.

DESCRIPTIVE ARTICLE

Peer Teaching Among Physical Therapy Students DuringHuman Gross Anatomy: Perceptions of Peer Teachersand Students

James W. Youdas,* Brianna L. Hoffarth, Scott R. Kohlwey, Christine M. Kramer, Jaime L. PetroProgram in Physical Therapy, Mayo School of Health Sciences, Mayo Clinic, Rochester, Minnesota

Despite nearly 200 accredited entry-level physical therapist education programs in theUnited States that culminate in a doctoral degree, only a paucity of reports have beenpublished regarding the efficacy of peer teaching in gross anatomy. No one has describedthe usefulness of peer teaching from the viewpoint of the peer teacher. An organized peerteaching method provided by four second-year doctors of physical therapy (DPT) stu-dents in a semester course in gross anatomy had a positive impact on the academic per-formance in gross anatomy of first-year DPT students. The unique feature of the weeklypeer teaching sessions was a packet assembled by the second-year peer teachers, whichcontained diagrams, fill-in-the blank questions, and helpful mnemonic devices. This studysurveyed perceptions of first-year DPT students in response to a peer teaching method,using a structured 10-item questionnaire and a five-point Likert scale. Second-year DPTpeer teachers provided written reflections about the benefits and challenges of serving asa peer teacher. Results revealed that 13 planned peer-teaching experiences provided byfour second-year DPT students were valuable and promoted a firm understanding of ana-tomical relationships important for the clinical competence of physical therapist students.Moreover, peer teachers acknowledged acquiring clinically desirable teaching, academic,organizational, and time management skills from the experience. As a result, physicaltherapist educators may wish to consider this model of peer teaching to augment theirteaching strategies for a class in gross human anatomy. Anat Sci Ed 1:199–206, 2008. © 2008

American Association of Anatomists.

Key words: gross anatomy teaching; educational methodology; peer teaching; physicaltherapy education

INTRODUCTION

Peer teaching began in Greece during the first century A.D.,slowly spreading throughout Western Europe until it reachedAmerica (Wagner, 1990). Conditions for peer teaching aremost ideal when the tutor (teacher) and tutee (student) areboth students and about the same age. Educators contendthat peer teaching is successful because peer tutors and tuteescommunicate more effectively than do teachers and students

(Allen and Boraks, 1978). Numerous examples of peer teach-ing in gross anatomy exist in the dental (Bruecker and Mac-Pherson, 2004) and medical literature (Yeager, 1981; Peppleret al., 1985; Yeager and Young, 1992; Nnodim, 1997; John-son, 2002). Investigators described how dental or medicalschool classmates shared personal dissection and peer teach-ing experiences to make more efficient use of time spent inthe anatomy laboratory. Educators at the University of Mary-land (Walker-Bartnick et al., 1984) described a one-to-onetutor/tutee model designed to benefit freshman and sopho-more medical students experiencing academic difficulty in thebasic sciences. Upper-class and graduate students wererecruited as tutors based upon their academic competency inthe basic sciences. Tutored students received passing grades in84% of the courses for which they were tutored. A vast ma-jority of the tutored students perceived the tutoring sessionsto be productive and valuable. More recently, a physicaltherapist educator enhanced physical therapy (PT) student

*Correspondence to: James W. Youdas, PT, MS, Program in PhysicalTherapy, 1105A Siebens Building, Mayo Clinic, Rochester, MN 55905,USA. E-mail: youdas.james@mayo.edu

Received 30 April 2008; Revised 3 July 2008; Accepted 7 July 2008.

