Peer-assisted versus faculty staff-led skills laboratory training: a randomised controlled trial

Although peer-assisted learning (PAL) is widely employed throughout medical education, its effectiveness for training in technical procedures in skills laboratories has been subject to little systematic investigation. We conducted a prospective, randomised trial to evaluate the hypotheses that PAL is effective in technical skills training in a skills laboratory setting, and PAL is as effective as faculty staff-led training.

Volunteer Year 3 medical students were randomly assigned to one of three groups. Two of these received regular skills training from either cross-year peer tutors or experienced faculty staff. Following training, both groups were assessed using an objective structured clinical examination (OSCE) (three stations assessing various injection techniques) which was video-recorded. Two independent video assessors scored the OSCEs using binary checklists and global ranking forms. A third student group was assessed prior to training and served as a control group.

A total of 89 students (mean age 23.0 +/- 0.2 years; 41 male, 48 female) agreed to participate in the trial. Confounding variables including prior training as a paramedic or previous experience in performing the technical procedures did not significantly differ between the three study groups. In the OSCE, PAL (58.1 +/- 1 binary points, 4.9 +/- 0.1 global ranking points) and faculty-led groups (58.3 +/- 1 binary points, 4.7 +/- 0.1 global ranking points) scored significantly higher than the control group (33.3 +/- 1 binary points, 2.7 +/- 0.1 global ranking points; all P < 0.0001). There was no significant difference between the PAL and faculty-led groups (P = 0.92 for binary checklists, P = 0.11 for global rankings).

Peer-assisted learning is a successful method for learning technical procedures in a skills laboratory setting and can be just as effective as the training provided by experienced faculty staff.