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Table 1 Examples of PAL activities within The University of Sydney Medical School

From: Planning peer assisted learning (PAL) activities in clinical schools

“Tutor”/“Examiner”

PARTICIPANTS

Tutee” /“Examinee”

PARTICIPANTS

PARTICIPATION

VOLUNTARY/COMPULSORY

RESOURCE REQUIREMENTS

TRAINING PROVIDED

EVALUATION

FORMATIVE CLINICAL LONG CASE EXAMINATIONS

Description: Senior students (Year 3 and Year 4) act as co-examiners assessors of their direct peers, alongside a faculty member. Student examiners are responsible for finding patients on wards [32,33,34,35].

Purpose: Designed to prepare students for their summative long case examinations by informing them of their strengths and weaknesses

Year 3 and Year 4 medical students.

Year 3 and Year 4 medical students.

Participation is compulsory for all Year 3 and Year 4 students.

Hospital ‘in-patients’

Faculty

Students

Small rooms

Exam administrator

One senior faculty member is required to act as a co-examiner at each set of long case examinations

Students (examiners and examinees) are provided with a 30 min briefing.

Students value the experience as examiners and examinees.

Acting as a co-examiner provides insights into the exam process.

Student co-examiners are more lenient markers than faculty.

Student co-examiners find it difficult to provide honest and critical feedback

FORMATIVE OSCE EXAMINATIONS

Description: Students are examined at five OSCE stations to assess communication, physical examination or procedural skills. Year 4 students assess Year 1 and 2 students. Year 3 students act as simulated patients [36, 37].

Purpose: Designed to prepare Year 1 and Year 2 students for their summative OSCEs, in terms of the OSCE process, and to inform them of specific areas of knowledge and skills that need strengthening.

Year 3: simulated patients

Year 4: assessors

Year 1 and Year 2 medical students

Participation is compulsory for all Year 1 and Year 2 students; and voluntary for Year 3 and Year 4 students.

Small rooms

Exam administrator

Preparation of OSCE material, including OSCE questions, marking sheets.

Faculty review and facilitation of feedback

Student assessors (Year 4) and simulated patients (Year 3) are provided with a 30 min briefing. Year 1 and 2 students are provided with written information.

Year 3 Student simulated patients believed the exercise improved their knowledge base, confidence in clinical skills, and developed their understanding of the patient-doctor relationship. They found it helpful in preparing for their own future examinations. It reduced the logistical demands and cost to clinical schools with limited resources.

Year 4 examiners found peer assessment to be a very useful learning activity.

Although students felt confident in the accuracy of their marking, they consistently rated their peers as performing better than do faculty.

However, students need further training in how to globally assess a fellow student’s overall performance objectively to provide accurate feedback.

PEER TUTORING (A STUDENT LED PROGRAM)

Description: Senior students (Years 3 and 4) tutor junior students (Years 1 and 2). Four tutees are assigned to a pair of tutors. Year 3 students tutor Year 1 students, and Year 4 students tutor Year 2 students. Tutorials are one hour long, covering clinically relevant content that is aligned with the current teaching block. Tutorials are designed to supplement existing teaching to enhance tutee’s knowledge base. Tutorial delivery is interactive, with 20 min briefing, 20 min ward teaching, and 20 min debriefing [4].

Purpose: The Peer tutoring program is a formal, student led program, supported by staff, designed to provide additional support to junior students, and allow senior students the opportunity to practice teaching skills, and reinforce their own knowledge.

Year 3 and Year 4 students as tutors (Year 3 students tutor Year 1 students; and Year 4 tutor Year 2 students)

Year 1 and Year 2 medical students

Participation is voluntary for all students

Students

Small rooms

Faculty review of tutor material

Student tutors and tutees are provided with a one hour briefing by the senior student leads.

The peer tutoring program provided a framework within the medical curriculum for senior students to practice and improve their medical knowledge and teaching skills. Concurrently, junior students were provided with a valuable learning experience that they reported as being qualitatively different to traditional teaching by faculty.

PEER TEACHER TRAINING (PTT) PROGRAM (interprofessional)

Description: Delivered as a six module, interprofessional, blended learning program, participants are provided with theoretical background, and opportunities for active participation in small group interprofessional learning teams [19, 22, 38].

Purpose: The Peer Teacher Training (PTT) program is designed to support health professional students in the development of their teaching, assessment and feedback skills, in preparation for PAL activities, and future health professional practice.

Senior students from all healthcare (medicine, nursing, pharmacy, health sciences, dentistry) faculties are invited to attend

Senior students practice teaching and clinical handover in small groups with other senior students

Participation is voluntary for all students

Administrative support

Faculty & alumni (‘graduates’ of previous PTT programs) to facilitate small groups

Students are required to complete pre-reading and preparation before attending the face-to-face class

The flipped learning, interprofessional format was successful in developing students’ skills, competence and confidence in teaching, assessment, communication and feedback. Importantly, participation increased students’ awareness and understanding of the various roles of health professionals.