Published online 4 September 2008 in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/ase.44

© 2008 American Association of Anatomists

Anatomical Sciences Education SEPTEMBER 2008 Anat Sci Ed 1:199–206 (2008)

performance in a gross anatomy course (Lake, 1999) usinga group peer teaching model. All third-year PT students en-rolled in the gross anatomy course were eligible to attendtutoring sessions conducted by fifth-year PT students selectedby the PT faculty. Lake assessed third-year students’ percep-tions of the peer teaching process using a two-question surveyand a 10-point Likert scale. Tutored students acknowledgedthe usefulness of peer teaching in gross anatomy and stronglyencouraged the program’s faculty to incorporate peer teachinginto other courses within the professional PT curriculum.Nevertheless, Lake did not assess the benefits of peer teachingfrom the perspective of the fifth-year peer tutors.

Although perceived benefits of peer teaching have beendescribed for tutees, few reports have discussed the benefitsof peer teaching from the perspective of the tutors. Ocel et al.(2003) surveyed 57 third-year medical students over a 17-year period. All served as teaching assistants (TAs) during thefirst-year course in gross and developmental anatomy atMayo Medical School. Ninety-seven percent of the TAs per-ceived the experience improved their one-on-one communica-tion skills necessary for patient care. Presently there is no in-formation in the literature that describes the perceptions ofsecond-year doctor of PT (DPT) students who served as peerteachers to first-year DPT students in a semester course ofhuman gross anatomy.

Our primary aim in this study was twofold: (1) to surveyperceptions of first-year DPT students about the peer teachingmethod implemented in Anatomy for Physical Therapists and(2) to describe the teaching, academic, and organizationalbenefits as well as challenges of peer teaching as perceived byfour second-year DPT students who served as peer teachers/tutors. We believe this is the only such report in the literaturerelevant to the effect of peer teaching in gross anatomyinstruction for entry-level DPT students.

MATERIALS AND METHODS

Traditionally, human gross anatomy has been a foundationalcourse in any PT curriculum (Mattingly and Barnes, 1994).At Mayo School of Health Sciences, Anatomy for PhysicalTherapists is a six-credit class that met 3 days per week(Monday, Wednesday, Friday) for three consecutive hours perday during the 16-week fall semester of 2007. During the firstclass hour, students received a lecture discussing the grossanatomy of the structures to be dissected during the subse-quent 2-hr laboratory session. In the gross anatomy labora-tory (Ellis, 2001), students were divided into seven groups offour students. Each group was assigned to a specific dissec-tion table for the duration of the course. Students usedinstructions provided by the instructor and an atlas as a guidefor daily dissection (Netter, 2003). For any given anatomylaboratory session, the 28 first-year DPT students had threefull-time PT faculty available to assist with the dissectionsand clarify questions. Students’ academic performance wasassessed throughout the course via 10 quizzes and four writ-ten and laboratory practical examinations. Weekly quizzeswere announced and typically occurred on Fridays, whereasthe four written and laboratory practical exams were sched-uled on a monthly basis.

Peer teaching was incorporated into the course, Anatomyfor Physical Therapists, as an educational method to enhancethe learning of anatomical concepts by first-year DPT stu-dents. Four second-year DPT students were selected by the

course coordinator to serve as peer teachers for the first-yearDPT students. The course coordinator selected the four peerteachers from a class size of 28 DPT students, based uponhis/her stellar academic performance and dissection skillsdemonstrated within Anatomy for Physical Therapists courseduring fall semester, 2006. Furthermore, the course coordina-tor was also impressed by each peer–teacher’s oral communi-cation skills displayed throughout the 2006–2007 academicyear. Upon completion of the course, each second-year stu-dent was remunerated for his/her time by the Mayo ClinicPhysical Therapy Alumni Association.

Prior to the 2007 fall semester, the course coordinatorand peer teachers established dates and times for the 13peer teaching sessions. Peer teaching review sessions wereeach 90 min in length and occurred during late afternoon toaccommodate both first-year and second-year students’ aca-demic schedules. The theme for each peer teaching sessionwas developed based upon weekly terminal behavioral andinstructional objectives contained in the course syllabus.Daily lecture and laboratory, content for Anatomy for Phys-ical Therapists course was identical for both 2006 and 2007fall semesters; hence, the four peer teachers were familiarwith the anatomy course resources. Materials used ateach session included articulated skeletons or individualbones, cadaveric tissue dissected by first-year DPT students(Ellis, 2001), anatomical atlases, a variety of prosectedjoints, and the course textbooks (Drake et al., 2005;Jenkins, 2002).

