Peer tutoring as a means of enhancing nursing students’ professional development

1. Peer tutoring as a means of enhancing nursing students’ professional development K. H. Yuen & A. Tiwari The University of Hong Kong Peer Tutoring

2. Preregistration Preparation of Nursing Students • From hospital-based training to university degree education • competent practitioners who are: • professional • critical thinkers • reflective • self-reliant • patient-oriented Peer Tutoring

3. Or, are they? • University-prepared nurses oriented towards • preservation • replication of past practice Peer Tutoring

4. Through peer tutoring... • Students learn with and from each other • Gain better insight into professional values of nursing • Develop professional role conception Peer Tutoring

5. Objectives 1. Facilitate better understanding of professional nursing roles 2. Acclimatise students to the demandsof the profession 3. Enhance confidence and skills in dealing with role conflict Peer Tutoring

6. The peer tutoring project Phase 1 • A pilot scheme • December 2002 - July 2003 Phase 2 • A revised peer tutoring scheme • August 2003 - June 2004 Peer Tutoring

7. Student Tutors • Phase 1 • 10 • second-year nursing students • Phase 2 • 20 • second- and third-year nursing students Peer Tutoring

8. Tutees • Phase 1 • 10 • First-year nursing students • Phase 2 • 20 • First-year students Peer Tutoring

9. Phase 1 Peer Tutoring

10. Selection • Voluntary • Self select • Involvement of the Student Union • One tutor to one tutee • Pairing decided by project coordinator Peer Tutoring

11. Publicising the Project... • Nursing students • Head of Department • Programme coordinator • Year coordinator Peer Tutoring

12. Briefing • During the first workshop • For both student tutors and tutees Peer Tutoring

13. Training workshop • Three • Initial, mid-way, final • Purpose • Explanation about the scheme • Training of tutoring skills • Feedback from tutors and tutees Peer Tutoring

14. Implementation • Student tutors - tutees • Face to face tutorials • Electronic contact • Student tutors - scheme coordinators • Use of discussion forum • Monthly workshop Peer Tutoring

15. Monitoring • Weekly reports • Discussion forum • Monthly workshop Peer Tutoring

16. Rewards • Certificates for student tutors and tutees • Book tokens for student tutors • Social function Peer Tutoring

17. Evaluation • Focus group interview • Before and after peer tutoring • Student tutors, tutees and comparison groups • Summative evaluation • Questionnaire • Monthly report • External assessor’s report Peer Tutoring

18. Measurements • Changes: • Understanding of nurses’ roles • Acclimatisation to the demands of the profession • Confidence and skills in dealing with role conflict • Comparison: • Change over time • Comparison groups Peer Tutoring

19. Understanding of nurses’ roles • Tutees: • No obvious changes between pre- and post-intervention • Student tutors: • Obvious changes • A more ‘professional’ understanding • Comparison groups: • No obvious changes Peer Tutoring

20. Acclimatisation • Tutees: • No obvious changes • Student tutors: • No obvious changes • Comparison groups: • No obvious changes Peer Tutoring

21. Role conflict • Tutees: • No obvious changes between pre- and post-intervention • Student tutors: • Obvious changes • More confident • Comparison groups: • No obvious changes Peer Tutoring

22. Unexpected findings • Apparent enhanced professional development among student tutors • No obvious enhancement among tutees • Student tutors supporting tutees during the SARS outbreak • Student tutors reacted to SARS with increasedconfidence Peer Tutoring

23. Summative evaluation • Student tutors: • Positive evaluation of peer tutoring scheme • Improvement in patience, communication • Learn from tutees • Not enough communication among student tutors • Discussion forum not user-friendly Peer Tutoring

24. Summative evaluation • Tutees: • Positive evaluation of peer tutoring scheme • Support from student tutors valued • More structured meeting arrangement with their tutors • More informal workshops Peer Tutoring

25. Improvements Suggested • To improve communicationamong student tutors • Less often and more flexible form of reporting • If IT is to be used, it should be more user-friendly • To have less formal and more interactive workshops Peer Tutoring

26. Phase 2 Peer Tutoring

27. Improvement (1) • Clear and specified content 1. The concept of profession - What is a profession - Characteristics of a profession 2. Professional socialisation - A novice nurse’s perception of a nurse and nursing - The norms and values of the nursing profession - The process of professional socialisation Peer Tutoring

28. Improvement (1) • Clear and specified content 3. Nursing identity - The giving up of societal and media stereotypes about being a nurse or nursing - The adoption of the values and norms of professional nursing 4. Role conflict - Causes of role conflict - Literature on the professional socialisation of nursing students - Transition from the role of a student nurse (newcomer) to that of a professional nurse (insider) Peer Tutoring

29. Improvement (2) • Re-defined outcome measures • For tutors - Internalisation of the norms and values of nursing - Development of a nursing identity - Confidence in handling role conflict - Teaching/tutoring skills - ‘All round’ skills in teamwork, communication and leadership Peer Tutoring

30. Improvement (2) • Re-defined outcome measures • For tutee - Understanding of the norms and values of nursing -Insight into nursing identity - Knowledge and skills for handling role conflict - Interest in learning Peer Tutoring

31. Improvement (3) • Less formal workshops • For student tutors only • Sharing of ideas and experience • Tutoring skills provided in CD-ROM Peer Tutoring

32. Improvement (4) • More structured tutor-tutee meetings • Meeting schedule & learning agreement • Date • Topic • Mode of contact • Duration • Venue Peer Tutoring

33. Improvement (5) • More communication among student tutors • Workshops for student tutors • BBQ at the beginning and end of phase 2 Peer Tutoring

34. Improvement (6) • More user-friendly discussion forum • Password of student’s choice Peer Tutoring

35. Improvement (7) • Reporting less often and more user-friendly • Monthly report • Electronic • Refine some of the items Peer Tutoring

36. Improvement (8) • Formative & summative evaluation • Compare changes over time • Refine some of the items Peer Tutoring

37. Improvement (9) • Refine the questions used in focus group interview • To reflect the objectives and outcome measures Peer Tutoring

38. Improvement (10) • Production of a course manual • Details of the project clearly described • With summary of activities • And action plan Peer Tutoring

39. Conclusion 1. Peer tutoring seemed to have enhanced nursing students’ professional development (student tutors, end of phase 1) 2. The design of the project should be both structured and informal 3. Outcome measures should reflect learning objectives 4. Clear outline of learning content is required 5. A course manual is essential 6. Both student tutors and tutees were capable of functioning independently and creatively Peer Tutoring

40. Peer Tutoring