Peer mentorship in clinical education: outcomes of a pilot programme for first year students

Impact of Clinical Anatomy Peer Mentorship Program on Student Leaders: A Mixed-Methods Study

INTRODUCTION

Clinical Anatomy Mentorship Program (CAMP) was developed as a student-led approach to providing hands-on surgical experience and mentorship to third-year medical students during their surgery clerkship at an academic institution. Fourth-year medical students were selected to lead these educational events, teaching underclassmen surgical curriculum and skills in a near-peer method of clinical teaching.

METHODS

A focus group and survey were administered to the fourth-year medical students who served as CAMP leaders from fall 2021 to spring 2022 to assess how their leadership role impacted their personal and professional development.

RESULTS

A 10-question survey was administered to 19 students, with 14 responding, for a response rate of 74%. Serving as a mentor facilitated the development of students' professional interests, including increased interest in future teaching roles (93%) and leadership positions (86%), particularly as surgical clerkship director (70%) and program director (90%). All students reported that their involvement in CAMP increased their confidence in teaching and surgical knowledge, and 86% reported improved surgical skills. A subset analysis of seven CAMP leaders via the focus group demonstrated several reported benefits to serving as a peer mentor in CAMP, including increased interaction with peers, improved sense of comradery and support, more authentic peer-mentorship connections, and increased confidence and perceived preparedness for surgical residency.

CONCLUSIONS

The confidence, leadership, and improved surgical knowledge and skills obtained through the CAMP leadership role led to improved personal and professional development of student leaders.

"Coaching and Peer-Assisted Learning" (C-PAL) - The mental health nursing student experience: A qualitative evaluation

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.

ABSTRACT

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.

Perceptions from Athletic Training Students Involved in an Intentional Peer-Assisted Learning Pedagogy

Context: Peer-assisted learning (PAL) has been shown to benefit students across educational levels. Current research has investigated perceptions of PAL, postgraduate impact, as well as prevalence. This study investigated athletic training students' perceptions of an intentional PAL pedagogy on both the peer-student and peer-tutor. In this study, the peer-tutors had training prior to implementation.

Objective: To explore athletic training students' perceptions of an intentional PAL pedagogy.

Design: Qualitative study using a phenomenological approach.

Setting: Focus group interviews with professional undergraduate athletic training students.

Patients or Other Participants: Eleven athletic training students from 1 accredited athletic training program volunteered for this study. Five students (4 females, 1 male) serving as peer-tutors and 6 (5 females, 1 male) peer-students participated in focus group interviews in spring term 2015. The peer-tutors completed training prior to tutoring the peer-students.

Main Outcome Measure(s): Focus group interviews were conducted with a structured interview protocol. The peer-student and peer-tutor groups were asked separate questions. Interview data were analyzed inductively to uncover dominant themes, first by organizing the data, then summarizing into codes, and finally interpreting. Credibility was secured through member checking, triangulation, and investigator triangulation.

Results: Themes indicated that both peer-students and peer-tutors perceived that, through PAL, they collaborated, built relationships, gained confidence, were exposed to varied techniques, and the PAL pedagogy served as a way to review and practice, which changed their clinical educational experiences. Peer-tutors developed skills in leadership and teaching through their PAL experience.

Conclusions: Evidence demonstrated that PAL created a learning environment in the student's clinical educational experiences that involved collaboration, relationships, confidence building, and more time for review and practice.

Peer-assisted teaching: An interventional study

Peer-assisted learning (PAL) as an educational philosophy benefits both the peer-teacher and peer-learner. The changing role of paramedicine towards autonomous and professional practice demands future paramedics to be effective educators. Yet PAL is not formally integrated in undergraduate paramedic programs. We aimed to examine the effects of an educational intervention on students' PAL experiences as peer-teachers. Two one-hour workshops were provided prior to PAL teaching sessions including small group activities, individual reflections, role-plays and material notes. Peer-teachers completed the Teaching Style Survey, which uses a five-point Likert scale to measure participants' perceptions and confidence before and after PAL involvement. Thirty-eight students were involved in an average of 3.7 PAL sessions. The cohort was predominated by males (68.4%) aged ≤ 25 (73.7%). Following PAL, students reported feeling more confident in facilitating tutorial groups (p = 0.02). After the PAL project peer-teachers were also more likely to set high standards for their learners (p = 0.009). This PAL project yielded important information for the continual development of paramedic education. Although PAL increases students' confidence, the full role of PAL in education remains unexplored. The role of the university in this must also be clearly clarified.

