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Building effective and supportive communities of practice in an asynchronous environment can enable students to learn from each other at their own convenient times without the need to meeting for discussing concepts. In an undergraduate course with a large amount of content to learn, working collaboratively to answer practice exam questions can help encourage deeper learning and understanding. This project examined whether exam performance can be positively influenced by online collaboration during revision and suggests that the quality of an individual’s contribution has a direct effect on his/her subsequent exam performance. We compared two student cohorts’ exam marks from their previous 3 years of exams with how they performed in Year 4 after using PeerWise (an online repository of multiple-choice questions that are created, answered, rated and discussed by students). In addition, we looked at the quantity and quality of their contribution in PeerWise to evaluate how this affected their fourth year exam performance. We confirmed that exam performance is improved by authoring questions in PeerWise, but found it is further enhanced by replying to, and commenting on, others’ posts as well.

Context: The study was carried out to ascertain the effectiveness of peer-assisted learning (PAL) as compared to teacher-assisted learning. Aims: The aim of this study is to determine the efficacy of PAL for the first MBBS students. Settings and Design: A retrospective analytical study on medical education was conducted at a medical college in North India. Materials and Methods: The study had two activities. In the first, six students of the same batch were randomly selected to conduct a peer-guided symposium. A total of 83 students participated in this activity as experimental group. For the second activity, 54 students participated as a control group for a tutorial class conducted by two faculty members. In both activities, a questionnaire pertaining to the topic was given before and after the activity, and scores obtained were taken as pre- and post-activity scores, respectively. Change in performance, understanding, and knowledge was assessed. Statistical Analysis Used: Pre- and post-activity scores were compared using t-test. Mann–Whitney U-test was used to determine which activity was better. Results: Both activities showed a significant improvement in postactivity scores (P < 0.001) indicating that both activities are comparable and effective; however, improvement was better in teacher-assisted tutorial as compared to peer-assisted symposium (P < 0.001). Conclusions: Improvement in postactivity score of peer-assisted symposium showed that PAL may be implemented under the guidance of a teacher.

Arjun Menon, Rahul Menon, Vishnou MourougavelouFaculty of Medicine, Imperial College London, London, UKWe read with great interest the research by Shields et al,1 evaluating the most effective ways of teaching the clinical abdominal examination to medical students. As medical students ourselves, we too have noticed how variability in cohort size, teaching style, and levels of practice can affect competency when performing a clinical examination.At Imperial College, London, students are taught to perform examinations on real and simulated patients from an early stage. It is natural that students would like to examine real patients with clinical signs as without this experience early on in their medical career, it would put them at a disadvantage when they are required to recognize pathology. A randomized experiment found that what students valued most was the “authenticity” of real patient encounters.2 We do however acknowledge that simulated patients have their benefits, especially during the early learning stage. Furthermore, finding real patients who are willing to volunteer their time for the teaching of medical students can be challenging.1Another important factor to the successful teaching of the clinical examination is the size of the group. In a study of 48 medical students studying the musculoskeletal examination, it was found that through small-group interactive examination skills teaching, the students improved their skills immediately after the teaching but also maintained these acquired skills several months on.3 The controls on the other hand, who only carried out regular clerkship activities, such as hospital placements, were unable to improve their examination skills.3Authors' replyHelen M Shields,1 Nielsen Q Fernandez-Becker,2 Sarah N Flier,2 Byron P Vaughn,2 Melissa H Tukey,2 Stephen R Pelletier,3 Douglas A Horst21Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, 2Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 3Center for Evaluation, Harvard Medical School, Boston, MA, USAWe are happy to respond to the excellent comments in the Letter to the Editor by Arjun Menon, Rahul Menon, and Vishnou Mourougavelou, medical students at Imperial College, London, regarding our recently published article entitled “Volunteer Patients and Small Groups Contribute to Abdominal Examination’s Success”.1We completely agree with Imperial College London’s routine practice of using “real patients” from the beginning of medical school for students to practice their physical examination skills. We would like to clarify and confirm that it is also our practice to use “real patients” for our Abdominal Examination Exercise. Our ability to recruit sufficient “real” volunteer patients each year for 43–46 small groups for the Abdominal Examination is the result of the popularity of this exercise with these patients.1 We have not had the difficulty in recruiting patients as noted by Bokken et al2 perhaps because all the patients came from the practices of the two Directors of the Abdominal Examination (HS and DH) who were committed to utilizing “real” patients.View the original article by Shields et al

Abstract Objective The objectives of this study were to; (a) evaluate the current practices of peer assisted learning among second year and final year medical students of Faculty of Medicine, University of Colombo, Sri Lanka; (b) identify reasons for engaging in peer assisted learning; (c) identify perceived weaknesses in current learning activities; and (d) determine student characteristics associated with engaging in peer assisted learning. Results This cross sectional study interviewed two hundred and eighty-four eligible students. Average number of hours spent on peer assisted learning during a week was significantly greater among second year students compared to final year students (15.1 vs. 7.1 h, p

Peer-assisted learning is one of many educational strategies that can assist students׳ learning and their professional development. Its value could be enhanced if combined with a student centered learning strategy such as team-based learning. Purpose: The aim of this pilot study is to evaluate the impact of peer-assisted learning associated with team-based learning on the learning experience of dental students. Method: Forty-two dental students participated in peer-assisted learning associated with team-based learning activities and 6 of them took the role of tutors in the team-based learning sessions. A structured on-line questionnaire was sent to 42 students to evaluate their perception regarding the impact of peer-assisted learning associated with team-based learning on their learning experience. Thirty-eight (90.5%) participants out of 42 answered the questionnaire. Sixteen students volunteered to participate in focus-group interviews for verification of the questionnaire responses. Results: Thirty-two participants (84%) agreed that peer-assisted learning associated with team-based learning improved the way they study and increased their interest in the subject. Thirty-five students (94%) indicated that they enjoyed this learning experience. In addition, they would recommend this program to their colleagues. Thirty-one (82%) agreed that peer-assisted learning associated with team-based learning improved their teaching skills. Furthermore, thirty-one students (82%) indicated that it increased their communication skills. All participants agreed that they were satisfied with the overall program. The results obtained from both students׳ survey and focus-group interviews were consistent. Discussion: Our findings suggested that peer-assisted learning associated with team-based learning was a valuable strategy to enhance learning among students. It can also provide these students with teaching experience which could help their professional development.

