Iwata Kazuya, Furmedge Daniel S, Sturrock Alison, Gill Deborah
Academic Centre for Medical Education, University College London Medical School, London, UK.
Med Educ. 2014 Jul;48(7):698-704. doi: 10.1111/medu.12475.
Peer-assisted learning (PAL) is recognised as an effective learning tool and its benefits are well documented in a range of educational settings. Learners find it enjoyable and their performances in assessments are comparable with those of students taught by faculty tutors. In addition, PAL tutors themselves report the development of improved clinical skills and confidence through tutoring. However, whether tutoring leads to actual improvement in performance has not been fully investigated.
As high-achieving students are already en route to succeeding in final examinations, we wanted to examine whether participation in a peer-tutoring programme in itself leads to better final-year examination performance.
We conducted a retrospective analysis of results on final-year written and clinical examinations at University College London Medical School during 2010-2012. Z-scores were calculated and the performances of PAL tutors and students who were not PAL tutors were compared using analysis of covariance (ancova). Year 4 examination results were used as indicators of previous academic attainment.
Of the 1050 students who attempted the final examination, 172 were PAL tutors in the final year. Students who acted as PAL tutors outperformed students who did not in all examination components by 1-3%. Z-scores differed by approximately 0.2 and this was statistically significant, although the significance of this difference diminished when controlling for Year 4 results. Students who acted as PAL tutors who had scored in the top quartile in Year 4 examinations scored significantly better in a long-station objective structured clinical examination (LSO).
Although students who acted as PAL tutors performed better than students who did not in final-year examinations, this difference was small and attributable to the students' background academic abilities. High-achieving students appear to be self-selecting as peer-tutors and their enhanced performance in LSOs may reflect their inherent academic abilities. Although peer-tutoring in itself did not lead to enhanced examination performance, further studies are required as many factors, such as the proximity of examinations and previous tutoring, can potentially affect the relationship between peer-tutoring experience and examination performance.
同伴辅助学习（PAL）被认为是一种有效的学习工具，其益处已在一系列教育环境中得到充分证明。学习者觉得它很有趣，并且他们在评估中的表现与由教师指导的学生相当。此外，PAL导师自己报告说通过辅导提高了临床技能并增强了信心。然而，辅导是否能真正提高表现尚未得到充分研究。
由于成绩优异的学生已经在通往期末考试成功的道路上，我们想研究参与同伴辅导计划本身是否会导致更好的毕业考试成绩。
我们对2010 - 2012年伦敦大学学院医学院毕业笔试和临床考试的结果进行了回顾性分析。计算了Z分数，并使用协方差分析（ancova）比较了PAL导师和非PAL导师学生的表现。四年级考试成绩被用作先前学业成绩的指标。
在参加期末考试的1050名学生中，有172名在最后一年担任PAL导师。担任PAL导师的学生在所有考试科目中的表现均比未担任导师的学生高出1 - 3%。Z分数相差约0.2，这具有统计学意义，尽管在控制四年级成绩后这种差异的显著性有所降低。在四年级考试中处于前四分位数的担任PAL导师的学生在长时间站客观结构化临床考试（LSO）中得分显著更高。
虽然担任PAL导师的学生在毕业考试中的表现优于未担任导师的学生，但这种差异很小，且归因于学生的背景学术能力。成绩优异的学生似乎是自我选择成为同伴导师的，他们在LSO中的表现提升可能反映了他们固有的学术能力。虽然同伴辅导本身并没有提高考试成绩，但由于许多因素，如考试临近程度和先前的辅导经历，可能会潜在地影响同伴辅导经历与考试成绩之间的关系，因此需要进一步研究。