The professional socialization of the graduate assistant athletic trainer

CONTEXT

The graduate assistant athletic trainer (AT) position often serves as one's first experience working independently as an AT and is also an important aspect of the professional socialization process. The socialization experiences of graduate assistant ATs have yet to be fully explored.

OBJECTIVE

To understand the socialization process for graduate assistant ATs during their graduate experience.

DESIGN

Qualitative study.

SETTING

We conducted phone interviews with all participants.

PATIENTS OR OTHER PARTICIPANTS

A total of 25 graduate assistant ATs (20 women, 5 men) studying in 1 of 3 academic tracks: (1) accredited postprofessional athletic training program (n = 8), (2) postprofessional athletic training program (n = 11), or (3) a nonathletic training degree program (n = 6). The average age was 25 ± 5 years, and the median age was 24 years. Participants were certified by the Board of Certification for an average of 2 ± 0.4 years.

DATA COLLECTION AND ANALYSIS

We analyzed the data using a general inductive approach. Peer review, field notes, and intercoder reliability established trustworthiness. Data saturation guided participant recruitment.

RESULTS

The ability to gain clinical independence as a practitioner was an important socialization process. Having the chance to develop a relationship with a mentor, who provided support, guidance, and more of a hierarchical relationship, was an important socializing agent for the graduate assistant AT. Participants used the orientation session as a means to understand the expectations and role of the graduate-assistant position. Academic coursework was a way to achieve better inductance into the role via the opportunity to apply classroom skills during their clinical practice.

CONCLUSIONS

Socializing the graduate assistant blends formal and informal processes. Transition to practice is a critical aspect of the profession; thus, supporting autonomous practice with directed mentoring can promote professional maturity.

Perceived frequency of peer-assisted learning in the laboratory and collegiate clinical settings

CONTEXT

Peer-assisted learning (PAL) has been recommended as an educational strategy to improve students' skill acquisition and supplement the role of the clinical instructor (CI). How frequently students actually engage in PAL in different settings is unknown.

OBJECTIVE

To determine the perceived frequency of planned and unplanned PAL (peer modeling, peer feedback and assessment, peer mentoring) in different settings.

DESIGN

Cross-sectional study.

SETTING

Laboratory and collegiate clinical settings.

PATIENTS OR OTHER PARTICIPANTS

A total of 933 students, 84 administrators, and 208 CIs representing 52 (15%) accredited athletic training education programs.

INTERVENTION(S)

Three versions (student, CI, administrator) of the Athletic Training Peer Assisted Learning Survey (AT-PALS) were administered. Cronbach α values ranged from .80 to .90.

MAIN OUTCOME MEASURE(S)

Administrators' and CIs' perceived frequency of 3 PAL categories under 2 conditions (planned, unplanned) and in 2 settings (instructional laboratory, collegiate clinical). Self-reported frequency of students' engagement in 3 categories of PAL in 2 settings.

RESULTS

Administrators and CIs perceived that unplanned PAL (0.39 ± 0.22) occurred more frequently than planned PAL (0.29 ± 0.19) regardless of category or setting (F(1,282) = 83.48, P < .001). They perceived that PAL occurred more frequently in the collegiate clinical (0.46 ± 0.22) than laboratory (0.21 ± 0.24) setting regardless of condition or category (F(1,282) = 217.17, P < .001). Students reported engaging in PAL more frequently in the collegiate clinical (3.31 ± 0.56) than laboratory (3.26 ± 0.62) setting regardless of category (F(1,860) = 13.40, P < .001). We found a main effect for category (F(2,859) = 1318.02, P < .001), with students reporting they engaged in peer modeling (4.01 ± 0.60) more frequently than peer mentoring (2.99 ± 0.88) (P < .001) and peer assessment and feedback (2.86 ± 0.64) (P < .001).

CONCLUSIONS

Participants perceived that students engage in unplanned PAL in the collegiate clinical setting with a stronger inclination toward engagement in peer modeling. Educators should develop planned PAL activities to capitalize on the inherent desire of the students to collaborate with their peers.

