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Abstract Background Peer-assisted learning represents a favoured method of teaching in universities. The COVID-19 pandemic has necessitated transferring medical education to digital formats, and subsequently, the question has arisen of whether online tutorials might be effective. This study, thus, investigated the efficacy of online tutorials in a communication course by assessing the interaction, verbal communication, and nonverbal communication of tutors and students. Methods Second-year medical students were invited to participate in this longitudinal quantitative study. Validated and self-developed questionnaires (e.g., Jefferson Empathy Scale) including 39 questions (rated on a 7- or 5-point Likert scale) were used to assess the different variables including interaction, verbal and nonverbal communication and students’ learning success. Results Out of 165 medical students, 128 took part in the study. The students as well as tutors reported that they found each other likeable (Mstudents = 4.60±0.71; Mtutors = 4.38±0.53; p > .05). Learning success increased throughout the communication course (Cohen’s d = 0.36–0.74). The nonverbal and verbal communication in the simulated patient (SP) encounter was also rated as high by all three groups (Mnonverbal = 3.90±0.83; Mverbal = 4.88±0.35). Conclusions Interaction as well as nonverbal and verbal communication occurred in the online format, indicating that online tutorials can be effective. The implementation of SPs increases the efficiency of synchronous online learning as it enhances the simulation of a real patient–physician encounter. Thus, online tutorials are a valuable amendment to medical education.

Objectives: Undergraduate ultrasound education is becoming increasingly important, but its expansion is limited by time, space and the availability of trained faculty. In order to validate an alternative and more accessible teaching model, our aim was to assess whether combining teleguidance and peer‐assisted learning to teach ultrasound is as effective as traditional in‐person methods. Methods: Peer instructors taught 47 second‐year medical students ocular ultrasound via either teleguidance or traditional in‐person methods. Proficiency was assessed using a multiple‐choice knowledge test and objective structured clinical examination (OSCE). Confidence, overall experience, and experience with a peer instructor were measured using a 5‐point Likert scale. Two one‐sided t‐tests were used to measure equivalency between the two groups. The null hypothesis that the two groups were not different was rejected when P < 0.05. Results: The teleguidance group performed as well as the traditional in‐person group in terms of knowledge change, confidence change, OSCE time and OSCE score (p = 0.011, p = 0.006, p = 0.005 and = 0.004, respectively, indicating the two groups are statistically equivalent). The teleguidance group rated the experience highly overall (4.06/5), but less than the traditional group (4.47/5; P = 0.448, indicating statistical difference). Peer instruction was rated 4.35/5 overall. Conclusion: Peer‐instructed teleguidance was equivalent to in‐person instruction with respect to knowledge change, confidence gain and OSCE performance in basic ocular ultrasound. [ABSTRACT FROM AUTHOR]

Introduction: There is an expectation that healthcare professionals display competence in teaching, assessment and providing feedback. Development begins with formative peer‐assisted learning and teaching in the undergraduate environment. Using peers or near‐peers (in this case having 1 year more experience than the examination cohort) to provide assessment in summative exams remains unexplored. This study investigates how the use of near‐peers compares to marking by academic staff in a summative OSCE. Materials and Methods: BDS4 Peer assessors (PAs) developed an OSCE question and marking schedule. Each PA (n = 3) was paired with an academic staff assessor (ASA) (n = 3). Peer and academic marked the candidates independently. Two years later, the process was repeated on the same cohort of candidates with the PA now 1‐year post qualification. Statistical analysis compared the scores awarded by PA during each timeframe and against the marks awarded by the ASA. Results: During round 1, 28 students (62.2%) were awarded the same score by PA and ASA. On 17 occasions, there was a discrepancy (37.8%). Bias was skewed in favour of PA scoring higher (mean difference of differences −0.0667). During round 2, 27 students (55.1%) were awarded the same score by PA and ASA. On 22 occasions (44.9%), there was a discrepancy. Bias was skewed in favour of ASA scoring higher (mean difference of differences 0.0612). Discussion: Levels of agreement between PA and ASA are strong. Our results show PA mark more leniently as undergraduates and less leniently at 1‐year post graduation. Conclusions: Peer assessors are able to write OSCE stations, produce marking schemes and effectively assess their near‐peers. [ABSTRACT FROM AUTHOR]

Introduction: Peer-assisted learning (PAL) is a student-centered active learning process which provides a flexible approach for students to prepare and organize their learning prospectus and gives opportunity for collaboration among peers. Aims: The purpose of this study was to assess the effectiveness and impact of online PAL session in enhancing the knowledge of breast cancer and breast self-examination (BSE) among medical students. Settings and Design: This was a cross-sectional, quasi-experimental study done using mixed-method design. Subjects and Methods: Online PAL session was conducted for premedical and preclinical students by the peer tutors for 93 medical students in March 2020. Knowledge of breast cancer and BSE was compared with the pretest and posttest scores. Feedback survey from tutees, tutors, and faculties was taken to evaluate conduct and satisfaction of the workshop for improvements in future. Statistical Analysis Used: Data were analyzed using SPSS 22. Descriptive data were presented as frequency and percentage. Continuous data were presented as mean and standard deviation. Paired sample t-test was applied for statistical significance of pretest and posttest data. Results: Significant improvements were observed in the posttest scores of knowledge on breast cancer and BSE. The mean satisfaction score was high among the tutees, tutors, and faculties, indicating that PAL session had significant impact on students. Conclusions: PAL sessions can be a dynamic tool to create a safe and successful learning environment for students to learn on sensitive health issues such as breast cancer and BSE. [ABSTRACT FROM AUTHOR]