Introduction Oral presentation and public speaking skills are poorly emphasised in the medical school curriculum. The student grand round was created to tackle this deficiency by changing the way in which students are taught, from traditional lecture-based learning to interactive small-group peer-to-peer teaching. This approach encourages students to become responsible for their own learning, develop their public speaking and teaching skills, as well as identify and address gaps in their knowledge. Aims The primary aims of this study were to determine the understanding of students before and after peer teaching, including retention of concepts via quiz scores and confidence of students in giving SBAR (Situation, Background, Assessment, Recommendation) handovers. The secondary aim is to determine the place of student-led grand round teaching in the medical curriculum as a means of developing teaching skills and encouraging active learning. Methods A cohort of 21 third-year medical students from Leicester University attended a weekly peer teaching programme where students presented a case they had encountered during their clinical attachment. Peer teachers were required to research some background and pathophysiology regarding the topic and teach in an interactive manner and create discussion regarding the topic. The students then summarised the case and practised the skill of concise handovers using the SBAR format. Knowledge and understanding were assessed with an interactive quiz, and feedback via a survey was gathered before and after sessions. Each student engaged in case discussion and received input from a specialty registrar regarding their presentation skills, case knowledge, and SBAR handover. Results Individual and combined session analysis demonstrated a significant improvement in scores across understanding the topic and confidence in SBAR. Student recommendation for the session cumulatively was significant (p=0.02); however, comparison of medical student recommendations of individual sessions did not yield statistically significant results. There was a significant improvement in the overall quiz score (p=0.045), and average scores improved from 51% to 70% (p=0.043). There was a significant increase in the mean quiz result after the first two sessions (28-55% (p=0.002) and 56-85% (p=0.0001), respectively). Summary The student grand round is a promising teaching initiative that capitalises on peer teaching, a valuable learning theory that centres around students taking on the role of teachers to instruct their peers. Results from this study have shown that this method of collaborative teaching is effective in improving the understanding of medical topics, increases confidence in public speaking and precise handover skills, and therefore better prepares medical students for their career as future clinicians., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Nazari et al.)

Introduction: In recent years, medical education has witnessed a shift in the integration of ultrasound into the preclinical years of medical school. Given the exponential increase in accessibility to ultrasound technology, students now have the opportunity to create peer learning groups in which ultrasound concepts can be taught from peer to peer, empowering students to work together to integrate ultrasound concepts early in their preclinical education. This project investigates the efficacy of peer-taught student tutors (PTSTs) in imparting the fundamentals of basic ultrasound techniques to first-year medical students in the setting of identifying and labeling upper extremity musculoskeletal (MSK) anatomy.  Methods: First-year medical students were instructed to identify volar forearm structures with an ultrasound probe. Students and instructors were given access to an ultrasound probe, ultrasound gel, an iPad, and a standardized patient. Students were taught either by an ultrasound instructor (UI) or PTST. After a hands-on demonstration by a UI or PTST, participating students were told to take screenshots and label their images as accurately as possible, identifying the aforementioned volar structures on a standardized patient without any feedback. The labeled screenshot images of volar structures were graded based on the ability to clearly visualize the intended structures.  Results: The results of this study compare the efficacy of PTSTs as educators of basic sonographic identification techniques with that of UI faculty members. A chi-square analysis was performed between the images obtained by the UI and PTST students, and there was no statistically significant difference in identification accuracy between the groups (p = 0.7538, 0.1977, 0.1812, 0.301). When using the Mann-Whitney U rank test, there remained no statistically significant difference between the accuracy of the students taught by STs compared to students taught by UIs (p = 0.7744, 0.09538, 0.07547, 0.1846). Another finding showed that students belonging to both teaching groups were generally not able to infer the pathology of volar wrist structures when given pathology identification questions regarding upper extremity ultrasound. Using chi-square with Yates correction, there is no sufficient evidence to justify an association between the ability to answer pathology-based ultrasound questions and instructor type (p = p = 0.6299, 0.8725)., Conclusions: This study supports the interpretation that the capability of first-year medical students to learn novice MSK sonographic identification is independent of whether the educator is a PTST or UI. This interpretation reveals a promising avenue toward the integration of the fundamentals of ultrasound identification early in medical education with little to no concern for the exhaustion of institutional resources. Along with the other well-documented benefits of the utilization of STs in medical school, a peer tutoring system centered on ultrasound skills designed in the way this study describes can be an effective, resource-sparing system that enhances medical students' sonographic capabilities early in their preclinical years., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Aquino et al.)

Purpose: Interprofessional education (IPE) on a ward supports students to generate interprofessional patient care plans as a means to learn about the roles, responsibilities, and clinical reasoning of other professions. We investigated how clinicians guide the clinical reasoning of students from their own and other professions and whether clinicians from nursing, midwifery, and medicine could scaffold students from all professions, that is, by providing just-in-time and tailored support. Methods: Nine supervising clinicians from medicine, nursing, and midwifery were interviewed and a repeat interview held 3 to 15 weeks later; one nurse supervisor was interviewed only once. Using conventional content analysis, themes were identified inductively. Next, we applied an existing scaffolding framework to conceptualise how clinicians supported the clinical reasoning in an IPE setting. Results: Themes were clinicians' interventions and intentions, results of interventions and of IPE, characteristics of students and clinicians, interactions between clinicians and students, and logistics. Clinicians applied various interventions and expressed several intentions to guide the learning of students from all professions. Clinicians stimulated students' clinical reasoning by structuring meetings, asking students to explain their thoughts to each other and through giving group assignments. Thus, clinicians used peer-assisted learning for the students. By collaborating with other supervising clinicians regarding the form and amount of guidance to give to the students, clinicians applied peer-assisted learning for themselves as well. Conclusion: Clinicians can learn to scaffold the clinical reasoning of students from different professions, when they are provided with training, good examples, and structures. An existing scaffolding framework can serve as an overview of aims and interventions to provide just-in-time guidance to students from all professions. The scaffolding framework is useful for training clinicians and for depicting the pedagogical approach for IPE wards. [ABSTRACT FROM AUTHOR]