Enhancing the effectiveness of the teaching and learning of core clinical skills

Over the last decade there has been great deal of debate about pre-registration nursing students' lack of confidence and ability, in performing core clinical skills in the UK [P. Elliott, Locality based teaching, Senior Nurse 13 (2) (1993) 35-39; S. Jowett, I. Walton, S. Payne, Challenges and Change in Nurse Education - A Study of the Implementation of Project 2000 Slough: NFER, 1994; P. Hilton, Clinical Skills Laboratories: teaching practical skills, Nursing Standard 10 (37) (1996) 44-47; , Integrating theory and practice: Professional Letter from the Chief Nursing Officer for England London; , Making a difference. Strengthening the nursing, midwifery and health visiting contribution to health and health care, London.]. A variety of solutions have been suggested in attempting to address these perceived deficits. One such initiative within the University of Sheffield was the introduction of the Clinical Demonstrator role, whereby clinicians were seconded to the School of Nursing for a fixed period of time to provide additional support to neophyte students in the classroom, laboratory and clinical settings. An action research approach was adopted where ongoing evaluation influenced further developments [W. Carr, S. Kemmis, Becoming Critical: Education Knowledge and Action Research, Falmer Press, London, 1986]. Formal and informal evaluation was therefore undertaken throughout and this influenced the evolution of the role. The methods used included; questionnaires; reflective diaries; focus group interviews; and ongoing dialogue with lecturers, students, demonstrators, clinicians and trust representatives. Since the start of this 5 year project there have been 25 Demonstrators in post who have in total supported 10 pre-registration nursing student cohorts undertaking the Common Foundation Programme (N=1496). As the study progressed they also provided support to more senior Adult Branch students undertaking the final year of the course (N=76). The outcomes have been exceptionally positive, though a number of lessons have been learnt along the way. This paper outlines this innovative project and shares a number of broad conclusions that can be drawn from the study.

Accuracy and reliability of peer assessment of athletic training psychomotor laboratory skills

CONTEXT

Peer assessment is defined as students judging the level or quality of a fellow student's understanding. No researchers have yet demonstrated the accuracy or reliability of peer assessment in athletic training education.

OBJECTIVE

To determine the accuracy and reliability of peer assessment of athletic training students' psychomotor skills.

DESIGN

Cross-sectional study.

SETTING

Entry-level master's athletic training education program.

PATIENTS OR OTHER PARTICIPANTS

First-year (n  =  5) and second-year (n  =  8) students.

MAIN OUTCOME MEASURE(S)

Participants evaluated 10 videos of a peer performing 3 psychomotor skills (middle deltoid manual muscle test, Faber test, and Slocum drawer test) on 2 separate occasions using a valid assessment tool. Accuracy of each peer-assessment score was examined through percentage correct scores. We used a generalizability study to determine how reliable athletic training students were in assessing a peer performing the aforementioned skills. Decision studies using generalizability theory demonstrated how the peer-assessment scores were affected by the number of participants and number of occasions.

RESULTS

Participants had a high percentage of correct scores: 96.84% for the middle deltoid manual muscle test, 94.83% for the Faber test, and 97.13% for the Slocum drawer test. They were not able to reliably assess a peer performing any of the psychomotor skills on only 1 occasion. However, the φ increased (exceeding the 0.70 minimal standard) when 2 participants assessed the skill on 3 occasions (φ  =  0.79) for the Faber test, with 1 participant on 2 occasions (φ  =  0.76) for the Slocum drawer test, and with 3 participants on 2 occasions for the middle deltoid manual muscle test (φ  =  0.72).

CONCLUSIONS

Although students did not detect all errors, they assessed their peers with an average of 96% accuracy. Having only 1 student assess a peer performing certain psychomotor skills was less reliable than having more than 1 student assess those skills on more than 1 occasion. Peer assessment of psychomotor skills could be an important part of the learning process and a tool to supplement instructor assessment.

Evaluation of mentorship programme in nursing education: a pilot study in Turkey

Mentorships increase the students' confidence, help ease the difficulties associated with their new environment and reality, increase self-esteem and help socialize students into the nursing role. The main objective of the programme was to support mentee students in facilitating their transition to the university and nursing. This descriptive, exploratory study was designed using Maslow's hierarchy of needs and a pre/post test Rotter's locus of control. Sixty-two (62) first-year students and fifty-eight (58) fourth-year students were eligible to be in the mentoring programme. Mentors and mentees contacted each other weekly as required to provide information and support. Nursing lecturers were available to support the mentors for regular contact over the 13 weeks of the programme. The data were collected by questionnaire for the first-year and fourth-year students. In addition, in order to determine the efficacy of the mentoring programme, Rotter's Locus of Control Scale was administered to first-year students both at the beginning and the end of the study. The majority of first-year students stated that they benefited from the programme. It was established that the mentoring programme influenced the locus of control positively. The mentoring programme may be used to improve the adaptation of nursing students to both the university and nursing profession.

