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Peer assisted learning in the clinical setting: an activity systems analysis.

Bennett D, O'Flynn S, Kelly M - Adv Health Sci Educ Theory Pract (2014)

Bottom Line: Differing perspectives within the group were opportunities for expansive learning.PAL in the clinical environment presents challenges specific to that context.Planning learning opportunities on clinical placements, must take account of how students learn in workplaces, and the complexity of the multiple competing activity systems related to learning and social activities.

View Article: PubMed Central - PubMed

Affiliation: Medical Education Unit, School of Medicine, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland, d.bennett@ucc.ie.

ABSTRACT
Peer assisted learning (PAL) is a common feature of medical education. Understanding of PAL has been based on processes and outcomes in controlled settings, such as clinical skills labs. PAL in the clinical setting, a complex learning environment, requires fresh evaluation. Socio-cultural theory is proposed as a means to understand educational interventions in ways that are practical and meaningful. We describe the evaluation of a PAL intervention, introduced to support students' transition into full time clinical attachments, using activity theory and activity systems analysis (ASA). Our research question was How does PAL transfer to the clinical environment? Junior students on their first clinical attachments undertook a weekly same-level, reciprocal PAL activity. Qualitative data was collected after each session, and focus groups (n = 3) were held on completion. Data was analysed using ASA. ASA revealed two competing activity systems on clinical attachment; Learning from Experts, which students saw as the primary function of the attachment and Learning with Peers, the PAL intervention. The latter took time from the first and was in tension with it. Tensions arose from student beliefs about how learning takes place in clinical settings, and the importance of social relationships, leading to variable engagement with PAL. Differing perspectives within the group were opportunities for expansive learning. PAL in the clinical environment presents challenges specific to that context. Using ASA helped to describe student activity on clinical attachment and to highlight tensions and contradictions relating PAL in that setting. Planning learning opportunities on clinical placements, must take account of how students learn in workplaces, and the complexity of the multiple competing activity systems related to learning and social activities.

No MeSH data available.


Related in: MedlinePlus

Activity systems in the clinical setting
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Fig2: Activity systems in the clinical setting

Mentions: Two competing activity systems were identified involving students on clinical attachment. Triangular diagrams are seen in Fig. 2 illustrating these. The first is entitled Learning from Experts. This was the activity which students saw as the primary function of their clinical attachments. The Learning with Peers, through the PAL intervention, represented a second competing activity, which took time from the first and was in tension with it. The subject in both systems is the medical student and the object is learning in the clinical setting. The tool, for Learning from Experts, is time spent with experts, while the tool for Learning with Peers is the PAL process. The community in which both activities took place was the hospital community, comprising patients, fellow students, university faculty, junior doctors, consultants, nurses and other allied health care professionals. The rules and division of labour for the PAL process were prescribed by faculty. We now discuss the rules under which both activities took place, the division of labour within them and the tensions/contradictions between them (see Fig. 2).Fig. 2


Peer assisted learning in the clinical setting: an activity systems analysis.

Bennett D, O'Flynn S, Kelly M - Adv Health Sci Educ Theory Pract (2014)

Activity systems in the clinical setting
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4495258&req=5

Fig2: Activity systems in the clinical setting
Mentions: Two competing activity systems were identified involving students on clinical attachment. Triangular diagrams are seen in Fig. 2 illustrating these. The first is entitled Learning from Experts. This was the activity which students saw as the primary function of their clinical attachments. The Learning with Peers, through the PAL intervention, represented a second competing activity, which took time from the first and was in tension with it. The subject in both systems is the medical student and the object is learning in the clinical setting. The tool, for Learning from Experts, is time spent with experts, while the tool for Learning with Peers is the PAL process. The community in which both activities took place was the hospital community, comprising patients, fellow students, university faculty, junior doctors, consultants, nurses and other allied health care professionals. The rules and division of labour for the PAL process were prescribed by faculty. We now discuss the rules under which both activities took place, the division of labour within them and the tensions/contradictions between them (see Fig. 2).Fig. 2

Bottom Line: Differing perspectives within the group were opportunities for expansive learning.PAL in the clinical environment presents challenges specific to that context.Planning learning opportunities on clinical placements, must take account of how students learn in workplaces, and the complexity of the multiple competing activity systems related to learning and social activities.

View Article: PubMed Central - PubMed

Affiliation: Medical Education Unit, School of Medicine, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland, d.bennett@ucc.ie.

ABSTRACT
Peer assisted learning (PAL) is a common feature of medical education. Understanding of PAL has been based on processes and outcomes in controlled settings, such as clinical skills labs. PAL in the clinical setting, a complex learning environment, requires fresh evaluation. Socio-cultural theory is proposed as a means to understand educational interventions in ways that are practical and meaningful. We describe the evaluation of a PAL intervention, introduced to support students' transition into full time clinical attachments, using activity theory and activity systems analysis (ASA). Our research question was How does PAL transfer to the clinical environment? Junior students on their first clinical attachments undertook a weekly same-level, reciprocal PAL activity. Qualitative data was collected after each session, and focus groups (n = 3) were held on completion. Data was analysed using ASA. ASA revealed two competing activity systems on clinical attachment; Learning from Experts, which students saw as the primary function of the attachment and Learning with Peers, the PAL intervention. The latter took time from the first and was in tension with it. Tensions arose from student beliefs about how learning takes place in clinical settings, and the importance of social relationships, leading to variable engagement with PAL. Differing perspectives within the group were opportunities for expansive learning. PAL in the clinical environment presents challenges specific to that context. Using ASA helped to describe student activity on clinical attachment and to highlight tensions and contradictions relating PAL in that setting. Planning learning opportunities on clinical placements, must take account of how students learn in workplaces, and the complexity of the multiple competing activity systems related to learning and social activities.

No MeSH data available.


Related in: MedlinePlus