Elsevier

Resuscitation

Volume 83, Issue 7, July 2012, Pages 894-899
Resuscitation

Simulation and education
Peer-led training and assessment in basic life support for healthcare students: Synthesis of literature review and fifteen years practical experience☆

https://doi.org/10.1016/j.resuscitation.2012.01.013Get rights and content

Abstract

Background

In 1995, the University of Birmingham, UK, School of Medicine and Dentistry replaced lecture-based basic life support (BLS) teaching with a peer-led, practical programme. We present our 15-yr experience of peer-led healthcare undergraduate training and examination with a literature review.

Methods

A literature review of healthcare undergraduate peer-led practical skills teaching was performed though Pubmed.

The development of the Birmingham course is described, from its inception in 1995–2011. Training methods include peer-led training and assessment by senior students who complete an European Resuscitation Council-endorsed instructor course. Student assessors additionally undergo training in assessment and communication skills. The course has been developed by parallel research evaluation and peer-reviewed publication.1, 2 Course administration is by an experienced student committee with senior clinician support. Anonymous feedback from the most recent courses and the current annual pass rates are reported.

Results

The literature review identified 369 publications of which 28 met our criteria for inclusion. Largely descriptive, these are highly positive about peer involvement in practical skills teaching using similar, albeit smaller, courses to that described below.

Currently approximately 600 first year healthcare undergraduates complete the Birmingham course; participant numbers increase annually. Successful completion is mandatory for students to proceed to the second year of studies. First attempt pass rate is 86%, and close to 100% (565/566 students, 99.8%) following re-assessment the same day. 97% of participants enjoyed the course, 99% preferred peer-tutors to clinicians, 99% perceived teaching quality as “good” or “excellent”, and felt they had sufficient practice. Course organisation was rated “good” or “excellent” by 91%. Each year 3–4 student projects have been published or presented internationally. The annual cost of providing the course is currently £15,594.70 (Eur 18,410), or approximately £26 (Eur 30) per student.

Conclusions

This large scale, peer-led BLS course demonstrates that such programmes can have excellent outcomes with outstanding participant satisfaction. Peer-tutors and assessors are competent, more available and less costly than clinical staff. Student instructors develop skills in teaching, assessment and appraisal, organisation and research. Sustainability is possible given succession-planning and consistent leadership.

Introduction

In 1995 the University of Birmingham replaced didactic lecture-based teaching of basic life support (BLS) to first-year healthcare students with a peer-led programme in which BLS and automated external defibrillation (AED) skills are taught and assessed by trained senior students.1 This move to a peer-led programme was proposed and developed by three medical students as a practical solution to the lack of clinical instructors. Senior students undergo a weekend instructor course to enable them to deliver supervised training to first year students. At inception, 200 medical and dental students were taught per year. The course now trains and assesses approximately 600 healthcare students (medical, physiotherapy and dental), and is approved by the European Resuscitation Council. We report the development of our course, the administration and costs, outcomes of training, and place our experiences in the context of a systematic review of peer-led undergraduate teaching. We aim to provide the reader with key information that would allow them to set up a similar course.

Section snippets

Systematic review of peer led medical teaching and assessment

A Pubmed search through the National Library of Health3 was performed of articles up to 2011, and combined with hand-searching systematic reviews. Search terms included; “education”, “training”, “peer led”, “peer assessment”, “peer delivered”. Articles were excluded if the published language was not English, articles were not original research or reviews or did not focus on peer assessment or teaching, if the instructors or examiners were not healthcare students, and if the subject topic did

Systematic review

Of 369 publications on the subject of peer teaching or assessment by healthcare students, 169 were excluded from the review because they failed to assess, or teach, a tangible, instructed skill. Following exclusions, 28 were retained for final analysis and are described in Appendices 2 and 3 (modified QUOROM flow diagram in Appendix 1).4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31

Articles reported peer teaching of groups of 28–358

Discussion

Basic life support training requires many practical tutors. Using students as tutors is cost effective, requires limited input from clinicians, and facilitates a high teacher to candidate ratio. Furthermore, student teachers, examiners and managers benefit greatly from participating.

Candidate feedback shows that students believe the instruction is of high quality, enjoy being taught by peers and prefer them to faculty instructors. Candidates also benefit from a high instructor to student ratio

Conclusion

Basic life support is often the first stage in teaching healthcare students about resuscitation of an acutely unwell patient. It remains a core skill for under- and postgraduate healthcare providers but is typically instructor intensive.

The Birmingham peer-led model has developed over more than 15 years to provide practical training that could not otherwise have been delivered, and to a standard at least equivalent to that provided by senior staff but with greater reliability and at much lower

Conflict of interest statement

All authors confirm they have no conflict of interest.

Acknowledgements

We would like to acknowledge the contributions of all those who have organised, taught and supervised the course over the previous 15 years. Special thanks are reserved for Gavin Perkins and Hannah Shore who originally founded the course with Jonathan Hulme.

References (35)

  • G.D. Perkins et al.

    Basic life support training for health care students

    Resuscitation

    (1999)
  • V. Bucknall et al.

    Peer assessment of resuscitation skills

    Resuscitation

    (2008)
  • H.J.J.M. Berden et al.

    A scoring system for basic cardiac life support skills in training situations

    Resuscitation

    (1992)
  • A.L. Macrae et al.

    Benefits and perceptions of the BLS/AED peer-assessment role

    Resuscitation

    (2010)
  • G.D. Perkins et al.

    Peer-led resuscitation training for healthcare students: a randomised controlled study

    Intensive Care Med

    (2002)
  • National Library for Biotechnology Information, US National library of Medicine [cited 3 June 2010]. Available from:...
  • F. Rengier et al.

    A three-day anatomy revision course taught by senior peers effectively prepares junior students for their national anatomy exam

    Ann Anat

    (2010)
  • M. Knobe et al.

    Peer teaching: a randomised controlled trial using student-teachers to teach musculoskeletal Ultrasound

    Med Educ

    (2010)
  • A.A. Gursoy et al.

    The effects of peer education on University students’ knowledge of breast self-examination and health beliefs

    J Cancer Educ

    (2009)
  • D.J.R. Evans et al.

    Near-peer teaching in anatomy: an approach for deeper learning

    Anat Sci Educ

    (2009)
  • J.D. Kibble

    A peer-led supplemental tutorial project for medical physiology: implementation in a large class

    Adv Physiol Educ

    (2009)
  • P. Weyrich et al.

    Undergraduate technical skills training guided by student tutors – analysis of tutors’ attitudes, tutees’ acceptance and learning progress in an innovative teaching model

    BMC Med Educ

    (2008)
  • J.G. Wong et al.

    Formal peer-teaching in medical school improves academic performance: the MUSC supplemental instructor programme

    Teach Learn Med

    (2007)
  • W.E. Mouradian et al.

    A new oral health elective for medical students at the University of Washington

    Teach Learn Med

    (2006)
  • T.S Tang et al.

    “Learning by teaching”: a peer-teaching model for diversity training in Medical School

    Teach Learn Med

    (2004)
  • J.H. Johnson

    Importance of dissection in learning anatomy: personal dissection versus peer teaching

    Clin Anat

    (2002)
  • J.O. Nnodim

    A controlled trial of peer-teaching in practical gross anatomy

    Clin Anat

    (1997)

    • Cited by (0)

    ☆

    A Spanish translated version of the abstract of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2012.01.013.

    View full text
    Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.