Peer Assisted Learning (PAL)

Author: Sarah Baillie Last updated February 2010

Introduction

Peer assisted learning, or the “the acquisition of knowledge and skill through active helping and supporting among status peer equals” (Topping 2001 [1]) is increasingly used in medical education, and has recently been introduced at the Royal Veterinary College (RVC), University of London. Our initial use of PAL involved 3rd year students using a simulator, the Haptic Cow, to teach their classmates the basic skills required to perform bovine rectal palpation.

It was clear from the medical literature on PAL that the tutors should be trained for, and supported in, their role. Therefore, the PAL project team, Dr Sarah Baillie of LIVE and Helen Shore also from the RVC, have developed a workshop ‘Train the Trainers’ with assistance from Dr Deborah Gill, University College London. The workshop includes sections on: ‘Lesson Planning’, ‘Aims and Objectives’, ‘Questioning’, and dealing with shortfalls in knowledge. After attending the workshop, peer tutors were trained to use the simulator and then delivered one-to-one practical classes in a didactic format using a predetermined lesson plan.

We gathered feedback from both tutors and learners in focus groups and via questionnaires. Students were very positive about PAL. The tutors considered it helped with their communication skills and confidence in a range of contexts. The learners appreciated being taught by someone who “really understands how difficult this is!” A paper describing the study has been published in the Journal of Veterinary Medical Education [2].

We continue to train PAL tutors to teach bovine rectal palpation using the Haptic Cow in preparation for farm animal extramural studies (EMS) and practical classes at college.

Ongoing Uses of PAL at the RVC

We have also run a project exploring a more challenging application of PAL where a peer tutor facilitates a small group role-play tutorial - the ‘Simulated Fertility Visit’. The tutorial was developed by Dr Sarah Baillie using the Haptic Cow to represent a typical fertility visit to a dairy farm and is run as part of the Farm Animal Rotation at the RVC. A study was undertaken to investigate the use of PAL in this context - a peer tutor facilitates the tutorial (following a similar format to that used by staff facilitating communication skills practical classes). This project has been funded by the Royal College of Veterinary Surgeons Trust.

The Simulated Fertility Visit: A member of staff has the role of the ‘farmer’ and students take turns as the ‘vet’ and examine a series of virtual cows for pregnancy diagnosis and with fertility problems. In each scenario, the farmer gives a brief description of the cow. The vet then takes a more detailed history, palpates the simulated cow, makes a diagnosis and discusses treatment options. The student ('vet') is able to practise communication skills, palpation of the bovine reproductive tract and vertical integration of knowledge. A valuable component of the exercise is that mistakes carry no serious consequences. Therefore, high stakes situations, particularly associated with diagnosing pregnancy, can be practised with the option to ‘roll back’ and replay the scenario if necessary. The Simulated Fertility Visit has proved very popular with students. Feedback gathered about the tutorial when facilitated by a peer tutor suggests that the other students were more prepared to take risks and “try out” mistakes than when a member of staff was facilitating.

This project also led to the development of a Computer Aided Learning (CAL) package about routine fertility visits: ‘An Insider’s View of Farming for Outsiders’ (to be presented at International Conference on Communication in Veterinary Medicine, 2008). It is designed to help actors prepare for the farmer role in the ‘Simulated Fertility Visit’ tutorial and in other farm animal communication skills scenarios. The CAL package is also available for students to use in preparation for farm animal extramural studies (EMS).

Teaching Skills for All

We are currently running the PAL workshop ‘Train the Trainers’ for all students in 3rd year with the aim of providing them with skills that would enhance their learning in intramural rotations (IMR) and extramural studies (EMS). In the long term, if PAL were incorporated into the curriculum and became a legitimate outcome in undergraduate education then the vets of the future would be better equipped for their role as EMS providers.

Future plans include continuing to investigate applications of PAL in our curriculum. Students have suggested other areas where PAL might be applicable e.g. anatomy, animal husbandry, in the clinical skills laboratory, and possibly with the tutors as mentors for students experiencing difficulties with certain parts of the course, and there may be potential in an interprofessional setting i.e. student vets and student nurses.

References

1. Topping K. (2001). Peer Assisted Learning: A Practical Guide for Teachers, Brookline Books, MA.

2. Baillie S, Shore H, Gill D, May S. Introducing Peer Assisted Learning into a Veterinary Curriculum: A Trial with a Simulator. Journal of Veterinary Medical Education, (2009), 36(2): 174-179. (Adobe PDF) .