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

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Peer assisted learning (PAL) in clinical settings presents challenges. Activity systems analysis revealed tensions between PAL and traditional learning, impacting student engagement and highlighting the need for contextualized planning.

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Area of Science:

  • Medical Education
  • Socio-cultural Theory
  • Learning Sciences

Background:

  • Peer assisted learning (PAL) is prevalent in medical education, traditionally studied in controlled environments.
  • Evaluation of PAL in complex clinical settings requires novel approaches.
  • Socio-cultural theory offers a framework for understanding educational interventions.

Purpose of the Study:

  • To evaluate a PAL intervention designed to aid medical students' transition to clinical attachments.
  • To explore how PAL functions within the clinical environment using activity theory.

Main Methods:

  • Employed activity theory and activity systems analysis (ASA) to evaluate a PAL intervention.
  • Junior medical students participated in weekly peer assisted learning sessions during clinical attachments.
  • Qualitative data collected post-session and via focus groups were analyzed using ASA.

Main Results:

  • ASA identified competing activity systems: 'Learning from Experts' and 'Learning with Peers' (PAL).
  • PAL created tension with 'Learning from Experts,' impacting student engagement due to beliefs about clinical learning and social dynamics.
  • Differing student perspectives within PAL groups offered opportunities for expansive learning.

Conclusions:

  • Peer assisted learning in clinical settings faces unique contextual challenges.
  • Activity systems analysis effectively highlighted tensions and contradictions in PAL within the clinical workplace.
  • Effective planning of clinical placements must consider student learning in workplaces and competing activity systems.