Objective: This study aimed at assessing the effects of two verbal encouragement modalities on the different offensive and defensive performance indicators in handball small-sided games practiced in physical education settings. Methods: A total of 14 untrained secondary school male students, aged 17 to 18, took part in a three-session practical intervention. Students were divided into two teams of seven players (four field players, a goalkeeper, and two substitutes). During each experimental session, each team played one 8 min period under teacher verbal encouragement (TeacherEN) and another under peer verbal encouragement (PeerEN). All sessions were videotaped for later analysis using a specific grid focusing on the balls played, balls won, balls lost, shots on goal, goals scored, as well as the ball conservation index (BCI), and the defensive efficiency index (DEI). Results: The findings showed no significant differences in favor of TeacherEN in all the performance indicators that were measured, whereas significant differences in favor of PeerEN were observed in balls played and shots on goal. Conclusions: When implemented in handball small-sided games, peer verbal encouragement can produce greater positive effects than teacher verbal encouragement in terms of offensive performance. [ABSTRACT FROM AUTHOR]

Peer tutorials – one form of peer-assisted learning (PAL) – are becoming increasingly important in health professions education (HPE). Student tutors usually undergo preparation to support learners in interactive and self-directed learning; however, it is unclear whether and to what extent tutors need special preparation to facilitate interprofessional PAL (iPAL) or what impact this preparation might have. To investigate these questions, a mixed-methods study is underway that consists of three sub-studies: (1) an online survey exploring current tutor preparation in Germany, (2) group discussions on training with iPAL tutors in Germany, and (3) interviews with international experts. The quantitative data are analyzed using descriptive statistics, and the qualitative data are analyzed thematically. This study will provide multi-perspective insights into tutor preparation for iPAL. Results may be used to support conclusions and stimulate debate on the didactic legitimacy and design of tutor preparation as well as to inform future research. [ABSTRACT FROM AUTHOR]

Abstract Background Clinical skill training (CST) is indispensable for first-year surgical residents. It can usually be carried out through video-based flipped learning (FL) within a web-based learning environment. However, we found that residents lack the process of reflection, blindly imitating results in losing interest and passion for learning in the traditional teaching pattern. The teaching method of "spot the difference" (SDTM), which is based on the fundamentals of the popular game of "spot the difference," is designed to improve students' participation and reflective learning during skill training. This study aimed to evaluate this novel educational model's short-term and long-term effectiveness for surgical residents in China. Methods First-year residents who required a three-month rotation in the head and neck surgery department were recruited to participate in a series of CSTs. They were randomized into SDTM and traditional FL (control) groups. Clinical skill performance was assessed with validated clinical skill scoring criteria. Evaluations were conducted by comparing the scores that contain departmental rotation skill examinations and the first China medical licensing examination (CMLE) performance on practical skills. In addition, two-way subjective evaluations were also implemented as a reference for the training results. Training effects were assessed using t tests, Mann–Whitney–Wilcoxon tests, chi-square tests, and Cohen’ s effect size (d). The Cohen’ s d value was considered to be small (0.8). Results The SDTM group was significantly superior to the control group in terms of after-department skill examination (t=2.179, p0.8). There were no significant differences between the two groups on clinical competence (t=0.819, p=0.415, d=0.18), the first-time pass rate for CMLE (χ2 =1.663, p=0.197, d=0.29), and short-term operational skills improvement (t=1.747, p=0.084, d=0.39). Conclusions SDTM may be an effective method for enhancing residents' clinical skills, and the effect is significant both short- and long-term. The improvement effect seemed to be more significant in the peer-involved SDTM than training alone. However, despite positive objective results, SDTM still risks student learning burnout. Trial registration ISRCTN registry, ISRCTN10598469 , 02/04/2022，retrospectively registered.

Abstract Introduction Peer-assisted learning programs have been focused on providing students with competencies to deliver lectures and facilitate workshops, whereas involvement of students as co-developers of educational programmes has been relatively under-described in the literature. Likewise, the use of students as facilitators in simulation-based training and debriefing is also scarce. In this paper, we describe how medical students were co-developers of a novel course on patient safety and how they were trained as student facilitators to conduct simulation-based training and debriefing, as well as workshops. Methods Medical students co-developed a course in patient safety consisting of three simulation-based scenarios and three workshops. The students were educated in relevant patient safety topics. They were trained to become student facilitators to conduct workshops, simulations and debriefings at a patient safety course for medical students. A questionnaire was developed to evaluate the course participants´ perception of the learning objectives and the student facilitators following the latest course in 2020. In addition, semi-structured interviews with the student facilitators were conducted to explore their perceptions of being part of the course. Results A total of 92% of the course participants completed the evaluation of the course. The majority of the course participants found that the student facilitators created a safe learning environment and had the necessary skills to teach. The learning objectives for the course were found to be useful. A total of 10 interviews with the student facilitators were conducted. We found that the student facilitators were motivated to teach in the course, as a way of improving their teamwork, leadership qualities and communication skills, as well as their resume. Some of the student facilitators mentioned that they were able to create a safe learning environment, whereas others mentioned a feeling of inadequacy for their teacher role. In addition to developing their teaching skills, they mentioned that they developed their medical expertise, alongside their communication-, collaboration-, leadership- and professional skills. Conclusion This study illustrates how medical students were involved in the co-development, delivery and implementation of a course in patient safety. The evaluation of the course shows that student facilitators succeeded in creating a safe learning environment. The interviews of the student facilitators reveal their various motivations for teaching, in addition to different perceptions of their experience as a student facilitator. Some expressed a positive feeling of being able to establish a safe learning environment, whilst others expressed a feeling of inadequacy when facilitating peers. In addition, the student facilitators indicated that they developed themselves both professionally and personally.