During the third review session, second-year tutorsdesigned a simulated laboratory practice practical identical tothe format used for the actual practical exam. First-year stu-dents sequentially rotated among 25 separate stations, withstructures identified on human cadaveric specimens by papermerchandise tags or bones with chalk markings, respectively.Students were permitted 90-sec per station to identify the twostructures before a timer sounded, and the class advanced tothe next station. Upon completion of the simulated anatomylaboratory practical first-year students were provided withthe correct answers to the 50 items. First-year students thenhad the opportunity to review their answers and seek clarifi-cation from a second-year tutor if they were puzzled by aparticular item.

The distinctive feature of the weekly peer teaching reviewsession was a packet assembled by one of the peer teachers.The packet’s uniqueness stemmed from a variety of learningresources including prominent anatomical relationships gath-ered from class notes, textbook descriptions, or a tutor’s ownsuccessful study strategies developed when he/she was a first-year student. Approximately 80% of the study questionsrequired a three- to five-sentence explanation, whereas 20%asked the first-year student to fill-in-the blank, label a dia-gram, or identify a structure on a cadaveric specimen or skel-eton. The primary task of preparing the learning packet wasrotated on a weekly basis among the four peer teachers, yet itremained collaborative. The tutor responsible for preparingthe learning packet would request critical comments from his/her peers about the most appropriate way to assemble thelearning materials. A day or two prior to the weekly reviewsession, the lead tutor would distribute a packet withoutanswers to his/her classmates for their review and comple-tion. Development of the learning packet required 2–3 hr ofthe peer teacher’s time and involved selecting appropriateresources, reading and reviewing chapters from course text-books, perusing previous anatomy notes, preparing review

200 Youdas et al.

questions and answers, and then photocopying the materials.Peer teachers selected ‘‘big concept’’ anatomical relationshipsthey deemed foundational for understanding concepts coveredin subsequent courses during the remainder of the DPT cur-riculum. Peer teachers did not lecture during the review ses-sions. At the start of each review session, learning packetswere distributed, and first-year DPT students gathered insmall groups of two to four students. Review sheets providedtalking points for first-year student groups by stimulating crit-ical thinking and discussion of anatomical topics. All fourpeer teachers circulated among student groups and providedindividual attention to students or groups by answering ques-tions or reviewing key concepts. When requested, a peerteacher would go into the anatomy laboratory and use a first-year student-dissected cadaver to review anatomical relation-ships. The majority of peer teaching review sessions wereheld on Thursdays so first-year DPT students could preparefor a Friday quiz. Because the first three written and labora-tory practical examinations were scheduled on Wednesdays,the peer teaching review session for that week was scheduledfor Tuesday afternoon. Pretest sessions differed from prequizsessions by providing a general overview of anatomical rela-tionships covered within the preceding 4 weeks, in additionto a general question-and-answer session. The course coordi-nator did not assist the peer tutors with developing the con-tents of the study packet. However, he did provide feedbackto second-year tutors regarding first-year students’ perform-ance on weekly quizzes or monthly written and laboratorypractical exams.

A structured questionnaire (Table 1) was distributed to allfirst-year students upon conclusion of Anatomy for PhysicalTherapists during the fall semester of 2007. Completion of

the questionnaire was voluntary and anonymous. A total of28 students (100%) responded to the questionnaire. In addi-tion to the 10 survey items, the questionnaire also containedfour open-ended questions that provided an opportunity forthe first-year students to make narrative comments about var-ious features of the peer teaching experience (Table 2). Fur-thermore, upon completion of the course, each of the foursecond-year students reflected upon his/her experience anddescribed the teaching, academic, and organizational benefitsand challenges of serving as a peer teacher (Table 3). Thisstudy was approved by the Mayo Clinic Institutional ReviewBoard.