Clinical leadership project

Nurse educators seek innovative strategies to maximize student learning in the classroom and clinical settings. Students enrolled in a nursing leadership and management course often find they spend more clinical time observing leaders than practicing the necessary skills to lead others in the provision of nursing care. In addition, opportunities to explore the nurse educator role often do not exist in baccalaureate nursing education, despite the shortage of nurse educators. An experience was developed in a baccalaureate nursing program to give senior students, under supervision of faculty, the opportunity to lead and evaluate lower-level students providing patient care in the clinical setting and to experience the role of nursing faculty. Feedback from senior students was positive, and students noted increased proficiency in leadership ability and critical thinking. Student interest in the nurse educator role was also enhanced. Program expansion and evaluation with faculty, clinical staff, and patients are planned.

Nursing student participation in mentoring programs to promote adolescent health: practical issues and future suggestions

The purpose of this study was to explore the practical issues encountered by nursing students who participated in three mentoring programs to promote adolescent health as well as to suggest future mentoring program options for promoting healthy adolescent behavior. The principal investigator and the nursing students recorded practical issues as they arose and prepared memos on these issues offering suggestions for future programs. The written records and memos were reviewed and analyzed using a content analysis process. The content analysis revealed a number of issues and suggestions for future mentoring programs. These issues included the general advantages of mentors, growth in professional capability, progress in professional socialization, and the acquisition of health promotion strategies. Discussion on these issues allows us to assess the potential of nursing students as mentors in a mentoring program to promote adolescent health. Future program development includes program delivery within longer, more regularly structured periods of time while using a multifaceted collaborative approach that can then be evaluated with an appropriate scale to maximize the effects of the program.

A systematic review of peer teaching and learning in clinical education

AIMS AND OBJECTIVES

The purpose of this review is to provide a framework for peer teaching and learning in the clinical education of undergraduate health science students in clinical practice settings and make clear the positive and negative aspects of this teaching and learning strategy.

BACKGROUND

The practice of using peers incidentally or purposefully in the clinical education of apprentice or undergraduate health science students is a well-established tradition and commonly practiced, but lacks definition in its implementation.

METHOD

The author conducted a search of health science and educational electronic databases using the terms peer, clinical education and undergraduate. The set limitations were publications after 1980 (2005 inclusive), English language and research papers. Selection of studies occurred: based on participant, intervention, research method and learning outcomes, following a rigorous critical and quality appraisal with a purposefully developed tool. The results have been both tabled and collated in a narrative summary.

RESULTS

Twelve articles met the inclusion criteria, representing five countries and four health science disciplines. This review reported mostly positive outcomes on the effectiveness of peer teaching and learning; it can increase student's confidence in clinical practice and improve learning in the psychomotor and cognitive domains. Negative aspects were also identified; these include poor student learning if personalities or learning styles are not compatible and students spending less individualized time with the clinical instructor.

CONCLUSIONS

Peer teaching and learning is an effective educational intervention for health science students on clinical placements. Preclinical education of students congruent with the academic timetable increases student educational outcomes from peer teaching and learning. Strategies are required prior to clinical placement to accommodate incompatible students or poor student learning.

RELEVANCE TO CLINICAL PRACTICE

The findings from this systematic review, although not statistically significant, do have pragmatic implications for clinical practice. It can increase clinical placement opportunities for undergraduate health students, assist clinical staff with workload pressures and increase clinician time with clients, while further developing students' knowledge, skills and attitudes.

Evaluation of the mentor–mentee relationship in an occupational therapy mentorship programme

Mentor group relationships in an occupational therapy university curriculum were investigated. In phase I, mentors (n = 23) and mentees (n = 124) were surveyed over a four year period. In phase II, 14 mentees from the same time period were surveyed after graduation. It was found that mentors and mentees surveyed agreed that their mentor group leader displayed more mentoring (i.e. ongoing partnership for guidance and support) than coaching (i.e. short-term relationship for providing feedback on areas requiring change) characteristics, and most agreed that, post-graduation, their mentor group leader had been a mentor to them. Mentees viewed their mentors predominantly as a role model or counsellor and emphasized knowledge, experience, guidance, and support as desirable attributes of a mentor. Contact with mentors for resources, support, or job-related purposes continued after graduation for more than half of mentees. Some mentees reported that peer mentoring had also occurred. Limitations of the study include the small sample size in Phase II and some aspects of survey design. Future areas of research identified include studying the development of the relationship over time (i.e. pre-, mid-way, and post-programme), comparing relationships between mentors and mentees who have similar versus dissimilar expectations for the programme, further examining peer mentoring or group relationships, and continuing post-graduation surveys with a larger sample size for increased reliability.

Isolated rural general practice as the focus for teaching core clinical rotations to pre-registration medical students

BACKGROUND

Earlier studies have successfully demonstrated that medical students can achieve success in core clinical rotations with long term attachments in small groups to rural general / family practices.