Objective: To evaluate the effectiveness of a training program for tutors in peer-assisted learning using objective structured teaching evaluation scores. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Lahore Medical College and Institute of Dentistry, Lahore Pakistan, from Jul 2022 to Oct 2022. Methodology: Peer-assisted learning was introduced for fourth-year MBBS students rotated in the Ear, Nose, and Throat Department. Twenty-two students, demonstrating strong academic performance and a willingness to teach, were chosen as peer-assisted learning tutors. A series of workshops was conducted to equip these tutors with effective peer-assisted teaching and learning strategies. To gauge the influence of the training on the tutors' teaching abilities, data were collected using 12 stationed Objective Structured Teaching Evaluation scores, both pre-and post-workshop series. Results: Of the 22 students, 16(72.73%) were females, while 6(27.27%) were males. Their ages ranged from 21-24 years, with a mean age of 22.45±0.73 years. The study revealed a significant improvement in total Objective Structured Teaching Evaluation raw scores for Peer-assisted learning tutors. The Pre-Objective Structured Teaching Evaluation median score was 35(IQR: 9), exhibiting a substantial increase to 61(IQR: 5.75) Post-Objective Structured Teaching Evaluation, with a statistically significant change (p<0.001). Conclusion: The research results indicate that training Peer-Assisted Learning Tutors in teaching and learning principles significantly enhanced their teaching skills. [ABSTRACT FROM AUTHOR]

This study focuses on undergraduate student paraprofessionals who facilitated peer study groups for academically challenging college courses. A grounded qualitative research study of these student facilitators at an institution identified their professional identity development in unexpected ways that went against written policies for teacher attitudes and behaviors. Rather than perceiving themselves as peer study group facilitators following a narrow job description, many of them referred to themselves as teachers and acted accordingly, breaking the boundaries of behavior established by the study group program administrator. This article unmasks this professional identity emergence, postulates the mechanism for this choice, presents a model to explain it, and makes recommendations for talking openly about this identity and the subsequent behaviors that occurred as a result by the facilitators and the implications for the PAL program.

Objective: To investigate the impact of peer-assisted learning (PAL) in chest tube insertion education on surgical residents. Methods: This study is a quasi-experimental study conducted on thirty general surgeon residents enrolled in the PAL program. They were divided into two learner groups (A and B) based on the period of residency start. Group A and B had six and one months of general surgery residency experience, respectively. All participants received adequate training for chest tube insertion by a recently graduated general surgeon. Chest tubes insertion skill was assessed using the tool for assessing chest tube insertion competency (TACTIC) test. Results: Post-TACTIC test score was significantly higher (p=0.001) than Pre-TACTIC test score in both groups. However, a comparison of mean Pre-TACTIC test scores and mean Post-TACTIC test scores between group A and group B showed that PAL effectiveness in group A was significantly higher (p=0.001) than group B. Conclusion: There was a positive relationship between the PAL program and the improvement of chest tube insertion technical skills in surgical residents. Based on our findings and similar studies, it can be concluded that the PAL program can increase the chest tube insertion skill of surgical residents.

Abstract 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.

Abstract Background Peer-assisted learning is a method of active learning that is gaining traction throughout higher education. In the medical curriculum, peer-assisted learning has been the subject of independent studies collecting various types of data. However, an overall analysis of those studies providing objective measurements of the influence of peer-assisted learning could be particularly useful for teachers and students alike in a knowledge-heavy curriculum such as medicine. In this study we set out to analyse the efficacy of peer-assisted learning on medical students’ learning of clinical knowledge and skills that is assessed through some objective examination, and thereby define whether such approaches have a reproducible benefit for inclusion in the medical curriculum. Methods Databases including Pubmed, Embase and Science Direct were searched for relevant studies containing randomized controlled trials (RCTs) of peer-assisted learning published before July 29th ,2020. A meta-analysis was performed by using RevMan 5.3 software. Results Thirteen studies involving 2,003 medical students were analyzed for clinical knowledge and skills gains that included some objective measurement of learning. The results of this meta-analysis indicated that considering all these studies together, peer-assisted learning leads to improvements in clinical knowledge and skills learning for medical students compared with traditional teacher-led passive learning. One study was found likely to be a source of significant heterogeneity, and when this was removed from the meta-analysis, the pooled effect was no longer statistically significant. Conclusions Peer-assisted learning can be an effective method of learning applied to medical student education. Active learning through peer-assisted learning should be seen as complementary to teacher-led approaches. Two of the individual studies on peer-assisted learning show a statistically significant benefit on examination performance compared to the other studies considered, that either show negligible benefits or at worst no detriment in learning. This highlights the need for more high-quality and focused randomized control trials to identify those critical parameters that lead to improved student learning using such approaches.

Background: Community health workers (CHWs) act as a bridge between community and clinical care in caring for HIV patients. This study aimed to evaluate the effectiveness of peer education in improving HIV knowledge, attitude, and perception of CHWs in Babol, Iran in 2019. Methods: This was a quasi-experimental study conducted among CHWs in the health centers of Babol, Iran. The city was divided into two areas of the North and the South according to the geographical map. Then, based on the list of the health centers in each of the areas, one health center was randomly selected and assigned to either the experimental or the control group. Results: Following peer education, all study variables including knowledge score, attitude, and perception about HIV-related issues significantly improved in the experimental group compared to the pre-intervention phase (P = 0.002, P = 0.02, and P = 0.00 respectively). The most significant change was in misconception score with a approximately large effect size (0.78), presenting an increase of 95.53% from 15 to 29.33 after the intervention, while attitude and knowledge respectively presented 85.04% and 81.07% increase with a smaller effect size of 0.57 and 0.52. Conclusion: In the study peer education proved to be an effective strategy in improving the knowledge, attitudes, and perception of CHWs concerning HIV/AIDS. Therefore, the peer-topeer training model can fill a critical gap in the training of CHW based on the idea that not only do the CHWs themselves need to enhance their knowledge of related topics but they also need to train others. In turn, this will result in providing cost-effective health promotion and prevention services in a more culturally appropriate manner. [ABSTRACT FROM AUTHOR]