RESULTS

Perceptions of Students/Tutees

Attendance by first-year DPT students at the peer teachingsessions was not mandatory. According to students’ self-reports, 67.9% (19) of first-year students attended between 9and 13 of the peer teaching review sessions. Four students(14.3%) indicated that they attended between six and eightpeer teaching sessions, whereas five first-year DPT students(17.9%) reported attending between three and five peerteaching sessions.

The majority of students (question 1, 78.6%, by combin-ing students who responded with ‘‘agree’’ and ‘‘stronglyagree’’) indicated that peer teaching review sessions were use-ful for improving performance on weekly quizzes (Table 1).Similarly, 64% (question 2) of first-year students perceivedpeer teaching sessions improved their scores on the laboratory

Table 1.

Questions Included in the Questionnaire on the Peer Teaching Method and the Students’ Responses

Question N Mean SD

1 The peer teaching sessions improved my performance on the weekly quizzes. 28 4.07 0.71

2 The peer teaching sessions improved my scores on the lab practical exams. 28 3.75 0.65

3 The peer teaching sessions improved my scores on the written examinations. 28 4.21 0.69

4 The peer teaching sessions were well organized. 28 4.07 0.81

5 The peer teaching sessions were adequately timed and appropriately sequenced throughout the fall

semester of 2007.

28 4.25 0.52

6 The peer teaching sessions reinforced what had been previously presented during formal classroom

lectures and laboratory sessions.

28 4.21 0.5

7 The peer teachers clearly answered my questions. 28 4.21 0.5

8 The peer teaching sessions provided me with alternate strategies to correctly identify important

anatomical concepts.

28 3.96 0.58

9 The peer teachers emphasized functional movement patterns during the weekly teaching sessions. 28 3.79 0.5

10 The peer teaching sessions helped me develop an effective strategy for the study of anatomyoutside the formal classroom and laboratory sessions.

28 3.86 0.71

Rating scale: 1 5 strongly disagree; 2 5 disagree; 3 5 neither agree nor disagree; 4 5 agree; 5 5 strongly agree.

Anatomical Sciences Education SEPTEMBER 2008 201

practical exams (Table 1). Approximately 11% of studentswrote that the simulated laboratory practical offered prior tofirst exam was the most helpful peer teaching experience

(Table 2). A majority of students (85.7%; question 3) per-ceived their scores on the written examinations wereimproved by attending peer teaching review sessions (Table

Table 2.

Student Narrative Responses to Open-Ended Questions on Survey Instrument

Questions and comments Responses Percentage Students’ comments

1. What was the most helpful peer-

teaching experience?

� Packets with

pictures

28.6 � ‘‘I really liked the worksheets and how the

teachers were available to answerquestions.’’

� Worksheets 21.5 � ‘‘I found the handout exercises helpful. Even

when I could not stay for the session, I

appreciated being able to take the handouthome and work on it individually.’’

� Finger extensormechanism

17.8

� Quiz format of

teaching

14.3

� Simulated lab

practical

10.7

� Small group review 7.1

2. Please comment on what youliked about the peer teaching

experience.

� Showed mealternative ways to

learn the material

28.6 � ‘‘I liked the ability to ask questions and havethem explained in a new way.’’

� Availability ofsecond-year

students to answer

questions

25.0 � ‘‘The peer teachers had other ways to learnthe material which helped me.’’

� Quality of packets/handouts

21.4

� Useful to prepare

for quizzes andexams

14.3

� Helped me identify

the ‘‘holes’’ in my

understanding ofanatomy

10.7

3. Please comment on what you

did not like about the peerteaching experience.

� Nothing disliked 35 � ‘‘I don’t always study well in groups.’’

� Lack of ‘‘organized’’lecture

30 � ‘‘I had to work and often could not attend.Also, with so many students it was hard to

get help and focus in the room.’’

� I don’t always study

well in groups.

