Benefits of “Near-Peer” Teaching

by Allison Graffeo, PharmD, PGY-1 Pharmacy Practice Resident, University of Mississippi Medical Center

Near-peer teaching involves students learning from more senior peers, individuals who are one or two years ahead of them in school or post-graduate training.¹ It is a well-established model used by medical education programs; however, not fully established in pharmacy education. Some educators criticize this method, stating that it would lower the quality of teaching, be difficult to implement and be unethical to use students as teachers. However, using near peers in the classroom, practice labs, and experiential learning environment allows pharmacy students to learn from a peer who has been through similar (and recent) experiences. In addition, it contributes to the more senior peers’ growth to teach and develop their professional skills.²

There are two distinct types of near-peer teaching models most commonly employed: classroom-based and experiential learning. The classroom-based model incorporates senior peers to lead lectures, discussion, and other activities in classes or practice labs serving as an assistant to the faculty member. This model engages students to learn from their senior peers who use a similar language. When using near peers in the experiential learning setting, the instructor integrates learners (often at multiple stages of development) to address real-world problems or to gain research experience. Over the last decade, many authors and researchers have investigated the applicability of these near-peer teaching models in pharmacy education.

At the University of Toronto, near-peer teaching was assessed in an experiential teaching model that was led by a clinical pharmacist/preceptor and assisted by a recent graduate PharmD student with 3 years of previous hospital experience.  The learners included a pharmacy resident who had been with the institution for 6 months, a third-year pharmacy (cooperative “Co-op”) student, and a fourth-year pharmacy (Structured Practical Experience Program “SPEP”) student. The recently graduated PharmD and resident were considered the senior peers to the third- and fourth-year students. These clinical experiences consisted of patient-care rounds on a hemodialysis unit with a medical team. The lead pharmacist would provide articles on specific topics to the students and residents to prepare for patient and therapeutic discussions. Senior learners led the discussions, and all members of the group were expected to be in attendance to bring various experiences to discussions. This allowed the senior peers to use concepts and language that the third- and fourth-year students could more easily understand and relate to while also having the preceptor available to explain concepts more deeply and fill in the gaps. These sessions occurred at least three times a week and included minimal direction from the pharmacist to allow the senior peers to take the lead.² Although the expected hierarchy was for the students to rely on the resident, it turned into a collaborative group with each member of the team contributing. This method provided a unique and positive approach, particularly with regard to collaboration with healthcare teams and the students reported that they greatly benefited from having a near-peer role model. They explained that they felt comfortable approaching the recently graduated pharmacist and resident and they developed a better understanding of pharmacy interventions.

The Oregon State University College of Pharmacy recently assessed the effectiveness of a classroom-based near-peer teaching model.  They measured third-year pharmacy students’ knowledge and confidence related to frequently prescribed medications. There was a total of 98 third-year pharmacy students involved in the “RxReady” near-peer teaching series which occurred immediately prior to their advanced pharmacy practice experiences (APPEs). Twenty-four students were randomly selected and were required to study a certain medication and present a 10-minute presentation to other students (with a faculty member present). Students who participated in the presentation had to complete pre- and post-quizzes (test of knowledge) as well as a survey to determine the effectiveness (change in student confidence) of this teaching style.³ Out of the 96 students who took part in the pre- and post-quizzes and surveys, there was a 15% increase (p<.001) in post-scores compared to the initial quiz and survey. Additionally, 96% of students achieved a higher score on the final knowledge assessment compared to the initial ones. Student confidence scores significantly improved after the presentations (IQR [(0-0.5) – 1]; p<.05).² Targeted questions on the surveys included recalling dosing and formulations, side effects, pharmacokinetics and pharmacodynamics, drug-drug interactions, and counseling points.³ This method may be a useful way to assist students with learning gaps and prepare students to give presentations and engage in patient education during the APPEs.

Lastly, a review article examined six educational research studies that assessed the various models for near-peer teaching. The paper examined near-peer teaching activities in pharmacy schools. Of the six studies included in the review, surveys and questionnaires were used to assess knowledge, problem-solving skills, attitudes, and values towards near-peer teaching methods. These studies revealed that near-peer teaching was accepted and had a positive impact on students’ experiences. Students strongly agreed that near-peer teaching promoted collaboration and that they were excellent role models.¹

The purpose of experiential learning is for students to see real-life situations which reinforce drug knowledge, help develop communication skills, and provide opportunities to practice problem-solving. Near-peer teaching enhances student experiences by providing mentorship and assistance from a senior peer. However, barriers remain within pharmacy programs to implement near-peer teaching as a structured teaching model. To be most effective, senior peers should be assigned a faculty preceptor to ensure all daily responsibilities are being met and are receiving adequate feedback. Additionally, senior peers could create “notebooks” including classroom-based and experiential learning activities which they can pass down and updated annually, aiding the transition from student “learner” to senior “near-peer” teacher. If pharmacy schools routinely had near-peer teachers throughout their curriculum, it would not only provide a unique learning environment for students and residents but help to increase the confidence and clinical skills of pharmacists.^1,2,3

 

References: 

1. Aburahma MH, Mohamed HM. Peer teaching as an educational tool in Pharmacy schools; fruitful or futile. Curr Pharm Teach Learn. 2017;9(6):1170-1179.
2. Leong C, Battistella M, Austin Z. Implementation of a Near-Peer Teaching Model in Pharmacy Education: Experiences and Challenges. Can J Hosp Pharm. 2012;65(5):394-398.
3. Tsai T, Vo K, Ostrogorsky TL, McGregor JC, McCracken CM, Singh H. A Peer-Teaching Model to Reinforce Pharmacy Students’ Clinical Knowledge of Commonly Prescribed Medications. Am J Pharm Educ. 2021;85(5): Article 8451.