Abstract:

The non-medical prescribing (NMP) course qualifies health care professionals to prescribe from the same formulary as doctors. The teaching team use a variety of methods to support student learning including personalised formative feedback (PFF) generated from audience response technology (ART). Since 2016 we have offered our NMP course in a flipped-distance model, these students also use ART and receive PFF. An unexpected outcome from the use of ART is spontaneous peer-assisted learning (SPAL), this phenomenon appears to support student learning beyond the predicted confidence building and tailoring of independent learning expected from PFF. The aim of this study was to assess student perceptions of SPAL. Secondary aims were to explore potential impacts of the learning model and study period on student perceptions of SPAL.

Successive cohorts of NMP students from 2009 have had access to the individualised ART system; four of these groups (n=107) completed a questionnaire about their perceptions of how ART promoted SPAL. Cohorts 1 (n=41), 3 (n=17) and 4 (n=27) undertook the traditional face-to-face NMP course at our Nottingham centre; cohort 2 (n=22) undertook our novel distance learning course. Students were administered an anonymous questionnaire containing 4 Likert style questions on their perceptions of SPAL. The questionnaire was administered either on paper on the last day of the course prior to marks release (cohorts 1, 2 and 4), or online after completing all assessments and receiving their marks (cohort 3). Our distance learning cohort (2) were compared to the 2 face-to-face cohorts who received the same questionnaire (1 v 2 v 4) and the cohort who undertook the questionnaire after receiving their marks were compared to the two face-to-face cohorts (1 v 3 v 4). Data was analysed in SPSS using Kruskal Wallis followed by Tukey post-hoc analysis.

Ninety two percent of students had their understanding supported by peer discussion; 82% discussed questions before answering; 82% were influenced by discussion and 91% of students had supported their colleagues with discussion. However, there were statistically significant differences between cohorts. When asked the following questions: “I discussed questions before answering”, “I supported colleagues with discussion” and “My understanding was supported by discussion”, students who had completed all assessments and received their marks (cohort 3) gave significantly more positive responses than cohorts 1 and 4. For the question “My answer was influenced by discussion”, however, there were no differences between the cohorts. No differences were observed between the distance learning group and the face-to-face students for any question.

The findings indicate there are no differences in student perceptions of SPAL between our traditional face-to-face course and our novel flipped-distance approach. However, the timing of questionnaire delivery appears to be crucial. There is potential for both selection and recall bias in the responses from students who had completed the course and received their marks; potentially reducing the validity of this cohort. As participation was voluntary and anonymous, potentially only students who were happy with their grade responded and positively skewed this cohort’s results. Despite this, we are continuing to review the qualitative elements of student feedback on SPAL to further improve support strategies which engage all learners through ART use.

Keywords:

Audience response technology, peer learning, prescribing.