Peer-assisted learning (PAL) is a potential approach for clinical education that can reduce the burden of clinical supervision and enhance learning. This study aims to identify opportunities for PAL through investigating how speech language therapy students perceive and already participate in PAL within a range of clinical practicum settings. The Speech Sciences students across all years at one institution were invited to participate in a cross-sectional survey that was adapted and revised from Tai et al. (2014). Speech Sciences students reported they applied PAL as part of their learning strategy in their clinical practicums, but still relied on supervisors as the main source of. PAL occurred more frequently in contexts where students already had some clinical experience and spent substantial amounts of time together. Students agreed that PAL enhanced their learning and emphasized a few advantages of PAL, such as having the opportunity to share their ideas, experiences, and knowledge, and providing a positive learning environment without pressure. Confidence to provide information or feedback to peers was cited as a shortcoming in PAL. PAL is a viable teaching approach that can be used in speech-language therapy clinical education program to reduce the supervisory burden. The findings from our study show that PAL is largely self-initiated among speech-language therapy students. However, PAL must be tailored to suit different clinical education year levels and clinical settings to benefit. Case discussion may be one area where scaffolded PAL activities could represent a feasible first step to increasing PAL. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The concept of peer-assisted learning (PAL) has been implemented at many medical faculties. Due to the Covid-19 pandemic, parts of the medical education experience transitioned to digital formats. However, little is known about PAL and online student tutorials. PAL is effective due to cognitive and social congruence. This study aims to investigate these concepts in an online student tutorial on taking a patient's medical history. This longitudinal study took place in a preclinical communication course on how to take a patient's medical history. In an online student tutorial, the students learned how to take a patient's psychosocial medical history. Using standardised questionnaires, cognitive and social congruence were assessed. T-tests of independent samples were performed for data comparison. The participants included 128 second-year medical students and 5 student tutors. Cognitive congruence (Mstudent = 4.19 ± 0.56; Mstudenttutor = 4.04 ± 0.57) and social congruence (MStudent = 4.25 ± 0.56; MStudenttutor = 4.06 ± 0.57) were high for both students and student tutors in the online setting. In comparison to the face-to-face group, students in the online setting considered the student tutors to be significantly (p <.05) more socially congruent. Learning success increased during the course; however, it was not influenced by cognitive congruence. Cognitive and social congruence are high in an online setting. The students' learning success increased during the online tutorial. Based on the higher level of social congruence, student tutors might be very motivated to be open and approachable in an online setting. Simultaneously, students might pay more attention and participate actively in the online setting. Social and cognitive congruence contribute to the effectiveness of online student tutorials and, thus, online student tutorials should be integrated into medical training. [ABSTRACT FROM AUTHOR]

Patient-physician interviewing skills are crucial in health service delivery. It is necessary for effective care and treatment that the physician initiates the interview with the patient, takes anamnesis, collects the required information, and ends the consultation. Different methods are used to improve patient-physician interview skills before encountering actual patients. In the absence of simulated patients, peer simulation is an alternative method for carrying out the training. This study aims to show whether patient-physician interview skills training can be implemented using peer simulation in the absence of the simulated patient. This is a descriptive quantitative study. This research was conducted in six stages: identification of the research problem and determination of the research question, development of data collection tools, planning, acting, evaluation, and monitoring. The data were collected via the patient-physician interview videos of the students. The research team performed descriptive analysis on quantitative data and thematic analysis on qualitative data. Fifty students participated in the study. When performing peer-assisted simulation applications in the absence of simulated patients, the success rate in patient-physician interviews and peer-simulated patient roles was over 88%. Although the students were less satisfied with playing the peer-simulated patient role, the satisfaction towards the application was between 77.33% and 98%. In patient-physician interviews, the peer-simulated patient method is an effective learning approach. There may be difficulties finding suitable simulated patients, training them, budgeting to cover the costs, planning, organizing the interviews, and solving potential issues during interviews. Our study offers an affordable solution for students to earn patient-physician interview skills in faculties facing difficulties with providing simulated patients for training. [ABSTRACT FROM AUTHOR]

Whilst feedback is an essential component of clinical education, it is often lacking in clinical workplaces due to competing priorities. Peer feedback has been proposed as a potential solution but remains underexplored in terms of practicality and effects. We aimed to examine the experiences of peer feedback among paediatric trainees, and the associated feedback culture. Following an Interpretative Phenomenological Analysis approach, the personal experiences of 12 paediatric trainees were explored using semi-structured interviews. Interpretive themes were developed between the transcripts using processes of abstraction, subsumption, contextualisation, and cross-case analysis. Themes were subsequently subjected to member checking and peer debriefing processes. We found that peer feedback was influenced by three contextual factors, namely, prevalent feedback culture, interpersonal consent, and the quality of relationships. Peer feedback culture was lacking in clinical workplaces. Feedback between peers was constrained by avoiding criticism and maintaining work relationships. Social and cultural norms inhibited constructive peer feedback without explicit consent. Enabling peer feedback in clinical settings requires attention to cultural, relational, and consent barriers. Potential approaches should include helping clinicians to develop greater cultural reflexivity, resident training in how to be peer educators, and enhancing institutional supports for peer feedback. [ABSTRACT FROM AUTHOR]

