub-themes: (a) "Social" whereby "connecting with peers" is an important part in peer-assisted learning. (b) "Enabling" peers through "collaborative support for advice and guidance" and "reducing anxiety/increasing confidence." (c) "Organizational" aspects in peer-assisted learning in "establishing structure and navigating practice" and "establishing the role of the PAL." (d) "Learning" as a product of developing knowledge and skills through "sharing of practice experience" and "enhancing knowledge of care." The conceptual model presents a structure outlining elements required for developing effective knowledge and skills through peer-assisted learning.

Near-peer teaching in undergraduate nurse education: An integrative review

INTRODUCTION/BACKGROUND

Studies in peer learning and teaching reported in the nursing literature are mainly descriptive, summarising positive aspects using survey and interviews. Application of pedagogical approaches to near-peer teaching in undergraduate nursing, using educational psychology frameworks to explain the outcomes, is relatively unknown.

OBJECTIVES

The objective of this integrative review was to ascertain outcomes of near-peer teaching in undergraduate nurse education and theoretical frameworks used to explain outcomes of near-peer teaching.

DESIGN

Included qualitative and quantitative studies.

METHOD

The review was conducted in accordance with the PRISMA protocol and Joanna Briggs Institute processes and included studies published between the years 1990 and 2017. Quality appraisal involved two independent reviewers analysing the data, and narrative synthesis was used to report results.

RESULTS

Two hundred and twenty-one abstracts were assessed independently by two reviewers for relevance to near-peer teaching in undergraduate nurse education, 29 articles selected for further review with 10 meeting the inclusion criteria. Benefits of near-peer teaching were reported as creating a safe supportive learning environment, learners viewing near-peer teachers as effective role models and increased confidence experienced by learner and teacher. Studies focused mainly on cognition in relation to performance with little emphasis on metacognition or affective behaviours, highlighting the need for more studies to provide definitive evidence supporting this pedagogical approach and framing its implementation around theories, particularly from educational psychology.

CONCLUSION

Lack of training provided to near-peer teachers highlighted that it is imperative that faculty embed near-peer teaching into the curriculum. To develop this educational intervention, studies in near-peer teaching are required to assess affective behaviours and metacognitive qualities of near-peer teachers to determine how this educational intervention can impact learning and performance of both the learner and near-peer teacher.

Student Perceptions Regarding Collaborative Intraprofessional Nursing Education

BACKGROUND

Teamwork is an important factor in the provision of high-quality health care. There is a lack of research on collaboration between nursing students at different program levels.

PURPOSE

The purpose of this project was to determine student perceptions about collaborative learning activities between prelicensure BSN and MSN students.

METHODS

Community assessments by BSN students identified health needs and issues for 6 underserved populations. Online MSN students used these assessments to create low-literacy patient education pamphlets. In turn, BSN students provided educational sessions at community sites using the pamphlets. Both groups completed presurveys and postsurveys assessing their perceptions of collaborative learning.

RESULTS

There were statistically significant differences between the respondent groups for 3 survey questions about how this project helped prepare them for future practice and professional collaboration. Eight qualitative themes were identified.

CONCLUSION

Although desiring more face-to-face interaction between groups, students reported that collaboration was important.

An exploration of peer-assisted learning in undergraduate nursing students in paediatric clinical settings: An ethnographic study

BACKGROUND

Peer-assisted leaning relates to the acquisition of knowledge and skills through shared learning of matched equals. The concept has been explored within the field of nurse education across a range of learning environments, but its impact in practice is still relatively unknown. This paper reports on findings when observing paediatric undergraduate nursing students who engage in PAL within the clinical practice setting.

OBJECTIVES

The aim of this paper is to report the findings of a study undertaken to explore peer-assisted learning in undergraduate nursing students, studying children's health, in the clinical practice setting.

DESIGN

A qualitative ethnographic study using non-participant observations.

SETTINGS

A range of inpatient paediatric clinical settings across two teaching hospitals.

PARTICIPANTS

First, second and third year paediatric student nurses enrolled on a Bachelor of Nursing Programme.

METHODS

Non-participant observations were used to observe a range of interactions between the participants when engaging in peer-assisted learning within the same clinical area. A total of 67 h of raw data collected across all observations was analysed using framework analysis to draw together key themes.

RESULTS

Of the 20 identified students across two hospitals, 17 agreed to take part in the study. Findings were aggregated into three key themes; 1. Peers as facilitators to develop learning when engaging in peer-assisted learning, 2. Working together to develop clinical practice and deliver care, 3. Positive support and interaction from peers to enhance networking and develop working structure.

CONCLUSIONS

Peer-assisted learning in undergraduate children's nursing students stimulates students in becoming engaged in their learning experiences in clinical practice and enhance collaborative support within the working environment. The benefits of peer-assisted learning in current clinical practice settings can be challenging. Therefore, education and practice need to be aware of the benefits and their contribution towards future strategies and models of learning.

How are we assessing near-peer teaching in undergraduate health professional education? A systematic review

BACKGROUND

Near Peer teaching (NPT) is reported as an effective pedagogical approach to student learning and performance. Studies in medicine, nursing and health sciences have relied mainly on self-reports to describe its benefits, focusing on psychomotor and cognitive aspects of learning. Despite increasing research reports on peer teaching internationally, little is known about the various domains of learning used in assessment of performance and objective learning outcomes of NPT.

OBJECTIVE

To determine the domains of learning and assessment outcomes used in NPT in undergraduate health professional education.

METHODS

Quantitative systematic review was conducted in accord with the PRISMA protocol and the Joanna Briggs Institute processes. A wide literature search was conducted for the period 1990-November 2015 of fourteen databases. Grey literature was undertaken from all key research articles. Studies meeting the inclusion criteria were eligible for consideration, including measured learning outcomes of near-peer teaching in undergraduate education in nursing, medicine and health sciences. Set limitations included publications after 1990 (2015 inclusive), English language and objective learning outcomes. A quality appraisal process involving two independent reviewers was used to analyse the data.

RESULTS

Of 212 selected articles, 26 were included in the review. Terminology was confusing and found to be a barrier to the review process. Although some studies demonstrated effective learning outcomes resulting from near-peer teaching, others were inconclusive. Studies focused on cognitive and psychomotor abilities of learners with none assessing metacognition, affective behaviours or learning outcomes from quality of understanding.

CONCLUSION

The studies reviewed focused on cognitive and psychomotor abilities of learners. Even though evidence clearly indicates that metacognition and affective behaviours have direct influence on learning and performance, indicating more research around this topic is warranted. Methodological quality of the studies and lack of theoretical frameworks underpinned by educational psychology may have contributed to inconsistencies in learning outcomes reported.