Abstract:

RATIONALE:
Globally, many medical schools, similar to ours, have adopted a non-dissection based integrated anatomy curriculum. Within such a setting, mastering visually complex anatomical concepts by large student cohorts within limited practical class time is difficult. Further, engaging such large student cohorts in hands-on experiences of practical skills in tandem with appropriate real time feedback to improve their deeper learning, is a real challenge.

OBJECTIVES:
- To design and evaluate a pedagogical approach which can enhance core competencies in basic medical sciences, encourage deeper, lifelong learning and promote feedback - all within the same practical class of large student cohort.
- To innovate technology enhancement strategies, that can create an effective collaborative peer assisted learning environment for hands-on practical experiments/exhibitions of the students, by the students, and to the students.

METHODS:
The present innovation, developed for the first time in the University for MBBS Year 1 (n=95-106) and MBBS Year 2 students (n=106-136) has been successfully implemented since 2008. With the aid of various anatomical resources, students, in collaborative learning groups, discussed practical tasks, specially designed by the authors, both during self directed sessions as well as in the first part of the practical session under guidance of clinical anatomy lecturers. For the last part of the practical, selected groups came up, in turn, to the technology enhanced demonstration console to present selected key tasks to their whole class through peer teaching demonstrations (PTD). Through interactive multimedia technology, PTD sessions allowed medical students to engage hands-on with available anatomical resources (models, radiological images, plastinated specimens, peer volunteers for living anatomy) and broadcast in real time their PTD to the whole class. Following the Kirkpatrick methodology, this innovation was evaluated at levels of Reaction (course evaluation and student feedback); Learning (summative exam grades) and Behaviour (Peer assessment and tutors’ review).

RESULTS:
This novel PTD ensured that the knowledge and skills learnt in the collaborative learning environment in individual small group were reinforced to attain a higher level of competency by teaching and demonstrating to the whole class (i.e. to all the groups). Faculty wise evaluation scores of this course improved (5-18%) in last two years after introduction of this innovation. Lecturers’ reviews and student evaluations were highly positive (>80%) towards this innovative strategy.It also resulted in an improvement of summative assessment scores (12%). The peer assessment of each demonstrating group indicated a high rating for use of specimens/models, accuracy of content and use of audiovisual aids. Peer assessments provided encouraging feedback to the student for their practical preparation and collaborative learning.

CONCLUSION :
This study describes the successful design, introduction and evaluation of a novel student-centered learning innovation. To our knowledge such PTD has not been previously used in practical skills training of large student cohorts. Through PTD, completing application-focused practical tasks collaboratively and demonstrating them to peers produced significant learning and development of transferable skills translating Joseph Joubert’s thoughts “To teach is to learn twice ” into practice.

Keywords:

Peer Assisted Learning, Technology Enhanced, Innovation, Non-Dissection Anatomy Practical Learning.