25 � ‘‘When identifying structures, it would be

nice to use figures from texts other than ourown to gain a different perspective.’’� Miscellaneous 10

4. Do you have any

recommendations for improvement

of the peer-teaching experience for2008?

� None 40 � ‘‘Spend more time examining the cadaveric

materials.’’

� More lab time 20 � ‘‘Have first-year students e-mail specificquestions to the peer teachers prior to each

teaching session so handouts focus on

specific students’ needs.’’

� Miscellaneous 20 � ‘‘Encourage the peer teachers to utilize adiscussion/review instead of a question/

answer format.’’

202 Youdas et al.

Table 3.

Second Year Physical Therapy Peer Teachers’ Reflections About the Benefits and Challenges of Serving asa Peer Teacher in Gross Anatomy

Perceivedbenefits orchallenges Second year peer teachers’ reflections

Teaching

benefits

� ‘‘Personally I received a great sense of accomplishment from the entire experience. Each week I left our sessions

feeling like I had helped someone learn something. It was a ton of work to prepare thematerial each week, but itfelt so awesome to answer questions, present new ideas, and give first-year students who are struggling with the

very same thing that I struggled with only a year earlier, strategies to grasp a challenging subject matter.’’

� ‘‘I gained a sense of confidence inmy ability to teach. It was something I had never had the opportunity to do before.

Being able to interact with peoplemy age and provide themwith beneficial ideas and knowledgewas empowering.’’

� ‘‘As a peer teacher, I was able to improve my teaching skills. This was a very beneficial learning process

because as a future DPT a lot of my job will require teaching others, so getting practice through peer

teaching will greatly benefit me in my future career!’’

� ‘‘I was able to learn throughout the semester teaching experience, so it becomes a two-way learningexperience instead of a one-way learning experience.’’

Academic

benefits

� ‘‘This experience was also extremely helpful in preparing me for my own class work. Most of the semester I

felt like I had an unfair advantage in my musculoskeletal I (MSK I) course. It made the MSK I class much

more enjoyable because I was not struggling to recall basic anatomical concepts. I also cannot begin toexplain the benefits of seeing and working with the cadavers (peer teaching) for the entire semester prior to

taking a lab practical at the end of the MSK I course.’’

� ‘‘Most of the semester coordinated material between what we were teaching in anatomy to what we were

learning in our MSK I class, which involved examination and evaluation of musculoskeletal problems. Duringlab time in our MSK I class, we were able to help our own classmates review anatomic landmarks and

understand the rationale underlying specific examination procedures.’’

� ‘‘As a peer teacher I was able to have anatomy fresh in my mind during the second year fall semester MSK I

class, hence it helped me better understand the new PT skills I was learning.’’

� ‘‘During the fall semester of second year, we had to take a comprehensive exam over the entire body of the

cadaver at the completion of our MSK I class. My peer teaching responsibilities helped me study throughout

the entire semester instead of putting it off until the week or two before the exam.’’

Organizationalbenefits

� ‘‘I discovered that I’m very visual and I need to draw and label and see images, and so we incorporated a lotof different diagrams and encouraged the students to draw the pathways of nerves and arteries to facilitate

learning. We knew what topics had been especially challenging for us during first year and those were the

topics we chose to focus on for most of our teaching sessions.’’

� I am a very organized person anyway, but this experience taught me how to compile information that will bebeneficial, understandable, and easily referenced in the future.’’

� ‘‘I learned new organizational skills from being a peer teacher because I needed to review my old notes and

prepare study packets for the first year DPT students.’’

� ‘‘My organizational skills were improved because I needed to complete my own homework as well asprepare to teach first year DPT students gross anatomical concepts.’’

Challenges

of peerteaching

� ‘‘Our fall semester during second year was a busy one and sometimes finding the appropriate amount of

time to prepare for these sessions was a definite challenge.’’

