Peer Assisted Learning in Sophomore Anatomy & Physiology II Laboratory: an Ultrahybrid Design

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Peer Assisted Learning in Sophomore Anatomy & Physiology II Laboratory: an Ultrahybrid Design. George A. Steer PhD Michael L. Slaughter MS Kimberly Whiter MS Chase Poulsen PhD Elliot Carhart PhD. Peer Assisted Learning in Sophomore Anatomy & Physiology II Laboratory: an Ultrahybrid Design. - PowerPoint PPT Presentation


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Peer Assisted Learning in Sophomore Anatomy & Physiology II Laboratory: an Ultrahybrid DesignGeorge A. Steer PhDMichael L. Slaughter MSKimberly Whiter MSChase Poulsen PhDElliot Carhart PhDPeer Assisted Learning in Sophomore Anatomy & Physiology II Laboratory: an Ultrahybrid DesignDiscussionPersonal experience(s) with peer tutors?SuccessesProblemsCoursesSciences vs. Humanities

IntroductionOur ConsiderationsAnatomy & Physiology Required by essentially all programs of studyLack of success in sequence of scheduled program delays full progression for one yearAS programs - freshman course

Interprofessional EducationInstitutional and Organizational commitment Virginia Tech Carilion School of Medicine and Jefferson College of Health Sciences Physician Assistant & MS Nursing

All undergraduate students will be working in teams after graduation IPE team building courses upper level courses @ JCHS

Introduces interprofessional team care at earliest stages of academic development

Makes the lab tangible somebody does this every dayWhy do I careGet through Dr. Steers lab so I can move onIntroductionReal AttachmentIntroductionNational perspectiveStudent success in undergraduate A&P is a focus of many institutions - nationallyFoundational course for all health professions

Attrition rates are as high as 40-70% in basic science courses despite increasing SAT scores and admission GPA

Two methods to improve student success in A&P are required or voluntary recitation sections Peer Assisted Learning (PAL)IntroductionPeer Assisted LearningStudent acceptance, recommendation and benefit from PAL has been empirically established across math and some science disciplines

PAL is characterized by three different methods; a) same-level equal status students of the same class with equal knowledgeb) same-level unequal status students of the same cohort but with unequal expertise and/or training - higher performers in the course and, c) cross-level students of higher academic level, upperclassmen, tutor students of lower academic ranking, underclassmen. Previously taken the course and performed well. Same Level Equal & Unequal StatusNo improvement in lecture examination performance in gross anatomy

Requires significant faculty time for preparation of the student tutor ensure consistent information delivery

Students described concern over the inadequate teaching performance of the tutor

Undergraduate human A&P student concernsmiscommunication, delivery of erroneous information and inability to stay on task

Cross Level Peer TutorsPhysician and nurse practitioner programs in the UK have positive outcomes and views of clinical training activities

Still requires significant time for faculty preparation of the tutorsHybrid Cross Level Peer TutorWe created a variation of Cross Level Tutors using students from several health care professional programs

Students from various health professional programs assist in the anatomy and physiology II laboratories

Peer tutors have displayed competency in laboratory exercises within their professional programs technical experts in the exerciseEliminates the vast majority of faculty time investment for tutor preparationThis study piloted a hybrid PAL activity where educators and students from various health professions programs delivered and assisted in A&P II lab exercises

The educator and student tutors delivered discipline-specific information during four standard laboratory exercises Hybrid Cross Level Peer TutorTutors participate in laboratory activities where they are the discipline specific expertMedical Laboratory ScienceBlood typing, blood cell differentiation and urinalysisEmergency Medical ScienceBlood pressure, ECGRespiratory TherapyBreathing & Respiratory Volumes

Hybrid Cross Level Peer Tutor

GoalsPromote the institutional philosophy of interprofessional education activities while utilizing current resources to improve the student learning experience Assess students recognition of the direct applicability of the laboratory activity to healthcare practice and the professional who performs the procedure

Assess the students perspective on the benefit of PAL to understanding the principles of the exercise