Universities offering accredited medical imaging degrees must ensure their graduates can deliver radiographic services including computed tomography (CT). On-campus high-fidelity simulation can potentially facilitate this learning outside the clinical environment yet there is a paucity of research validating its benefits in relation to diagnostic CT. A pragmatic multiple methods approach tested for differences in knowledge acquired from two high-fidelity CT simulation environments and explored student perceptions of the learning activities. Third year radiography students (n = 62) were randomly assigned to two groups prior to undertaking a CT placement. Group 1 completed learning activities on a remote-access CT scanner (RA) with peer-assisted learning (PAL). Group 2 completed identical tasks on a local-access CT scanner (LA) facilitated by a CT radiographer. RA students were offered additional scan time if so inclined. Students' CT knowledge was assessed pre- and post-clinical placement. Students were surveyed about their learning experiences. Assessment data was analysed via an ANOVA and survey data via descriptive statistics, t-test and thematic analysis. Assessment results demonstrated no significant difference in CT knowledge between the groups (F(1,60) = 0.3, p = 0.6). There was significant improvement in assessment scores between the pre- and post-clinical period for both groups (F(1,60) = 37.4, p < 0.001). Four themes emerged: remote versus local-access capabilities, facilitation versus PAL, use of a real scanner, and preparedness for the learning activity. CT knowledge acquisition via RA with PAL is comparable to LA with facilitation. Students reported increased satisfaction and confidence in CT skills via facilitated LA compared to RA students with PAL. Opportunity for CT knowledge acquisition is now available outside of the clinical centre via remote-access. PAL requires in-depth training of the peers in technologically rich learning environments. [ABSTRACT FROM AUTHOR]

Introduction: Although all medical school graduates are expected to be educators as residents, and subsequently as faculty, most students receive no formal education on how to teach. At the Uniformed Services University (USU), no formal educational training previously existed for senior medial students as they prepared for residency. A novel Medical Education Elective for MS4s was developed and run by MS4s with faculty mentoring at USU with implementation between January and June 2018.Materials and Methods: The overall goal of the 4-week course was to provide a forum for MS4s to gain exposure to educational theories and teaching methods with an opportunity to practice learned skills in the underclass curriculum. The course's three core components were: didactics, observed teaching, and independent teaching. The course was evaluated via multiple methods including verbal and survey feedback from both first and fourth year medical students.Results: The preliminary outcomes revealed the course had a positive impact on both first-year medical students (MS1s) and MS4s. As of May 2018, 100% (n = 59) of MS1s surveyed reported that having an MS4 teacher contributed positively to their learning experience. All MS4s surveyed (n = 12) agreed that the course enhanced their confidence in teaching.Conclusions: Medical education courses not only offer an opportunity for senior students to cultivate educational theoretical knowledge and teaching skills in preparation for residency but also contribute positively to the learning experiences of underclass students. Now that the elective has been piloted with initial data suggesting feasibility and benefit to both MS4 and MS1 students, the next steps are to focus on ensuring longevity of the course offering at USU and to consider working with senior students at other institutions that lack formal training in education to start similar student run medical education initiatives. [ABSTRACT FROM AUTHOR]

The Studentische Poliklinik is Germany's first student-run free clinic. Prior to fulfilling clinical obligations there, students must complete an extensive peer-assisted learning program (PAL). Due to capacity constraints, a web-based learning program involving virtual patients has been launched. The aim of this study was to evaluate and compare the effectiveness of Virtual Patient Learning (VPL) vs. PAL in the acquisition of basic medical knowledge and skills. Forty undergraduate medical students (m=9; f=31) in their third year were randomly assigned to either the PAL (n=20), or VPL (n=20). Short-term (after each seminar) and long-term learning retention (after completion of the electives) was measured using a validated theoretical test. Objective structured clinical examinations (OSCE) were used to assess practical knowledge. Additionally, the course itself was evaluated. Differences in theoretical knowledge between students in the PAL and VPL existed over the short term (VPL median = 100%; PAL median = 80; p = 0.006), but not over the long term (VPL = 94.17; PAL = 95.62%; p = 0.617). An assessment of practical skills showed no differences in OSCE scores between the two different groups (VPL = 79.30%; PAL = 80.26%; p = 0.141). Students assessed their learning experience and the comprehensibility of seminars as either "very good" or "good". Basic medical knowledge and skills can be taught as effectively using VPL as PAL. Given the cost-effectiveness, high reproducibility and freedom of time and place, VPL should be performed more often when teaching family medicine in student-run free clinics. Ultimately, this may result in enhanced treatment quality and patient satisfaction. [ABSTRACT FROM AUTHOR]

Peer-assisted study session attendance is associated with multiple indicators of student success. However, attendance levels are generally low. We applied an extended theory of planned behaviour model, incorporating student role identity, to the prediction of peer-assisted study session attendance. Participants were 254 undergraduate students enrolled in 24 peer-assisted study session supported units. Attitudes, subjective norms and perceived behavioural control each had a significant direct effect on attendance intentions, which had a significant direct effect on attendance. All three predictors also had significant indirect effects on attendance, mediated by intentions. After controlling for intentions, only perceived behavioural control had a significant direct effect on attendance. The model accounted for 61% and 42% of the variance in intentions and attendance, respectively. Student role identity did not improve the predictive utility of the model. Theory of planned behaviour–informed strategies for increasing peer-assisted study session attendance are recommended. [ABSTRACT FROM AUTHOR]

Purpose: The utility of peer-assisted learning (PAL) in anatomy education has been recognized. In this study, PAL was incorporated into osteology teaching for the first-year medical students and compared to traditional didactic methods (TDM). Methods: This was a cross-over intervention study. The class of 60 students was divided into two equal groups. The first group underwent PAL for five upper limb osteology sessions and TDM for all lower limb osteology classes. The second group underwent TDM for five upper limb osteology classes and PAL for lower limb osteology classes. A pre-session test (PrST) and post-session test (PoST) were conducted for each session using multiple choice type questions. Perceptions of students about PAL were collected using a questionnaire. Between and within group differences were estimated using the independent sample T test and paired T test, respectively. The responses in the questionnaire were summarized and open-ended responses categorized into broad themes. Results: Greater group differences were noted in the PrST as compared to the PoST mean scores, with the PAL group showing higher mean scores for both upper and lower limb sessions. Significantly higher PoST scores compared to PrST scores for all the sessions were observed regardless of the method used. Significantly higher scores in the PrST or PoST scores were noted in the PAL group for five sessions. Most aspects of PAL were appreciated by the students. Conclusions: This study provides evidence that PAL is at least as effective as TDM in learning osteology among the first-year medical students. [ABSTRACT FROM AUTHOR]