� ‘‘Teaching in a one-on-one or small groupsmademe uncomfortable at first. When I was looked to by the first yearstudents for advice or answers, I learned to be confident in my answer to them to establish their trust in me. I also

learned that it was O.K. if I did not know all the answers, because the first year DPTstudents understoodwe had a

full class load on top of peer teaching, and it was not possible to have all the answers.’’

� ‘‘At times it became difficult to juggle a full class load along with the reviewing and preparation necessary for

the peer teaching sessions, but overall it was a wonderful learning experience!’’

� ‘‘The only downside to the peer teaching experience was that it was another activity to do in an already busy

schedule, but still a worthwhile experience’’

Anatomical Sciences Education SEPTEMBER 2008 203

1). Questions 4, 5, and 6 dealt with the organization,sequencing, and reinforcement of anatomical concepts withinthe peer teaching sessions, respectively (Table 1). A high per-centage of students (85%; question 4) indicated that peerteaching review sessions were well organized. A vast majorityof first-year DPT students (96.4%; question 5) perceived thatthe review sessions were adequately timed throughout the fallsemester and anatomical concepts were reinforced (96.4%;question 6). Similarly, a great majority of first-year students(96.4%, question 7) indicated that the peer teachers clearlyanswered their questions (Table 1). Eighty-nine percent (ques-tion 8) of first-year students believed peer teaching reviewsessions provided alternate strategies to assist them identifyimportant anatomical concepts (Table 1). Seventy-five percentof first-year (Table 1) students perceived that the peer tutorsemphasized functional movement patterns during weeklyreview sessions (question 9). A majority of first-year students(82%, question 10) acknowledged that peer teaching sessionswere useful for acquiring an effective learning strategy whenstudying gross anatomy outside the formal classroom or labo-ratory sessions (Table 1).

Perceptions of Teachers/Tutors

Upon completion of Anatomy for Physical Therapists, thecourse coordinator requested each second-year student toprovide narrative reflections about the teaching, academic,and organizational benefits and challenges of serving as apeer teacher. Samples of these comments are contained inTable 3. Furthermore, near the end the 2007 fall semester,upon completion of musculoskeletal I (MSK I), all 28 second-year DPT students took a comprehensive gross anatomy labo-ratory practical. This exam was similar to the one they hadtaken a year before upon completion of Anatomy for PhysicalTherapists. The mean class score on the anatomy laboratorypractical was 92 out of 100 points (range 5 84–100). Threesecond-year tutors scored above the class mean (100, 99, and93 points), whereas one peer tutor scored lower than theclass mean (88 points).

DISCUSSION

Perceptions of Students/Tutees

Learning anatomical relationships as evidenced by academicperformance on written and laboratory practical exams wasan important reason for first-year students to attend weeklypeer teaching review sessions. In a related study (Youdaset al., 2007), 28 first-year DPT classmates alternated betweentutor and tutee roles in a gross human anatomy course. Sev-enty percent of first-year students attributed their successfulperformance on anatomy written and practical exams to rein-forcement of anatomical relationships during weekly peerteaching sessions. Similarly, first-year students in the presentstudy perceived the weekly peer teaching sessions improvedtheir scores on quizzes, and written and laboratory practicalexaminations. Nearly 80% of the study questions containedon the review worksheets assembled by the second-year tutorsrequired first-year students to retrieve anatomical relation-ships and describe them using three to five sentences. Thisformat was similar to the test style used on quizzes and writ-ten exams. Furthermore, by conducting a simulated labora-tory practical during the third peer teaching review session,second-year tutors prepared first-year students for a challeng-

ing test experience and simultaneously reduced their potentialtest anxiety.

