PedRIO TFAS – Final Report 2014/5
Evaluating the impact of cross professional peer tutoring
among nursing and physiotherapy students
Final report of a peer tutoring project within the Faculty of Health Sciences between the School of Health Professions and School of Nursing and Midwifery
Project Team Members:
Principal Investigator: Dr Fiona McLeod (Lecturer in Physiotherapy)
Caroline Jamison (Lecturer in Adult Nursing)
Kim Young (Pathway Lead, Adult Nursing)
Dr Karen Treasure (Research Assistant)
Project Development -
In 2013, following an invitation from the nursing team, five Stage 2 physiotherapy students volunteered to facilitate a practical seminar for Stage 1 nursing students on locomotor skills. The seminar, part of module ADN102, was delivered to the first year nursing cohort, at the K-Spa campus in Truro. Anecdotal responses from students who were involved were overwhelmingly positive and stimulated interest in more peer-learning opportunities.
The following year, the same process was repeated and extended to include an invitation to the Stage 2 nursing cohort to run a clinical skills workshop for first year physiotherapy students, as part of a clinical module PHY112. This time the practical sessions were informally evaluated via a student evaluation form designed to give feedback to the peer tutors involved. The response was again overwhelmingly positive and both nursing and physiotherapy peer tutors presented their experiences at the Plymouth University VC’s Teaching and Learning conference in 2013.
Given the novel character of these sessions, a largely positive response was likely from participating students and student-tutors alike, but further and more formal exploration of the pedagogic value of these sessions was desired by the project team. This led to the application for funding from the PedRIO Teaching Fellowship Award Scheme.
While peer-tutoring has been used to facilitate inter-professional learning and deliver clinical skills training elsewhere (Falchikov, 2001, Joseph et al 2011), this project will enable full evaluation of this local initiative and enable consideration of how this could provide inspiring individual development opportunities for students while promoting student-led inter-professional collaboration.
Project Aim and Objectives –
Aim:
This project aims to evaluate the impact of two peer tutored practical workshops designed to enhance clinical skills and inter-professional understanding among nursing and physiotherapy students. The tutors are student volunteers from the Stage Two physiotherapy and nursing programmes (K-Spa, Truro campus). The workshops are timetabled activities previously delivered by lecturing staff. The content was developed and led by students, but guided and supervised by academic staff.
Objectives:
1. To inform future teaching practice by enhancing the evidence base associated with inter-professional peer-tutoring
2. To develop recommendations that will inform future developments associated with this initiative
Methods used -
The research sought to engage Stage 2 student volunteers from nursing and physiotherapy programmes to plan and deliver an inter-professional, peer-tutored clinical workshop session for Stage 1 students of the opposite discipline, and to evaluate the experiences of both peer-tutors and students.
The research focussed on timetabled clinical workshops in modules ADN102 and PHY112.
The research strategy was as follows:
- Stage 2 nursing and physiotherapy students were invited, during spring 2015, to volunteer to plan and deliver a clinical workshop session for Stage 1 students of the opposite discipline
- 4 physiotherapy students and 8 nursing students volunteered as peer-tutors
- The RA was appointed to conduct the practical engagement of students with the research to ensure students understood that participation in the research was entirely voluntary and separate from any assessment processes
- All students and peer-tutors due to take part in workshops were asked to complete a Readiness for Inter-Professional Learning Scale questionnaire[1], both before and after the session
- All Stage 2 peer-tutors and some Stage 1 students (who were selected at random) were invited to participate in focus groups to further explore the impact of the sessions. Focus groups were specific to the session and cohort, rather than mixed.
- Analysis of the questionnaire data was undertaken using survey monkey
- Analysis of the qualitative focus group data was undertaken using thematic content analysis
Results –
Preliminary analysis of the questionnaire data shows an increased recognition of the value of inter-professional learning amongst Stage 1 students. While a majority showed support for inter-professional learning prior to the workshop, there was a clear and significant increase in the extent to which they agreed with beneficial learning outcomes after experiencing the workshop, as well as in their own ability to become more effective health professionals as a result.
Data from the focus groups with Stage 1 students reiterated this recognition of the value of inter-professional learning, as well as highlighting particular value in the sessions being peer-tutored. Although peer-tutors had been given no teacher training prior to the workshop, students spoke highly of their ability to communicate effectively and on their level of skills. Some students referred to the inspirational value of meeting peer-tutors who are only one academic year their senior and noting the depth of their knowledge as well as their confidence to teach in their field. Students also referred to the freedom gained in the peer-tutoring model, to ask questions that may not feel comfortable in the presence of a lecturer.
Valuable comments were gained from the focus groups, particularly regarding the timing of the workshops in the curriculum and the potential to use more inter-professional learning during the programme, for example with occupational therapists or nutritionalists. Some negative comments about the value of inter-professional learning during training highlighted mistaken assumptions about the consolidation of professional roles in practice, where the evidence suggests health professionals retreat into professional silos more often than expanding inter-professional knowledge in healthcare settings.
Focus groups with peer-tutors have been difficult to schedule given the nature of placements during Stage 2. These will thus take place during August, but early indications follow the pattern established in previous years which show that those who volunteered as peer-tutors were those who wanted to work on their presentation skills in a practical setting. They were not amongst those who would be expected to volunteer in the cohort, thus suggesting additional pedagogic benefits through the process of volunteering and leading to recognition of these sessions as a largely student-led initiative.
Recommendations from this work include the following:
- Expanding the amount of inter-professional learning for nursing and physiotherapy students at Stage 1 by creating links with other health care disciplines
- Necessary to identify teaching topics which are suitable to be run as student-led, peer-tutored practical workshop sessions
- Faculty support should be extended to enable the engagement of as many healthcare students as possible in peer-tutored, inter-professional learning sessions given the strong evidence of pedagogic benefits
- Continue to engage peer-tutors on a voluntary basis to ensure the greatest pedagogic benefits are gained from the exercise of peer-tutoring
Dissemination –
A paper is currently being written as a result of this research and it is intended to be submitted to the Journal of Inter-professional Care in late 2015.
A presentation will also be prepared for the Plymouth University PedRIO conference in 2016.
References –
Falchikov, N. (2001). Learning Together: Peer-tutoring in Higher Education. London, Routledge Falmer.
McFadyen, A., V. Webster, et al. (2005). "The Readiness for Interprofessional Learning Scale: a possible more stable sub-scale model for the original version of RIPLS." Journal for Inter-professional Care19(6): 595-603.
McFadyen, A., V. Webster, et al. (2006). "The test-retest reliability of a revised version of the Readiness for Interprofessional Learning Scale (RIPLS)." Journal of Inter-professional Care20(6).
Parsell, G. and J. Bligh (1999). "The development of a questionnaire to assess the readiness of health care students for interprofessional learning (RIPLS)." Medical Education33 95-100.
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[1] This format is an established tool in the evaluation of inter-professional learning in the healthcare disciplines which has been modelled and remodelled since first use. See for example: Parsell and Bligh, 1999; McFayden et al, 2005; McFayden et al, 2006