This study is an autoethnographic reflection on power and expertise in an evolving student/staff partnership. The partnership was initiated as pedagogical co-design in the development and implementation of a peer-assisted learning programme. Through a process of critical reflection that linked our partnership experience with themes from relevant literature, we (the staff and student authors) became co-researchers of our practice. The evolution of the partnership provided a unique perspective from which to compare our experiences of power and expertise across both contexts. We characterised our pedagogical co-design partnership as a shift from the more traditional 'power over' model of delivery towards 'power to empower' where both student and staff partners had agency and voice. Key to this important transition was a shared philosophy of student-centred teaching. As the partnership transformed from co-teaching to co-researching we needed to re-negotiate power dynamics; while our different pathways had converged on a common view of student-centred learning, our research expertise remained disparate. We were able to negotiate this challenge by drawing on our existing relationship based on respect, reciprocity and responsibility, reinforcing views of partnership that value equality of opportunity and a focus on learning and process, rather than equality of contributions and outcomes. [ABSTRACT FROM AUTHOR]

Candidates who study business disciplines are trained to be all-round administrative staff to handle business-related issues. Knowledge of a basic accounting principle for supporting financial decisions is vital in business operations, and is especially crucial for managerial workers of a listed company. Indeed, the accounting module is one of the core modules for higher education students who are studying in business disciplines. With the College Heads' endorsement when departments joined the Peer-Assisted-Learning using Supplemental Instruction (PALSI) scheme, the academic results of two accounting modules were collected anonymously for research purposes. The subject registration information shows that each cohort had at least 300 enrolments and, at most, over 800 enrolments. A review of academic results throughout four academic years was performed, the sample size of the study consisting of a total of 1,815 PALSI students and 5,869 non-PALSI students. This article focuses on the quantitative analysis in comparing the performance of PALSI students and non-PALSI students by monitoring their academic results consecutively in different cohorts. In this study, a t-test is implemented to evaluate the effectiveness of the peer-assisted learning scheme by identifying the academic results of each cohort to ascertain if there is a significant difference between the two groups. Similar investigation on the effectiveness of the PALSI scheme with different accounting knowledge background before joining the undergraduate programmes is implemented in the latter part. The findings of the analysis provide remarkable academic enhancement for students with PALSI support, and it is concluded that the scheme is worth extending to different subjects in the business discipline in the future. [ABSTRACT FROM AUTHOR]

Peer-assisted learning (PAL) is a common feature of health professions education, characterised as learning from and teaching others who are from a similar background. Evaluations of PAL identify a range of positive outcomes for peer tutors/tutees but rarely address the hidden curriculum, which is a by-product of the learners' educational experiences, shaped by wider organisational influences and culture. The aim of this case study was to explore the hidden curriculum associated with two modes of PAL used in the final year of an undergraduate medical programme in Thailand: Case Discussions and a Journal Club. A naturalistic evaluation approach, incorporating multiple data sources, was used to explore students' perspectives on PAL (interviews), student and faculty behaviours during PAL (observation) and the school's formal/written curriculum (document analysis). Three themes emerged from the thematic analysis of student interviews, triangulated with the observational data (reflecting positive and negative aspects of PAL): 1) developing self as a doctor; 2) learning through dialogue and feedback; and 3) barriers to learning. New insights were gained in relation to the influence of norms and social interactions i.e. recycling materials for Case Discussions and student difficulties with English language journals. Some of the barriers to learning are inherently connected to the study context and recommendations can be made locally for PAL review, however, revealing what is being learned, in the medical habitus, intended and unintended outcomes, highlights the importance of considering the hidden curriculum as an integral part of PAL planning, implementation and evaluation. [ABSTRACT FROM AUTHOR]

While peer-assisted (PAL) learning strategies have been successful in K-12 programs, such practices are used less commonly at the college level. In addition, PAL programs are aimed largely at student populations who are struggling (for example, learning disabled students) or in topics where many students encounter difficulty (for example, math and natural sciences). This means that while PAL strategies have shown their effectiveness, the view from the academy is that this help is largely remedial. This paper surveys the literature and analyzes the use of PAL programs in freshman-level general education classes at a large, diverse public university with particular focus on the humanities. We conclude that using peer-assisted learning is a vibrant addition to university education, with promising possibilities for humanities education. [ABSTRACT FROM AUTHOR]

A three-phased, mixed-methods study was conducted to explore the experiences of undergraduate radiotherapy students and their supervising practice educators within U.K. radiotherapy practice placement. Qualitative data were gathered from focus groups/interviews with volunteer participants to elicit in-depth perceptions about experiences of practice placement. Data were transcribed, verbatim, and manually coded and analysed by the researcher using the applied research methodology of framework analysis, enabling the investigation of the a priori theme 'practice placement model', and recommendations were made for improvement. Two radiotherapy placement models are confirmed, i.e. the single student model, and the paired student model, and advantages and disadvantages are identified for each. Study findings suggest that neither radiotherapy model is superior to the other in terms of placement education and experience. Previous and current experience of either model appears to bias students and practice educators towards that model, despite recognition of its disadvantages. The experiences of students and practice educators using the radiotherapy models are consistent with the experiences of other AHPs and nursing using similar practice placement models. It is recommended that all students should have access to peer-assisted learning on placement to improve critical thinking skills, to enable time for reflection, and to consolidate learning. • Radiotherapy practice placement models are comparable to those used in other healthcare professions. • Radiotherapy practice educators and students prefer the model with which they are most familiar, despite its disadvantages. • Peer assisted learning is essential for all radiotherapy students, regardless of placement model. [ABSTRACT FROM AUTHOR]