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Introduction: There is a paucity of research on conducting written formative assessment with constructive feedback for theory paper writing for postgraduates of Community Medicine in India. The concept of “Written Formative assessments with Peer-Assisted Learning Program” was implemented to improve the first 2 levels of Miller's Pyramid and assess its impact on the summative assessment. Materials and Methods: The program was conducted for 2 batches of postgraduate students in the Community Medicine enrolled for the academic session of 2016–2019 and 2017–2020. The written formative assessment was conducted every Saturday for 1 h from August to March month in 2018 and 2019. After each test, answer papers were evaluated by the peer and faculty from the department. Written and oral feedback was given by the peer. After IEC approval, we planned to assess the program's effect on level 1 and level 2 Kirkpatrick's framework. The data were analyzed using SPSS statistical package version 24 (SPSS Inc., Chicago, IL, USA). P < 0.05 was considered statistically significant. Results: Total 23 formative written assessments were conducted per year. The proportions of knowledge, comprehension, and analytical type of questions asked were 47%, 32%, and 21%, respectively. The mean attendance rate was 76.28% ±16.4%. There was no statistically significant difference in the average percentage of marks in formative (weekly test) and summative assessment (university final examination). There was a statistically significant positive co-relation of projected mean marks and summative assessment marks with the co-efficient of the determination being 22.6%. There was overall positive feedback of the formative and peer-assisted learning (PAL) from post graduate students. Conclusions: Written Formative Assessment with PAL program is one of the effective programs for postgraduate students to gain confidence in writing and presentation skills and to score higher in theory examination.

Background Peripheral venous catheterization (PVC) and blood sampling (BS) represent some of the first basic techniques that a medical student learns when starting clinical practice. As they are invasive maneuvers, there is a level of self-doubt that can be overcome through practice in a simulated setting. Peer-assisted medical simulation learning is an innovative educational technique that allows students to gain confidence in conducting clinical maneuvers in a safe environment. Simulation based learning focuses on trial and error, participants being able to approach the technique multiple times, without the risk of hurting a real patient. Additionally, the fact that the workshop is conducted by fellow students, creates a more comfortable learning setting. Aim of study Our aim is to determine the effectiveness of medical simulation in learning to perform PVC and BS and in increasing the level of confidence of the participants. Materials and methods Our study was conducted at the Department of Medical Simulation of the Center for Innovation and e-Health (CIeH), part of the University of Medicine and Pharmacy “Carol Davila” Bucharest, Romania, between March and December 2021. During this period, 2186 first year students took part in a peer-conducted simulation workshop, conducted by undergraduate medical students in all years of studies, who had previously undergone extensive training and evaluation. The aim of the workshop was to learn the basics in PVC and BS in a controlled environment. Through a questionnaire, we collected data regarding knowledge acquisition and auto-evaluation of the students’ skill and knowledge prior and after the training on a five-point scale. At the beginning of the questionnaire we obtained informed consent from the study participants. Results The response rate to the questionnaire was 66,10%. The participants obtained an average score of 60%. There were few participants that did not acquire enough information in order to answer correctly to the questionnaire. 80% of the respondents answered accurately on 2 out of 3 questions. We observed a 48,35% increase in the confidence level of participants regarding clinical knowledge and skill acquisition after the workshop. Prior to the workshop, only 10% of participants self-evaluated with a score of 4 or 5, compared to 85% of respondents after the workshop. Conclusions The medical simulation training led to a significant rise in students’ confidence and a high impact on the development of skill and knowledge. Through our basic workshops we want to familiarize the participants with the clinical environment, additional knowledge and skills being acquired once throughout their studies. The workshop's objective of increasing participants’ comfort regarding basic clinical techniques, such as blood sampling and peripheral venous catheterization, was accomplished. The outcome of the study enables us to adapt the curriculum and testing procedures to better meet the needs of the participants.

Anatomy and physiology courses have been identified as a major barrier to the persistence and graduation of undergraduate students seeking careers in the health professions. This break in the health profession’s educational pipeline may have implications for perpetuating racial/ethnic educational attainment disparities that further health disparities through a lack of representation in healthcare providers. Although Supplemental Instruction (SI) is a well-developed, evidence-based program for improving student success, it has traditionally been used primarily in lecture-based courses. In addition, much of the literature on peer-assisted learning in anatomy and physiology focuses on medical school students. Therefore, it is difficult to extrapolate the effectiveness of SI on freshman and sophomore undergraduate students in a laboratory-based course. Here, we describe the expansion of our SI program, in conjunction with a complete curricular redesign, to address student success in an undergraduate gateway anatomy and physiology laboratory. Students who participated in the SI laboratory sessions held outside of instructor-led class time were significantly more likely to be high performers in the course, and there were no students who participated in SI sessions who earned a final course grade below a C. In addition, students expressed high satisfaction with the SI program and indicated that SI leaders provided both content and emotional support. In conclusion, SI is a valuable program to address student success in a laboratory-based course, particularly when integrated thoughtfully and intentionally with other evidence-based best practices in curriculum.

Supplemental Instruction is an evidence-based academic support program which improves the success of higher education undergraduate students who participate in the program, including students from historically underrepresented populations. Sessions are led by near-peer leaders who have previously successfully completed the course. While the impacts of leading SI programs have previously been demonstrated, there is little research on the specific impacts on historically underrepresented student leaders at Hispanic-Serving Institutions (HSIs). Our study aims to elucidate the impact of leading SI on our diverse population of SI leaders at the largest private HSI in New York State. Data were collected from SI leaders on their reflective perceptions about their experiences as SI leaders through both surveys and focus groups. Our data demonstrate that our diverse SI leaders feel positively about their experiences in the SI program with a focus on three areas of perceived self-improvement: confidence, communication and community. These areas of perceived self-improvement are particularly important as they may lead to higher retention and graduation rates.

