Implementing a peer-learning approach for the clinical education of respiratory therapy students

With recent clinical placement demands exceeding supply, the University Health Network (UHN) Respiratory Therapy (RT) department implemented a 2:1 student-to-preceptor model where a focus on peer learning (PL) becomes a key component of program success. PL can be defined as students learning from and with each other in both formal and informal ways. The shift towards facilitative student-directed models in other health care professions can be seen globally with the literature suggesting that 2:1 models not only support increases in student capacity but also improve the student learning experience through PL strategies. The aim of this study was to explore the perceptions of RT preceptors and students regarding the 2:1 model as an educational strategy in the context of their clinical experience. The study further explored experiences of PL to understand how learning is enabled in RT practice-based education, particularly within 2:1 models.

A qualitative descriptive study using single-episode semi-structured interviews with RT preceptors (n = 10) and students (n = 10) was conducted during the 2015-2016 RT student clinical year. Twelve open-ended interview questions were designed to draw out study participants' PL experiences and exploration of issues using a 2:1 model in the context of their clinical experience. Data were recorded, transcribed verbatim, and analyzed using thematic analysis.

The content analysis resulted in two broad themes with respect to the RT 2:1 educational model: "enablers" and "barriers" to a PL approach. The 2:1 model was preferred by students and preceptors early on in the clinical training due to the benefits of PL, whereas opportunities to showcase independent practice was preferred towards the end of their clinical year. Furthermore, careful planning, resources, and supports need to be implemented to augment benefits and diminish potential disadvantages of using a 2:1 model structure.

Participants felt that a 2:1 model strongly contributes to a supportive learning environment and can have a positive influence on the RT student clinical experience at UHN. Along with the improved critical thinking and student engagement opportunities that a 2:1 model offers, increased placement numbers are also supported.