Peer-assisted learning is now being recognised as an effective learning strategy to support the development of health professionals. Furthermore, adopting coaching style dialogue and conversation enhances learning and development for both the coach and coachee and, in this instance, for year 1 and year 3 student paramedics. This article describes how the implementation of peer-assisted learning into the classroom setting can help to support student paramedics in the development of their own clinical skills and knowledge. It describes broadly the evaluation findings of a session whereby year 3 student paramedics coached year 1 student paramedics to further develop a range of clinical skills through demonstration and discussion. A summary overview of the findings reflects the multiple benefits of this innovative approach to facilitate learning, including a notable increase in professional knowledge and skills for both groups of students. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. 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. [ABSTRACT FROM AUTHOR]

Young children on the autism spectrum have minimal social interaction with their peers in inclusive preschool settings, thus limiting opportunities to build social relationships. Research indicates that explicitly training peers how to interact with classmates with autism spectrum disorder (ASD) can increase the likelihood of peer-directed behavior; however, less is known about other strategies that can be used to support the peer-related social interactions of children with ASD and how those strategies may be used in conjunction with trained peers. Video data were analyzed from 23 classrooms using the Learning Experiences and Alternative Program for Preschoolers and Their Parents model (an inclusive preschool program that emphasizes peer training and peer support) to provide a snapshot of environmental features and the role of implementation fidelity that may enhance or inhibit the social interaction of 52 children with ASD. Findings indicate that social interaction is most likely to occur when an adult is not present, during small group activities, pretend play, and large motor activities. Implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Academic support in the form of formal, peer-led study groups was initiated at a four-year college of pharmacy utilizing paid group facilitators and a student program coordinator under the direction of the Associate Dean for Student Affairs. This study's purpose was to assess the first year of this program from the viewpoints of the student participants, study group facilitators, and faculty. Student, study group facilitator, and faculty perceptions of the study group initiative were collected following the first year of operation via cross-sectional surveys and qualitative content analysis. Surveys addressed the perceived value of study groups and their impact on study habits, supportive relationships, and professional growth. A five-point Likert scale was used to note participants' level of agreement with each survey item, while open-ended questions gathered subjective feedback. The mean, standard deviation, and frequency were calculated for each survey item across the three participant groups and qualitative themes from free-responses were identified. Student survey responses overwhelmingly supported the value and continuation of study groups (93% to 100% agreed or strongly agreed), with both participants and facilitators expressing enthusiasm for the program. Facilitators felt adequately trained (85.7%) and that their roles positively influenced their professional development (85.7% to 100%). Faculty respondents agreed that the program was valuable and should be continued. Overall, students and facilitators perceived study groups to be valuable in supporting the academic success of pharmacy students. [ABSTRACT FROM AUTHOR]

Nursing students can find clinical learning to be challenging, unpredictable and stressful. To address this problem, this study integrated Mindfulness into Peer-assisted Learning (PAL) for nursing clinical education and investigated the feasibility and effectiveness on improving student participants' emotional reactions, and explored the perception and experience towards the programme. This quasi-experimental, repeated-measure, mixed methods study was conducted in a convenience sample of 126 Year 2 and Year 3 university nursing students. The participants engaged in an online mindfulness peer-assisted learning (PAL) programme that consisted of mindfulness practice, senior students sharing their experiences, and peer-assisted group learning. Emotional status (in terms of depression, anxiety and stress), burnout and self-efficacy were measured at baseline, 8 weeks after programme commencement and immediately after programme completion. Linear mixed-effects models and an intention-to-treat analysis were used to investigate changes in the dependent variables over time. Thirty-nine participants were also invited to engage in semi-structured interviews to explore their learning experiences in the programme. The programme significantly improved the participants' self-reported self-efficacy (β = 1.44, 95 % confidence interval (CI): 0.58 to 2.30, p = 0.001) and decreased their level of burnout (β = −2.31, 95 % CI: −3.24 to −1.38, p < 0. 001) but did not significantly alleviate their depression, anxiety or stress across time (p > 0.05). Three themes emerged from the qualitative data, namely 1) nurturing self-care capacity through mindfulness; (2) empowering essential skills for clinical placement; (3) maintaining momentum alongside various challenges and enablers. The mindfulness PAL programme may facilitate nursing students' clinical preparedness. Further trials are recommended to investigate its applicability and use in clinical nursing education. [ABSTRACT FROM AUTHOR]

Background: Cognitive development, motivation and confidence building among tomorrows practitioners forms basis of today's medical education. Learning through social interaction, discussing, clarifying doubts from peers can facilitate process of understanding and implementing knowledge and skills. Objectives: To introduce Peer-assisted learning [PAL] in radioanatomy and to assess efficacy and utility of Peer-assisted learning [PAL] in radio anatomy. To gather perception of students regarding PAL. Methods: Sensitization regarding PAL to students was given. Pre test Objective structured practical examination [OSPE] followed by PAL sessions where five peer tutors conducted session for rest of the batch describing all five selected radiographs. Post test OSPE was conducted for knowledge gain. Separate questionnaire evaluated peer tutors and peer students responses. Focused group discussion were conducted to collect feedback from students regarding PAL. Results: 72.5% of peer students agreed on appropriate time management by peer tutors, 68% agreed the explanation and elaboration was appropriate, 66% agreed that important facts were emphasized and 86% agreed the session was interesting. Post test results showed maximum knowledge gain was seen in identification of radiographs. Peer tutors felt their confidence level, time management understanding improved. Conclusion: Peer assisted learning session aroused interest in study and was more informative for students. Peer tutors acquired confidence and could explore their teaching skill.

Background: Peer-assisted learning (PAL) is used throughout all levels of healthcare education. Lack of formalised agreement on different PAL programmes may confuse the literature. Given the increasing interest in PAL as an education philosophy, the terms need clarification. The aim of this review is to 1) describe different PAL programmes, 2) clarify the terminology surrounding PAL, and 3) propose a simple pragmatic way of defining PAL programmes based on their design. Methods: A review of current PAL programmes within the healthcare setting was conducted. Each programme was scrutinised based on two aspects: the relationship between student and teacher, and the student to teacher ratio. The studies were then shown to fit exclusively into the novel proposed classification. Results: The 34 programmes found, demonstrate a wide variety in terms used. We established six terms, which exclusively applied to the programmes. The relationship between student and teacher was categorised as peer-to-peer or near-peer. The student to teacher ratio suited three groupings, named intuitively ‘Mentoring’ (1:1 or 1:2), ‘Tutoring’ (1:3–10), and ‘Didactic’ (1:>10). From this, six novel terms – all under the heading of PAL – are suggested: ‘Peer Mentoring’, ‘Peer Tutoring’, ‘Peer Didactic’, ‘Near-Peer Mentoring’, ‘Near-Peer Tutoring’, and ‘Near-Peer Didactic’. Conclusions: We suggest herein a simple pragmatic terminology to overcome ambiguous terminology. Academically, clear terms will allow effective and efficient research, ensuring furthering of the educational philosophy.