First-year students perceived the peer teaching review ses-sions were well organized and informative. First-year stu-dents’ satisfaction with organization and sequencing of thepeer teaching review sessions within this model of peer teach-ing was similar to the findings reported by medical students(Walker-Bartnick et al., 1984). Second-year tutors successfullyreinforced anatomical concepts presented previously by theanatomy course faculty, because peer tutors designedthe review packets according to weekly themes printed in theanatomy course syllabus. Moreover, second-year tutors rec-ommended publishing dates and times for the peer teachingreview sessions in the course syllabus to encourage first-yearstudents to mark session dates on their daily planners. Fur-thermore, the course coordinator anticipated that second-yeartutors would successfully answer first-year students’ questionsduring the peer review sessions. Peer teachers were selectedon the basis of their knowledge in anatomy and their commu-nication skills. Previous research (Medway, 1991) indicatedthat greater success was attained with tutors who wereintrinsically motivated. Additionally, Medway also reportedthat greater tutee learning took place with minimal social dis-tance between the tutor and tutee. First-year and second-yearPT students were about the same age with common extracur-ricular social interests. Because second-year tutors had suc-cessfully completed a rigorous year of academic study in PT,first-year students valued the insights provided by their seas-oned counterparts (Chambers et al., 2000).

Peer teaching review sessions were attractive to first-yearstudents because they utilized alternative strategies for learn-ing anatomical concepts. Using a reciprocal peer teachingmodel (Youdas et al., 2007), PT students acting as teachersoften shared an acrostic or mnemonic with a classmate thathe or she found helpful when learning anatomical facts. Inthe present study, first-year students commented that second-year tutors introduced mnemonic devices that facilitated re-trieval of functional anatomical relationships. Another strat-egy used by second-year tutors involved a variety of visualaids. Using a whiteboard and colored markers, second-yeartutors would request first-year students to diagram the path-way of common peripheral nerves from their respective originin the brachial or lumbosacral plexus to their terminal attach-ments in the extremity. First-year students would be asked tolist specific muscles and cutaneous regions supplied by eachnerve. On another occasion, while working in small groups,second-year tutors would distribute rubber gloves to first-yearstudents. Using colored markers, first-year students wouldpractice drawing the cutaneous distribution of the median, ul-nar, and radial nerve on the palmar and dorsal surface oftheir gloved hand (McMenamin, 2008). This exercise washelpful because the first-year student could better visualizethe three-dimensional overlap of the cutaneous innervation tothe hand.

Perceptions of Teachers/Tutors

Communication and teaching skills acquired during the anat-omy peer teaching experience by second-year tutors would bebeneficial during the student physical therapist’s professionalinteraction with patients (Wolff-Burke, 2005, Youdas et al.,2007). The four second-year students recognized that theweekly peer review sessions provided valuable opportunitiesto engage first-year students in one-on-one teaching moments.

204 Youdas et al.

Second-year students used words such as ‘‘awesome,’’‘‘empowering,’’ ‘‘beneficial,’’ and ‘‘two-way learning experi-ence’’ to describe the benefits of peer teaching. The professio-nal growth the peer teachers perceived from this semester-long peer teaching experience could be partially attributed totheir improved ability to communicate with the first-yearstudents.

Inadequate knowledge is a behavior that causes clinicalinstructors to question the clinical competence of a PT stu-dent (Hayes et al., 1999). Similar to medical student tutors(Walker-Bartnick et al., 1984; Nnodim, 1997), second-yearPT tutors acknowledged the academic merits derived frompeer teaching. Concurrent with peer teaching in gross anat-omy, the four second-year tutors were enrolled in MSK I, acourse that covered the rationale underlying examination andevaluation of musculoskeletal dysfunctions in patients. Sec-ond-year students recognized the academic benefit derivedfrom peer teaching, because unlike their second-year counter-parts, they were not struggling to recall anatomical relation-ships that formed the basis for many specific tests and meas-urements of the musculoskeletal system. Second-year studentsalso provided peer teaching to their own classmates near theend of the fall semester in MSK I course. All 28 second-yearDPT students were preparing for a mandatory comprehensiveanatomy laboratory practical covering the spine and extrem-ities. Based upon the four second-year peer tutors percep-tions’, we would expect each to apply appropriate knowledgeto the safe and effective assessment of patients with musculo-skeletal disorders.