Background: Peer-assisted learning represents a favoured method of teaching in universities. The COVID-19 pandemic has necessitated transferring medical education to digital formats, and subsequently, the question has arisen of whether online tutorials might be effective. This study, thus, investigated the efficacy of online tutorials in a communication course by assessing the interaction, verbal communication, and nonverbal communication of tutors and students. Methods: Second-year medical students were invited to participate in this longitudinal quantitative study. Validated and self-developed questionnaires (e.g., Jefferson Empathy Scale) including 39 questions (rated on a 7- or 5-point Likert scale) were used to assess the different variables including interaction, verbal and nonverbal communication and students' learning success. Results: Out of 165 medical students, 128 took part in the study. The students as well as tutors reported that they found each other likeable (Mstudents = 4.60±0.71; Mtutors = 4.38±0.53; p >.05). Learning success increased throughout the communication course (Cohen's d = 0.36–0.74). The nonverbal and verbal communication in the simulated patient (SP) encounter was also rated as high by all three groups (Mnonverbal = 3.90±0.83; Mverbal = 4.88±0.35). Conclusions: Interaction as well as nonverbal and verbal communication occurred in the online format, indicating that online tutorials can be effective. The implementation of SPs increases the efficiency of synchronous online learning as it enhances the simulation of a real patient–physician encounter. Thus, online tutorials are a valuable amendment to medical education. [ABSTRACT FROM AUTHOR]

Music educators often find themselves in the midst of a nearly impossible juggling act that includes preparing students for countless performances while also fostering the development of a wide range of musical skills; however, time and resource constraints frequently inhibit the teacher's ability to provide individual attention to every student. Implementing peer-assisted learning activities in an existing curriculum can alleviate some of the demand for direct teacher intervention by empowering students to help guide each other through the learning process. This structure can look different from traditional ensemble instruction, leaving teachers with questions about classroom management. The following guidelines and sample unit plans were designed to provide support for teachers as they incorporate collaborative learning in an effective and manageable way. [ABSTRACT FROM AUTHOR]

Anatomy consists of material that continually defines a student's undergraduate medical curriculum, and thus attaining a solid understanding of it is critical for academic success. Student exposure to anatomy prior to matriculation to the United States (US) medical school is highly variable, with some first introduced to the material in medical school. As a result, students without foundation in anatomy can struggle with adapting to the self-directed learning style that is required to excel with a prosection-based (i.e. hands-off analysis of a cadaver previously dissected by a professional) approach. In this study, second-year US medical students who have previously excelled in the first-year courses at the University of South Florida Morsani College of Medicine (in collaboration with faculty advisors) designed and offered a mock practical examination that mirrors the official practical exam specific to each course: a timed practical examination using dissected human cadavers and radiological imaging to assess anatomical knowledge, followed by a review session. Since the mock practical and review session was designed from a student's perspective, the material could be tailored to specifically address topics that students historically have struggled with. Students who participated in the mock practical and associated review sessions reported feeling more confident than their peers who did not participate. In addition, they significantly outperformed their peers on the official practical examination, independent of any demographic factors or educational background. This study demonstrates the benefits of incorporating peer-assisted learning (PAL) into the anatomical component of the medical school curriculum. [ABSTRACT FROM AUTHOR]

Introduction: Although 3D printing offers customised assistive technology devices at relatively low costs to address the access needs of individuals with disabilities, implementation barriers exist to achieve widespread technology adoption. To improve 3D technology acceptance and to better prepare future clinicians, peer-assisted learning (PAL) was undertaken between occupational therapy (OT) students and students with expertise in 3D printing to work to address real-life patient functional problems. Methods: 3D printing technology acceptance was measured between cohorts of OT students (Cohort Year 2020, n = 31; Cohort Year 2021, n = 32) without and with PAL integration approaches, respectively, at the conclusion of the 15-week term at project completion. Results: After the structured interprofessional PAL modules, Cohort Year 2021 improved in perception of Usefulness (p = 0.023) as compared to Cohort Year 2020, while the Ease of Use (p = 0.095), Attitude Toward Using (p = 0.313) and Intention to Use (p = 0.271) categories did not significantly differ between cohort years. Conclusions: PAL modules may improve perceptions of 3D printing Usefulness among OT students, however Ease of Use should continue to be explored as both 2020 and 2021 cohort average perceptions were neutral related to 3D printing technology. Identifying ideal training and mentoring approaches may alleviate the Ease of Use barriers to integration of this technology within both the classroom and practice settings and benefit patients. [ABSTRACT FROM AUTHOR]

Abstract Background Online communication has taken over in the last 2 years due to the frequent lockdowns because of the COVID-19 pandemic. Overburdened physicians in this pandemic are struggling to get enough time to teach clinical skills online to the students. Also, due to student’s safety issues, the students cannot fully attend the clinics. Therefore, in this scenario, online PAL (Peer Assisted Learning) sessions for clinical skill teaching and learning can be an effective alternative for undergraduate medical students. The academic limitations caused by the COVID-19 related lockdown however can have a pleasurable outcome if certain challenges, related to online PAL, are overcome. Therefore, the present study aims to identify the challenges of Peer Assisted Learning (PAL) sessions during online clinical skills training in the Ophthalmology module of undergraduate medical students. Methods This qualitative exploratory study, utilizing online focus group discussions to explore the challenges of online PAL in training and learning of clinical skills were carried at the Ophthalmology department of Batterjee Medical College, Jeddah; Saudi Arabia. A purposive convenient sampling technique was used to collect data. Data were transcribed and analyzed using thematic analysis. Results The study identified six themes that were further divided into smaller subthemes. The subthemes derived from the collected data were organized under the following major themes; infrastructure, learning environment, psychological problems, interaction deficit, learning desires, and desire for feedback on performance. The major challenge reported by the medical student during online PAL sessions was infrastructure in terms of network connection, scheduling, and timing of the session. The unprofessional learning environment, psychological problems in terms of behavioral issues and personality changes, interaction deficit with peers, tutor, and patient, learning desires, and desire for feedback on performance were the other important challenges faced by the students. Conclusion The challenges explored by our study can be used by the medical educators to incorporate online PAL as an effective, efficient, and alternative teaching and learning modality in the curriculum especially in compromised circumstances like the current COVID-19 pandemic.