In Brief: Academic libraries hire and train student employees to answer reference questions which can result in high-impact employment experiences for these students. By employing students in this role, opportunities are created for peer-to-peer learning and for a learning community to develop among the student employees. However, not everyone supports this practice. Some believe undergraduates...

Introduction: This project report describes the development, pilot phase, evaluation and implementation of a preparatory course week for incoming Erasmus medical students at the LernKlinik Leipzig, the Skills and Simulation Centre of the Medical Faculty, University of Leipzig.Project description: The aim of this project is to prepare Erasmus students for their year abroad using peer-assisted teaching as the method of choice. Major intended outcomes were support of language and clinical practical skill competency development, as well as enhancement of integration among international and German-speaking peer tutors. The methodological framework of Ross and Cameron was used in planning the Erasmus-Week. For planning the 2012 pilot project, a survey among Erasmus students of the academic year 2011/12 was performed. All succeeding cohorts were asked to participate in pre- and post-surveys which were analyzed quantitatively and qualitatively.Results: Between 2012 and 2017, n=173 European medical students spent their Erasmus year in Leipzig. Of these, n=148 (86%) participated in the Erasmus-Week. The country of origin of most Erasmus students was Rumania (20,3%). Among the most positively received aspects of the Erasmus-Week, the active use of German for medical purposes and the use of peer-teaching as the method of choice to learn and repeat basic medical examination skills were mentioned. Students emphasized their wish for being able to participate in further course offers.Conclusions: Offering a preparatory course week for incoming Erasmus students focusing on language and clinical practical skills training using peer-teaching as the method of choice may facilitate the integration of Erasmus students into their foreign medical curriculum. Further studies are underway to elucidate if these experiences influence later professional careers and choice of employment.

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. [ABSTRACT FROM AUTHOR]

The main objective of this study was to find the role of the student-level and school-level on students’ academic achievement. Research population included students, principals, vice-principals, and academic counselors of Tehran’s vocational and technical schools in the academic year 1391-92. 10 regions from 5 Tehran’s educational districts and 2 schools from each region were selected, with a total of 906 third-grade students from these schools and from 39 classes using multi-stage cluster sampling. 59 school staffs from the same classes and schools were also chosen to take part in this study. Standard AMS and MSLQ questionnaires were used for academic motivation and academic engagement, respectively, as well as researcher-made questionnaires for peer-assisted learning and quality of education. Reliability of the questionnaires were assessed using Cronbachs alpha coefficient, and their content and construct validity was checked using exploratory factor analysis. Academic achievement was calculated using the average of three scores including GPA (grade point average) of the previous year, GPA of three core courses and GPA of practical courses. Data was analyzed using descriptive statistics, correlation matrix, confirmatory factor analysis, structural equation modeling, and multi-level analysis. According to the unconditional model for the school-level, the average academic achievement of students in different schools was significantly different. For the school-level model, 6.13% and 12.05% of the variance of the academic achievement were originated from the student-level and school staff, respectively. In conclusion, 18.81% of the variance for academic achievement was related to the school-level. Findings of the research showed the importance of school level factors -at higher level- influencing other variables in predicting academic achievement.

Background: Basic surgical skills training is rarely emphasised in undergraduate medical curricula. However, the provision of skills tutorials requires significant commitment from time-constrained surgical faculty. Purpose: We aimed to determine how a peer-assisted suturing workshop could enhance surgical skills competency among medical students and enthuse them towards a career in surgery. Methods: Senior student tutors delivered two suturing workshops to second- and third- year medical students. Suturing performance was assessed before and after teaching in a 10-min suturing exercise (variables measured included number of sutures completed, suture tension, and inter-suture distance). Following the workshop, students completed a questionnaire assessing the effect of the workshop on their suturing technique and their intention to pursue a surgical career. Results: Thirty-five students attended. Eighty-one percent believed their medical school course provided insufficient basic surgical skills training. The mean number of sutures completed post-teaching increased significantly (p

One of the major components of medical education is training individuals in various skills related to health care. Training directly on patients has its challenges due to limited opportunities, concerns for patient safety and reluctance of patients. Clinical Skills Laboratory provides a stress-free environment for learning and honing skills under direct supervision. Surgery is predominantly a craft-based branch of medicine and undergraduate medical students have very little exposure to it. With an objective of improving basic surgical skills and improving the competency, a short-term training programme in the form of a workshop was planned, executed in a dedicated Clinical Skills Laboratory for interns posted in the surgical branches. The core areas of training were basic surgical skills required in day-to-day practice in the surgical specialties. Five broad categories of skills, gowning and gloving, instrument handling, knot tying, suturing techniques and universal precautions, were dealt with demonstration and hands-on practice sessions. A total of 14 skills lab training sessions over a period of 3 years from February 2014–March 2017 were conducted where a total of 264 interns participated. Analysis of the feedback showed 62.87% of the participants felt that the content was excellent, 63.63% opined that the presentations were excellent, 76.13% appreciated the demonstration and 60.6% were satisfied with the time allotted for practice sessions. This short-term training in basic surgical skills in a controlled environment helped in improving the interns' skills and confidence. Implementation of basic surgical skills training provided a complementary experience that facilitates the shortening of the learning curve and enhances the ability of the new doctors to perform various procedures. This model of training in skills laboratories could be inculcated in the curriculum as practical training for effective delivery of health care. [ABSTRACT FROM AUTHOR]