METHODS

In this study, three students from a class of 226 volunteered for this 1-year pilot program, conducted by the University of Queensland in 2004, for medical students in the 3rd year of a 4-year graduate entry medical course. Each student was based with a private solo general practitioner in a different rural town between 170 and 270 km from the nearest teaching hospital. Each was in a relatively isolated rural setting, rated 5 or 6 on the RRMA scale (Rural, Remote, Metropolitan Classification: capital city = 1, other metropolitan = 2, large regional city = 3, most remote community = 7). The rural towns had populations respectively of 500, 2000 and 10,000. One practice also had a General Practice registrar. Only one of the locations had doctors in the same town but outside the teaching practice, while all had other doctors within the same area. All 3 supervisors had hospital admitting rights to a hospital within their town. The core clinical rotations of medicine, surgery, mental health, general practice and rural health were primarily conducted within these rural communities, with the student based in their own consulting room at the general practitioner (GP) supervisor's surgery. The primary teacher was the GP supervisor, with additional learning opportunities provided by visiting specialists, teleconferences and university websites. At times, especially during medicine and surgery terms, each student would return to the teaching hospital for additional learning opportunities.

RESULTS

All students successfully completed the year. There were no statistical differences in marks at summative assessment in each of the five core rotations between the students in this pilot and their peers at the metropolitan or rural hospital based clinical schools.

CONCLUSION

The results suggest that isolated rural general practice could provide a more substantial role in medical student education.

Mentoring Undergraduate Nursing Students

Academic mentoring is frequently offered as one strategy to facilitate student success, but the research evidence may be wanting. The authors present an integrative review of the data-based scholarship published between 1992 and 2002. Analysis involved synthesizing the research evidence and presenting findings within a conceptual framework. Research priorities are offered.

Nursing alumni as student mentors: nurturing professional growth

Mentorship is a commonly used strategy for role and career development that has potential benefits for students in undergraduate nursing programs. In contrast to preceptorship, which generally involves clinical supervision and performance evaluation, mentorship is more focused on sharing and nurturing to promote personal and professional growth. This article describes a mentoring program at McMaster University School of Nursing in Canada in which baccalaureate nursing students are mentored by alumni from the same nursing program. Following a successful pilot project with level one students, the program was expanded to include nursing students in all levels who were interested in having a mentor. Both student mentees and alumni mentors have reported positive outcomes. Students felt supported in making personal, academic and career decisions whereas alumni found satisfaction in providing this supportive function, having re-connection with their alma matter, and sharing their professional experience and knowledge. Given the prospective gains not only for the individuals who take part in mentorship programs but also for the profession and beyond, consideration should be given to providing opportunities for nursing students to be mentored during their formative years.

Students' perceptions of the effectiveness of mentors in an undergraduate nursing programme in Hong Kong

AIM OF THE PAPER

This paper reports the results of a multiple-phase study on a mentoring scheme for nursing students in one of the universities in Hong Kong. Using a qualitative approach, students' perceptions of the various roles of mentors were collected, and this information was used as the basis to design a tool for subsequent evaluation of the mentoring scheme.

BACKGROUND

The nursing department in one of the universities in Hong Kong initiated and developed the idea of an 'Honorary Clinical Instructors' scheme (HCI scheme) for the supervision of the pre-registration nurses. The scheme was examined in a local context, where the Chinese culture dominated, so that a standardized protocol that takes into account the potential cultural dimensions could be established.

DESIGN

The mentoring roles outlined by the English National Board (ENB) for Nursing, Midwifery, Health Visiting were used as a framework to identify undergraduate nursing students' perception of the effectiveness of mentors. Information gathered from interviews with Year 2 students (n=12) and Year 3 students (n=10) was used as the basis to design a questionnaire for subsequent programme evaluation. An evaluation questionnaire based on the interviewing results was developed for further evaluation of the mentoring scheme.

FINDINGS

After the mentoring scheme was evaluated in semester one, a series of strategies were designed to improve the preparation of mentors and the implementation of the scheme. The strategies were identified as effective by the significant differences in the perceptions students had towards the mentoring scheme in semester one and semester two (t189=-4.80, P < 0.001), with semester two (n=81) having a mean score difference of 8.69 higher than in semester one (n=110).

CONCLUSIONS

It was concluded that the questionnaire developed in the project could be adopted as a useful instrument to evaluate the effectiveness of mentoring programmes for nursing courses, and that the results of this study may also stimulate more research interest in this area to improve the quality of clinical teaching in the pre-registration nursing education programmes in the future.