Introduction: Peer-assisted learning (PAL) is a teaching method that develops new knowledge and skills through active learning support from peers. Objectives: To assess the impact of PAL in medical education, by collecting quantitative data that explore its effectiveness. To evaluate students’ perception of and satisfaction with PAL. Methods: A 5-point Likert scale survey was developed for students participating in the PAL program either as tutors or learners. Data were compared and statistically analyzed according to gender, GPA, and year of study. Moreover, follow up of peer tutors and peer learner’s achievement was done through comparing their grades with those that not shared in PAL and with their GPA of previous year. Results: Statistical analysis of questionnaire data revealed that medical students regarded voluntary peer-teaching similarly to faculty teaching and have a generally positive perception of PAL. Most of the respondents reported that they benefited both professionally and personally from PAL activities. They recommended expanding the role of PAL and officially incorporating PAL sessions into the curriculum. Students’ achievement was significantly increased for those who acted as peer learners and peer tutors. Conclusions: Using PAL in conjunction with other teaching and learning methods provides additional value by fostering cooperation and social interaction among medical students and further prepares them for their future role as medical science educators. Additional research into the impact of PAL on academic achievement, both short- and long-term learning outcomes, in medical programs is warranted.

Muna Aljahany,1 Haifaa Malaekah,2 Hayat Alzahrani,1 Fatimah Alhamadah,3 Wireen Leila Dator4 1Clinical Sciences Department, Faculty of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 2Department of Surgery, Dr.Sulaiman Alhabib Hospital, Altakhasussi, Riyadh, Saudi Arabia; 3Department of Surgery, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia; 4Faculty of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi ArabiaCorrespondence: Haifaa MalaekahPrincess Nourah Bint Abdulrahman University, Airport Road, Riyadh, 11564, Saudi ArabiaTel +966118238711Email h_malaika@hotmail.comObjective: Since 2010, simulation-based learning has become increasingly popular as a well-recognized method of learning used by medical undergraduates in clinical settings. However, the relatively new concept of simulation-based peer-assisted learning has not yet been widely accepted, so it has not been well documented. Therefore, this study evaluated the perceived advantages of simulation-based peer-assisted learning among health professions students and interns and their acceptance of this new concept of learning from a student-instructor.Methods: This was a pilot study conducted with 11 students in various health profession fields at Princess Nourah bint Abdulrahman University (PNU). The students were given a comprehensive lecture on simulation scenario development and were assigned to four separate interdisciplinary teams for a practical session on simulation scenario writing. Then, they each completed a questionnaire seeking their opinion concerning their experience and concept understanding.Results: The results confirmed the advantages of interprofessional simulation-based peer-assisted learning as it helped in understanding the process as perceived by the study participants. All students expressed their willingness and enthusiasm to use simulation as a technique for peer-assisted learning.Conclusion: The study affirms the importance of developing student teachers’ teaching skills at an institutional level. The future implementation of simulation-based peer-assisted learning is dependent on the students’ awareness of the concept. By exploring a new dimension of medical education, the student teachers could expand their horizon of exposure to holistic case management and interactive learning and equip themselves with practical communication skills to excel in a real-world setting.Keywords: peer-assisted learning, simulation-based learning, student teachers, interprofessional education, teaching skills

Abdulkarim A Jawhari,1 Maha A Safhi,1 Mawadah M Magadmi,1 Rajwa H Alobaidi,1 Khaled M Alghamdi,1 Reem N Basyouni,1 Omar M Saggaf,1 Murad A Yasawy,2 Rania M Magadmi3 1Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 2Faculty of Medicine, Ibn Sina College, Jeddah, Saudi Arabia; 3Department of Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaCorrespondence: Abdulkarim A JawhariFaculty of Medicine, King Abdulaziz University, Jeddah, 23212, Saudi ArabiaTel +966559977079Email Kremjohari@gmail.comPurpose: Research methodology is an essential part of evidence-based medicine. Many educational programs include clinical research methodology within their curriculum. Moreover, students’ preferences for learning methods are different than before, as they now prefer alternative methods, such as peer teaching. Peer-assisted learning enhances students’ tutoring skills. Thus, the current study aimed to evaluate the effect of peer teaching on enhancing clinical research skills.Participants and Methods: Peer-assisted learning was evaluated during a four-week online research methodology course designed for medical students at King Abdulaziz University. A total of 121 students’ and 38 tutors’ attitudes and perceptions of peer teaching were evaluated using a self-administered questionnaire. The effectiveness of peer teaching was assessed using pre- and post-course knowledge tests. Chi-square was used to assess the association of qualitative data, and Mann–Whitney U-test and Wilcoxon rank test were used as nonparametric tests for the variables that were not normally distributed.Results: The post-course knowledge score was significantly higher than the pre-test score. Students had a positive perception of peer-assisted learning. Over 90% of the students preferred peer-assisted learning to traditional teaching. Similarly, the tutors had significantly positive perceptions of peer-assisted teaching. Younger students who had higher post-test mean knowledge scores had a good perception of peer teaching.Conclusion: The current study demonstrates students’ and tutors’ positive perceptions of peer-assisted learning as well as the effectiveness of peer learning. Medical schools should pay more attention to students and prepare them for peer-teacher roles.Keywords: peer-assisted learning, medicine, clinical, methodology, education

The programme LIFE (Líderes Inspirando Futuro y Éxito/Leaders Inspiring Future and Success) was developed to foster socio-emotional development of university students and pupils from urban marginalised schools in El Salvador. Youth in this region grow up facing many challenges, including a high rate of violence and a lack of access to opportunities. In LIFE, university students implement a workshop on teamwork and entrepreneurism for pupils from the 8th and 9th grades. They work in teams and become mentors for the pupils. The 8th and 9th graders also work in teams to develop a project plan. This article focuses on the perspectives and experiences of the university students, as documented through focus group interviews and learning diaries. The analyses revealed that students perceived learning outcomes in the areas of leadership, teamwork, strategic thinking/problem solving and personal growth. [ABSTRACT FROM AUTHOR]