Professional behaviors such as initiative, preparation, andself-reflection are highly valued by physical therapist clinicalinstructors when the DPT student is engaged in a clinicalrotation (Wolff-Burke, 2005). A major component of eachpeer teaching review session was the preparation of the learn-ing packet distributed to the first-year student. To prepare aneffective teaching and learning instrument, second-year tutorsinitially reviewed the anatomy course syllabus to confirmthey were covering anatomical relationships presented thatweek by a course faculty member. Next, tutors recalled spe-cific anatomical concepts that had been challenging for themto master during the first year. Such concepts provided impor-tant talking points that spurred small group discussion duringthe peer teaching sessions. Lastly, the learning packet wasassembled, critically reviewed, and revised by the tutorsbefore its distribution to first-year students. Moreover, thedesign and development of a weekly teaching packet demon-strated that second-year students possessed characteristics ofan adult learner, which would be valued highly by a clinicalinstructor.

Time management by a DPT student is another behaviorhighly valued by clinical instructors of PT (Wolff-Burke,2005). The four second-year students agreed that the peerteaching task was challenging because of personal time com-mitment. Not only did tutors prepare for the weekly peerteaching session, but they also were enrolled in seven classes(19 fall semester credit hours) with numerous assignmentsand group projects. Hence, it was imperative that the second-year tutor develop excellent time-management skills.

CONCLUSION

Peer teaching by four second-year DPT students was per-ceived to be an effective teaching method for use with 28

first-year DPT students when learning human anatomicalrelationships within a course that used traditional classroomlecture and laboratory cadaveric dissection. Additionally, allfour peer tutors acknowledged that peer teaching experiencesprovided an opportunity to (1) accrue experience teaching insmall groups; (2) deepen their understanding of gross anat-omy; (3) assemble meaningful learning materials; and (4)strengthen time-management skills. Such DPT student behav-iors are valued by clinical instructors of PT. As a result, phys-ical therapist educators may wish to consider using thismodel of peer teaching to augment their teaching strategiesfor a class in gross human anatomy.

ACKNOWLEDGMENTS

The authors thank Drs. Nathan J. Hellyer and David A.Krause from the Program in Physical Therapy at MayoSchool of Health Sciences, Mayo Clinic, Rochester, MN forsharing their keen knowledge of human motion, both in theanatomy classroom and dissection laboratory.

NOTES ON CONTRIBUTORS

JAMES W. YOUDAS, PT, MS, is an associate professor inthe Program in Physical Therapy at Mayo School of HealthSciences, Mayo Clinic, Rochester, Minnesota. He is the coor-dinator and an instructor in the Anatomy for Physical Thera-pists Course for the first-year Doctor of Physical Therapystudents.

BRIANNA L. HOFFARTH, BS, is currently a doctoral stu-dent in the Program of Physical Therapy at Mayo School ofHealth Sciences, Mayo Clinic, Rochester, Minnesota. Sheserved as a peer teacher in the Anatomy for Physical TherapistsCourse for the first-year Doctor of Physical Therapy students.

SCOTT R. KOHLWEY, BS, is currently a doctoral studentin the Program of Physical Therapy at Mayo School of HealthSciences, Mayo Clinic, Rochester, Minnesota. He served as apeer teacher in the Anatomy for Physical Therapists Course forthe first-year Doctor of Physical Therapy students.

CHRISTINE M. KRAMER, BS, is currently a doctoral stu-dent in the Program of Physical Therapy at Mayo School ofHealth Sciences, Mayo Clinic, Rochester, Minnesota. Sheserved as a peer teacher in the Anatomy for Physical TherapistsCourse for the first-year Doctor of Physical Therapy students.

JAIME L. PETRO, BS, is currently a doctoral student inthe Program of Physical Therapy at Mayo School of HealthSciences, Mayo Clinic, Rochester, Minnesota. She served as apeer teacher in the Anatomy for Physical Therapists Coursefor the first-year Doctor of Physical Therapy students.

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