Abstract Technology-enabled personalized systems of instruction (PSI) could streamline resource-intensive instructional strategies, potentially easing their delivery and accelerating student learning. This study evaluated the effectiveness and efficiency of a PSI that incorporated adaptive assessment, incremental rehearsal, and peer-assisted learning to teach sight words. Participants in grades 1–3 were randomly assigned to either a control condition or treatment condition. In the treatment condition, participants engaged in the PSI in dyads, working at their instructional level with minimal adult supervision. Compared to the control condition, target learners engaging in the PSI acquired previously unknown sight words, then maintained and generalized the words 30 days post-intervention with a moderate main effect (β = 0.28). On average, participants rated the PSI as positive or very positive. The potential for PSIs to make instructional activities more efficient, effective, and individualized is discussed. [ABSTRACT FROM AUTHOR]

Smart Learning Environments (SLEs) are designed by integrating Usability design principles, aesthetics and functionalities, however, contextual constituents supporting Smart Learning Behavior (SLB) are rarely considered. Particularly, how Peer-Assisted Learning (PAL) is effective when compared with Faculty-Assisted Learning (FAL) in a VoIP based Disruptive Learning Environment (DLE). Studies report that learners focus on superficial features instead of the underlying principles, concepts, or theories in design-centric SLEs. Likewise, learners acquire individual skills or pieces of knowledge in SLEs that they are unable to apply in user-centric complex contexts. In this paper, a framework is evolved to address the design and development considerations of SLEs with a focus to empirically validate the effectiveness of PAL in comparison with FAL. The study is a Quasiexperimental design with manipulative and controlled non-repeated groups. Disruptive contextual factors (DCF) are believed to be ingredients of SLB and are cross-examined using Univariate-Analysis, Cohen's D, Partial Eta squared values and Standardized Beta Coefficients. The experimental data was analyzed in PASW 2.0. This study empirically validates the effectiveness of DCF and concludes SLB is better supported through PAL than FAL in a SLE. The study findings support institutions of higher learning in the process of transition and transforming old models of university education into SLEs. While HCI researchers may benefit in defining cognitive thought processes behind PAL that support SLB in DLE. [ABSTRACT FROM AUTHOR]

This Conversation Starter article uses four selected abstracts, one each from the four regional Association of American Medical Colleges (AAMC) Group on Educational Affairs (CGEA) 2018 spring meetings, as a springboard for unpacking the definition of peer-assisted learning (PAL). The aim of this article is to prompt deeper reflection on this phenomenon and, in so doing, to foster scholarly program evaluation of this widely adopted instructional approach. This analysis calls for a more nuanced definition of PAL, one that emphasizes process over structure, one that stimulates examination of "doing" PAL and how this affects the personal and professional development of all involved. [ABSTRACT FROM AUTHOR]

Peer-assisted learning (PAL) has been found in medical, nursing, and dental education research to aid in preparing students to develop clinical judgment, leadership, and teamwork skills. This study sought to extend that research by assessing the effect of PAL on dentists in practice. The aim of this study was to ask practicing dentists who were clinically trained with PAL in dental school for their perceptions of the effects and value of that training for their patient care, team relations, and professional development. In addition, participants were asked for recommendations to improve pairing and the matching process. An electronic survey was sent in October 2017 to all 667 dentists who graduated from Midwestern University College of Dental Medicine-Arizona from 2012 to 2017, all of whom had been trained in a PAL-general practice model. A total 107 alumni responded, for a 16% overall response rate; the response rate averaged 16.7% for each class. The majority (83.6%) of responding dentists recommended peer learning in clinical dental education. Survey participants attributed their clinical judgment (72.3%) and teamwork (80.9%) skills to peer pairing in dental school. Among the respondents, 89.8% had taken leadership roles and were training team members, and 75.7% reported enjoying teaching others. Of the 65% who commented on peer pairing enhancements, 15% recommended rotation of peers for greater learning experiences, and 24% advised personality assessments for future pair matching. These results suggested that participating in PAL had helped prepare these alumni for practice. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: There is increasing demand for clinical placements for pre‐registration nursing students.New models of mentorship have been developed to meet the demand for clinical placements by increasing the number of students within each placement.At present there are no published research studies into the effectiveness of team mentorship utilized by pre‐registration nursing students within in‐patient mental health settings. What does this paper add to existing knowledge?: This paper reports findings from a study that explored the experiences of mental health students within the social world of their clinical placement, adopting a new approach to practice learning where students support each other's learning.Students found their engagement in the pilot project as valuable as being exposed to the new team mentorship model which introduced them to peer‐assisted learning.The learning that arose from peer‐assisted learning within team mentorship appeared to provide learning opportunities that enabled students' to develop greater self‐awareness and confidence. What are the implications for practice?: Peer‐assisted learning where students support the learning of each other, can lead to a wider range of learning opportunities for, as well as between, nursing students.In order for students to participate in care and become a "learning team," suitable in‐patient mental health wards need to be identified that can support this new approach to the supervision, assessment and support of students.The establishment of team mentorship within mental health in‐patient settings is dependent on the support provided by practice educators and university link lecturers to nurse mentors and coaches which in turn, determines the quality of the student experience. Introduction: This paper presents findings from a study that evaluated mental health nursing students' experience of a team mentoring model called Coaching and peer‐assisted learning (C‐PAL). At present there are no published research studies into the effectiveness of team mentorship utilized by nursing students within in‐patient mental health settings. Aim: The study utilized an interpretivist methodology where the focus was on individuals in their social world. Method: Two focus groups were held with fifteen students who had experienced C‐PAL in four in‐patient wards. Findings: Students' overall experience of piloting C‐PAL was positive. Learning opportunities (Theme 3) appeared to be dependent on the quality of peer support (Theme 5) which in turn, enhanced the learner experience and increased the level of student confidence (Theme 6). Less positive experiences included inadequate preparation (Theme 1), poor understanding of the model and competition for learning experiences. Implications for practice: We tentatively suggest that team mentorship models such as C‐PAL may be suitable for acute in‐patient mental health settings. The success of C‐PAL depends upon the preparation of nursing staff, mentors (Theme 4), coaches and students in relation to role expectations, shift rostering (Theme 2) and the implementation of "huddling" to promote opportunistic learning. [ABSTRACT FROM AUTHOR]