MethodsThree A&P II laboratory sections participated in the study; a control group (n1= 24) with a professor to student ratio of 1 to 12-20 received standard content delivery

an intervention group PAL (n2 = 17) that had a tutor to student ratio of 1:4 plus 2 faculty members. The PAL group had a faculty member and five student tutors from either the Medical Laboratory Science, Respiratory Therapy or Emergency Services programsMethodsAt the end of each laboratory session both groups completed a seven question survey (6 pt Likert), to assess students perception of the laboratory activities

Survey was developed by an expert panel using a consensus approach

Please indicate your agreement or disagreement with each of the following statements using the following scale - circle your answer below each statement

Strongly Disagree; Disagree, Somewhat Disagree; Somewhat Agree; Agree and Strongly Agree

This lab exercise was beneficial to my understanding of the material.

I received an appropriate amount of individualized attention to learn the material during this lab exercise.

I do not understand how the content of this lab exercise is applied to real life health care situations.

I am able to recognize which health professions utilize the content of this lab exercise within their scope of practice.

The content of this lab exercise did not reinforce the knowledge covered in lecture.

The content covered in this lab exercise is relevant to my future clinical practice.

I believe the Pre-Laboratory assignments were useful for understanding and comprehension of the material. ResultsIndependent-sample t-test s indicate a significant difference between groups within Survey Question (SQ)1,2, and 7. See Fig. 1. These included: (1) This lab exercise was beneficial to my understanding of the material(2) I received an appropriate amount of individualized attention to learn the material during this lab exercise(7) Rate the pre-laboratory assignments with respect to the usefulness for understanding the material

Students approached a significant difference in recognizing which profession performed the procedure (p=.071) and its application to their future clinical practice (p=.095).

Fig 1. Faculty CommentsPreparing labs required planning time with the professional students, but proved to be a great student learning experience

The Medical Laboratory Science labs required some theory delivery, to A&P student prior to performance of activity, which was provided by the faculty with the aid of professional students

PAL activity greatly increased interactions within the groups of students.Students fromdifferent plans of study conversed in a focused manner to deliver the contents oftheir activity.

DiscussionWe were able to design a program which: Dramatically reduced the instructor to student ratio

Upgrades 2 laboratory sessions from paper to hands on; lung volumes and ECG and expand others.

Assess the students perspectives of key components of their educational experience

Incorporates interprofessional education and awareness and clinical application of laboratory exercises into the earliest stages of the students pre-professional academic development.ObstaclesScheduling and availability of faculty and students JCHS not possibleCost, although minimal for this study, would be increased if all sections were included. Larger institution a real consideration

Limitations of the studyPopulation (age, academic development) , class size, and locationSurvey question #5 - actual lecture and lab coordination too late

Assumptions equality of professor(s), students, and content - to enable group comparisons.DiscussionReferencesTenney A, Houck B. Peer led team learning in introductory biology and chemistry courses: A parallel approach. J Math Sci: Collab Expl. 2003;6:11-20Crouch CH, Mazur E. Peer Instruction: Ten years of experience and results. Am J Phys. 2001 Sept;69(9):970-979. Falchikov N. Learning together. Peer tutoring in higher education. London: RoutledgeFalmer; 2001. Bently BS, Hill RV. Objective and subjective assessment of reciprocal peer teaching in medical gross anatomy laboratory. Anat Sci Educ. 2009 July/Aug;2:143-149. Krych AJ, March CN, Bryan RE, Peake BJ, Pawlina W, Carmichael SW. Reciprocal peer teaching: Students teaching students in the gross anatomy laboratory. Clin Anat. 2005;18:296-301.Hughes K. Peer-assisted learning strategies in human anatomy and physiology. Am Biol Teach. 2011 Mar;73(3):144-147. Gill D, Parker C, Spooner M, Thomas M, Ambrose K, Richardson J. Tomorrows doctors and nurses: Peer assisted learning. Clin Teach. 2006;3(1):13-18.Saunders C, Smith A, Watson H, Nimmo A, Morrison M, Fawcett T, Tocher J, Ross M. The experience of interdisciplinary peer-assisted learning (PAL). Clin Teach. 2012;9:398-402.Chart15.


Sheet1PALControlSQ1 (p=.037)5.65.2SQ2 (p=.028)5.55.1SQ7 (p=.017)5.334.9To resize chart data range, drag lower right corner of range.


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