Faculty of Health

Implementing Reciprocal Peer Tutoring (RPT) in

laboratory learning of undergraduate nursing

students

Swapnali Gazula PhD Candidate

Faculty of Health, Federation University Australia.

Supervisory Team: Prof Penny Paliadelis

Prof Simon Cooper

Prof Lisa McKenna

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Background literature • Professional requirements (NMBA, 2016, ANMAC, 2012 )

• Higher Education focus on transferrable skills (Rooney et al, 2015)

• Nursing industry recruiting requirements (Kenny, Nankervis, Kidd & Connell, 2012)

• RPT form of active learning (Manyama et al, 2016)

• Successfully implemented in health profession education

programs but not in nursing education (Gazula et al, 2016)

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Research Questions What is the effect of RPT on student learning in

undergraduate nursing laboratories?

4

RPT

What is the effect of RPT on

Knowledge?

Quant

What is the effect of RPT

on self reported

Attitudes on peer

teaching?

Quant What are Student

Perspectives

about RPT?

Qual

Methodology

Epistemology Pragmatism (Nagy, 2010, Jirojwong, Johnson, & Welch, 2012)

Methodology Mixed Methods Research (Wisdom & Creswell, 2013)

Design MM Convergent parallel design (Fetters, Curry, & Creswell, 2013).

QUANT and QUAL data (Creswell & Plano Clark, 2011)

Theoretical framework Peer assisted learning (Topping & Ehly, 2001)

Intervention- Reciprocal Peer Tutoring Priming students with the fundamentals of teaching theory

Students randomly paired in labs for RPT over 2 weeks

Two different set of nursing skills over two weeks

Facilitated by academics in a passive manner

Standardised lesson plans provided for both skills

Modified four stage technique for skills teaching (Bullock, Davis, Lockey, and Mackway-

Jones, 2016)

Tools

Pre and Post Questionnaire:

1. Knowledge (based upon two skills) ( Austin Health, 2017; Endacott, Jevon, & Cooper, 2009)

2. Self report attitudes, confidence and competence (McKenna & French, 2011; Williams, Olaussen & Peterson, 2011)

Analysed using SPSS – paired t tests

Focus group interviews

2 hours X 4 sessions

Analysed using thematic analysis (Van Manen, 1997)

Preliminary findings • 9% Males, 91% Females (n=102)

• Significant increase in post-test knowledge scores

p value <0.001

• Significant increase in post-test scores on self-report

attitudes about peer teaching, confidence and

competence to teach.

p value <0.001

Preliminary findings (contd)

Enhanced individual capabilities

Teaching

Teamwork

Work readiness

Providing feedback

Communication

Independent learning

Collaborative learning

Critical thinking

Problem solving

Resilience

Excerpt from a focus group interview Bob*: “Actually I had a very positive experience with peer teaching. The reason is, last year when I was doing my second year, I was working on the ward as an enrolled nurse. I had nursing students assigned to me. In fact, I had my second year batch mates as students to supervise. I felt really uncomfortable then. I requested that I shouldn't supervise them, but I couldn't get out of it. The students were also my peers, I found it really uncomfortable as technically we were at the same level and yet I had to supervise them. The nurse said they are not yet registered nurses Bob*, you are here and you are experienced in this place. So therefore, show them and teach them what you can. The student found it was not worthwhile either.

This year after my peer teaching experience, I got students to supervise again on the wards. These students were my peers from the University. We worked as a team and had fun learning. We said great! This is another aspect of peer teaching. We used the word ‘peer teaching’ and we felt fairly comfortable.

We said just forget about me being your supervisor and we started teaching each other. We learnt many things together. We found solutions together. If we didn’t find an answer, we went to the clinical teacher and got our answer. Therefore I have a very positive stance on peer teaching.” * Names changed

Recommendation for future research

- Extensive staff involvement in planning

- Have similar studies in various contexts: Clinical

placement, Graduate year

References • Austin Health. (2017). Trachesotomy Review And Management Service Retrieved January 2017 http://tracheostomyteam.org/

• Australian Nursing Midwifery Accreditation Council. (2012). Registered Nurse Accreditation Standards.

• Bullock, I., Davis, M., Lockey, A., & Mackway-Jones, K. (2016). Pocket guide to teaching for clinical instructors (Third edition ed.). Chichester, West Sussex: BMJ Books.

• Creswell, J., & Plano Clark, V. (2011). Designing and Conducting Mixed Methods Research (2nd ed.). Thousand Oaks, CA: Sage Publications.

• Endacott, R., Jevon, P., & Cooper, S. (2009). Clinical nursing skills : core and advanced. Oxford: Oxford University Press.

• Gazula, S., McKenna, L., Cooper, S., & Paliadelis, P. (2016). A systematic review of Reciprocal Peer Tutoring within tertiary health profession educational programs (Publication no. http://dx.doi.org/10.1016/j.hpe.2016.12.001). (2452-3011). http://www.sciencedirect.com/science/article/pii/S2452301116300712

• Jirojwong, S., Johnson, M., & Welch, A. (2012). Research Methods in Nursing and Midwifery Pathways to Evidence-Based Practice. South Melbourne: Oxford University Press.

• Kenny, A., Nankervis, K., Kidd, T., & Connell, S. (2012). Models of nursing student employment: an Australian action research study. Nurse Education Today, 32(5), 600-605.

• Manyama, M., Stafford, R., Mazyala, E., Lukanima, A., Magele, N., Kidenya, B. R., . . . Kauki, J. (2016). Improving gross anatomy learning using reciprocal peer teaching. BMC Medical Education, 16(95), 1-12. doi:10.1186/s12909-016-0617-1

• McKenna, L., & French, J. (2011). A step ahead: Teaching undergraduate students to be peer teachers. Nurse Education in Practice, 11(2), 141-145. doi:10.1016/j.nepr.2010.10.003

• Nagy, S. (2010). Using research in healthcare practice. Sydney: Lippincott, Williams & Wilkins.

• Rooney, D., Hopwood, N., Boud, D., & Kelly, M. (2015). The role of simulation in pedagogies of higher education for the health professions: Through a practice-based lens. Vocations and Learning, 8(3), 269-285.

• Topping, K. (2001). Peer assisted learning: A practical guide for teachers. Northampton, MA: Brookline Books.

• Van Manen, M. (1997). Researching lived experience : human science for an action sensitive pedagogy (2nd ed.. ed.). London, Ont.: Althouse Press.

• Williams, B., Olaussen, A., & Peterson, E. L. (2015). Peer-assisted teaching: An interventional study. Nurse Education in Practice, 15(4), 293-298.

• Wisdom, J., & Creswell, J. (2013). Mixed methods: integrating quantitative and qualitative data collection and analysis while studying patient-centered medical home models. Rockville, MD: Agency for Healthcare Research and Quality.

s.gazula@federation.edu.au