Background: Clinical skill training (CST) is indispensable for first-year surgical residents. It can usually be carried out through video-based flipped learning (FL) within a web-based learning environment. However, we found that residents lack the process of reflection, blindly imitating results in losing interest and passion for learning in the traditional teaching pattern. The teaching method of "spot the difference" (SDTM), which is based on the fundamentals of the popular game of "spot the difference," is designed to improve students' participation and reflective learning during skill training. This study aimed to evaluate this novel educational model's short-term and long-term effectiveness for surgical residents in China. Methods: First-year residents who required a three-month rotation in the head and neck surgery department were recruited to participate in a series of CSTs. They were randomized into SDTM and traditional FL (control) groups. Clinical skill performance was assessed with validated clinical skill scoring criteria. Evaluations were conducted by comparing the scores that contain departmental rotation skill examinations and the first China medical licensing examination (CMLE) performance on practical skills. In addition, two-way subjective evaluations were also implemented as a reference for the training results. Training effects were assessed using t tests, Mann–Whitney–Wilcoxon tests, chi-square tests, and Cohen' s effect size (d). The Cohen' s d value was considered to be small (<0.2), medium (0.2-0.8), or large (>0.8). Results: The SDTM group was significantly superior to the control group in terms of after-department skill examination (t=2.179, p<0.05, d=0.5), taking medical history (t=2.665, p<0.05, d=0.59), and CMLE performance on practical skill (t=2.103, p<0.05, d=0.47). The SDTM members rated the curriculum more highly than the control on the items relating to interestingness and participation (p < 0.05) with large effect sizes (d >0.8). There were no significant differences between the two groups on clinical competence (t=0.819, p=0.415, d=0.18), the first-time pass rate for CMLE (χ2 =1.663, p=0.197, d=0.29), and short-term operational skills improvement (t=1.747, p=0.084, d=0.39). Conclusions: SDTM may be an effective method for enhancing residents' clinical skills, and the effect is significant both short- and long-term. The improvement effect seemed to be more significant in the peer-involved SDTM than training alone. However, despite positive objective results, SDTM still risks student learning burnout. Trial registration: ISRCTN registry, ISRCTN10598469, 02/04/2022，retrospectively registered. [ABSTRACT FROM AUTHOR]

Peer-assisted learning (PAL) involves a student peer providing some form of support to a student mentee, usually participating at an earlier point in the same programme of study. PAL has been shown to have benefits for on-campus students. However, differences in on-campus and online programme delivery make it difficult to generalise these benefits to fully online distance learners (ODL). Of concern to providers of these types of programmes in higher education, are reports of increased student isolation, reduced motivation and early drop-out from their studies. Thus, providing PAL through an online environment may be one way to reduce these concerns. A systematic review of the published literature was performed to identify evidence of the potential benefits of formalised peer-assisted learning for students enrolled on a fully online, distance learning programme in higher education. A recognised methodology was used to search for relevant literature, and to synthesise results. Of the initial 2,225 individual studies identified from the search, only four met the full inclusion criteria for this review. The results of the four studies were inconclusive; differences between types of academic programmes, the design of the peer-support and the way in which they had been examined and reported were found. As a result, there was little more than a suggestion that in higher education, formal online peer-support might benefit fully online distance learners in some way. [ABSTRACT FROM AUTHOR]

Teaching and learning approaches in the college classroom can be enhanced beyond the traditional lecture by using technological tools and research-based instructional techniques. In particular, instructional technology can allow large numbers of students to engage with content, instructors, and each other in a meaningful learning process. Clickers, an example of such instructional technology, are personal response systems used to create an interactive learning environment in university lecture classes. Several research studies have shown that clickers, paired with the appropriate pedagogy, have a desirable impact on student outcomes in terms of higher attendance, increased engagement, and improved exam scores, which leads to overall enhanced learning outcomes. In this study, we specifically examined student performance on the final exam after using a peer instruction strategy with clickers in an post-exam review on earlier exams. The class was a large (approximately 130 students) introductory genetics course at a regional, public research university in the southeastern United States. The results showed significant improvement in student performance from the initial exam to the final exam on difficult concepts addressed using clicker-aided peer instruction. [ABSTRACT FROM AUTHOR]

The study of medicine poses an immense burden on the medical students to become competent in all the core competencies. Medical students understand the learning requirements of their peers and thus senior students or peers can significantly help to achieve learning outcomes. Peer-assisted learning has been implemented in both undergraduate and postgraduate courses in clinical as well as classroom settings. It is quite beneficial as it makes the learning process interactive, more focused, and conducted in a relaxed atmosphere. It also reinforces points that require more attention.

Background: The aims of this study were to compare the outcomes of faculty led learning with peer assisted learning in acquiring procedural skills and to analyze perceptions on the learning experience of both groups so that feasibility of adopting peer teaching can be considered in the skills laboratory. Methods: Medical students from 4th semester were divided into two groups – A - Individual learners and B - peer tutored students. Group A was taught bladder catheterization by faculty. Six volunteers were chosen as peer teachers, trained by faculty to perform and teach the procedure. Each peer teacher was assessed for training skills. Five to six students were then assigned to each peer teacher. At the end of the study period, each student was assessed for skills acquired by objective structured practical examination. Feedback from students on perceptions of their learning experience was collected using validated feedback instrument. Results: Fifty-seven students excluding peer teachers were assessed–30 in Group A and 27 in Group B. Mean competency scores of Group B was higher than those of Group A (P < 0.012). Median scores of perceptions on overall skill development, teacher contribution, and student satisfaction were not different between the groups. Conclusion: This study has demonstrated that peer teaching can be an effective and feasible tool to teach basic procedural skills to students. Perceptions on the learning experiences of individual and peer led groups in the skills laboratory were not different emphasizing the acceptability of the peer tutor approach.