The competencies required of the well-trained physician are constantly evolving, and medical education must adapt accordingly. In response, a growing number of influential medical education licensing and accreditation bodies have proposed frameworks that outline society’s expectations of physician competencies. In Canada, undergraduate and graduate curricula have undergone major changes to meet the specifications of the CanMEDS framework, and similar efforts are underway internationally. Nonetheless, ensuring the values enshrined within such frameworks become integral to a physician’s identity remains challenging. We believe that student-led curricular initiatives represent a novel way of approaching this shifting medical education landscape.In this article, we reflect on lessons we learned as medical students spearheading an initiative to change how organ and tissue donation is taught in Canadian medical schools. Citing relevant medical education literature where applicable, we include a detailed description of our approach as a roadmap for students contemplating their own curricular innovations. By outlining the factors influencing this project’s implementation, as well as the benefits and limitations of student participation in curriculum reform, we offer educators a fresh perspective on optimizing the student role in this important process. Ultimately, the authors argue that not only can student participation render curricular content more accessible to learners, but that the responsibilities students take on in this role naturally lead to the development of CanMEDs-based competencies such as advocacy, scholarship, and inter-professionalism. [ABSTRACT FROM AUTHOR]

Peer-assisted learning (PAL) is nowadays commonly implemented in medical education. Mostly PAL is utilized to specifically support teaching within one subject or a specific curricular situation. Here, we present a large-scale peer teaching program that aims to address the individual student's learning needs. In addition, it provides a platform for students to participate in academic teaching. A retrospective data analysis was performed to reveal the program's development and acceptance. The program was implemented in 2008/09 with three tutorials conducted by 24 student tutors to support students preparing for reexaminations. Since then, the program has continuously grown. In 2015/16, 140 tutors conducted 52 tutorials, consisting of 2,750 lessons for 1,938 tutees. New tutorial categories were continuously introduced. In 2015/16, these encompassed tutorials that were held concomitantly to the formal curriculum, tutorials that exceeded the contents of the formal curriculum, tutorials for preparation for the state examination, and electives. Evaluations among the tutees revealed that 93.5% of the respondents rated the courses overall as "good" or "excellent" (n = 13,489) in 2015/16. All elements of the peer teaching program are managed by one academic group. This encompasses the organization of tutorials, the quality management, and the qualification of tutors, including content-related supervision and didactic training. We conclude that the implementation of a large-scale peer teaching program can complement the formal curriculum. This might be beneficial for both tutors who can actively train their didactic and content-related competencies, and tutees who can autonomously consolidate and expand their knowledge. [ABSTRACT FROM AUTHOR]

Studies on Child x Instruction interactions show that learning growth depends on the fit of instruction to students' abilities. This study investigates short- and long-term effects of combining learning progress assessment (LPA) as a tool for teachers to constantly monitor their students' progress with differentiated reading instruction to address students' individual needs on reading fluency and reading comprehension. The study was conducted in German elementary school classrooms. Third grade classrooms ( n  = 28) were randomly assigned to either an LPA group with differentiated instruction or a control group (CG). Students in the treatment group showed higher growth in reading fluency than students in the CG ( d  = .30). The effect was stable over the two-year period of the study. Students with lower reading skills benefited more from the treatment. No effects were found on reading comprehension. Results are discussed with regard to teachers’ use of data to differentiate instruction. [ABSTRACT FROM AUTHOR]

Background Failure to transfer procedural skills learned in a laboratory to the bedside is commonly due to a lack of peer support/stimulation. A digital platform (Facebook) allows new clinical clerks to share experiences and tips that help augment their procedural skills in a peer-assisted learning/teaching method. This study aims to investigate the effectiveness of the innovation of using the digital platform to support the transfer of laboratory-trained procedural skills in the clinical units. Methods Volunteer clinical clerks (n = 44) were enrolled into the peer-assisted learning (PAL) group, which was characterized by the peer-assisted learning of procedural skills during their final 3-month clinical clerkship block. Other clerks (n = 51) did not join the procedural skills-specific Facebook group and served as the self-directed learning regular group. The participants in both the PAL and regular groups completed pre- and post-intervention self-assessments for general self-assessed efficiency ratings (GSER) and skills specific self-assessed efficiency ratings (SSSER) for performing vein puncture, intravenous (IV) catheter and nasogastric (NG) tube insertion. Finally, all clerks received the post-intervention 3-station Objective Structured Clinical Skills Examination (OSCE) to test their proficiency for the abovementioned three procedural skills. Results Higher cumulative numbers of vein punctures, IV catheter insertions and NG tube insertions at the bedside were carried out by the PAL group than the regular group. A greater improvement in GSERs and SSSERs for medical procedures was found in the PAL group than in the regular group. The PAL group obtained higher procedural skills scores in the post-intervention OSCEs than the regular group. Conclusion Our study suggested that the implementation of a procedural skill-specific digital platform effectively helps clerks to transfer laboratory-trained procedural skills into the clinical units. In comparison with the regular self-directed learning group, the peer-assisted learning characteristics of Facebook give additional benefits to the PAL group by enhancing their procedural skills. [ABSTRACT FROM AUTHOR]

Peer‐assisted learning has gained momentum in a variety of disciplines, including medical education. In Gothenburg, Sweden, medical students who have finished their compulsory anatomy courses have the option of working as teaching assistants (TAs). Teaching assistants provide small group teaching sessions as a complement to lectures given by faculty. Previously, TAs were left to handle the role as junior teachers by themselves, but since 2011, a continuation course in anatomy has been developed with the aim of providing the TAs better anatomy knowledge and guidance for teaching. The course was designed to comprise 7.5 ECTS credits (equivalent to 5 weeks of full‐time studies), and today all TAs are required to take this course before undertaking their own teaching responsibilities. This study aims to compare course evaluations of TA teaching before and after the introduction of the anatomy continuation course, in order to understand how students perceived teaching performed by self‐learned versus trained TAs. The results of this study demonstrate that there was a trend towards better teaching performed by trained TAs. The variability in rankings decreased significantly after the introduction of the continuation course. This was mainly due to an improvement among the TAs with the lowest levels of performance. In addition to comparing student rankings, TAs were interviewed regarding their experiences and perceptions within the continuation course. The course was generally positively regarded. The TAs described a sense of cohesion and appreciation since the institute invested in a course dedicated specifically for them. Anat Sci Educ 11: 403–409. © 2018 American Association of Anatomists. [ABSTRACT FROM AUTHOR]