This study explored the contribution of peer-assisted learning (PAL) in the development of evaluative judgement capacity; the ability to understand work quality and apply those standards to appraising performance. The study employed a mixed methods approach, collecting self-reported survey data, observations of, and reflective interviews with, the medical students observed. Participants were in their first year of clinical placements. Data were thematically analysed. Students indicated that PAL contributed to both the comprehension of notions of quality, and the practice of making comparisons between a given performance and the standards. Emergent themes included peer story-telling, direct observation of performance, and peer-based feedback, all of which helped students to define ‘work quality’. By participating in PAL, students were required to make comparisons, therefore using the standards of practice and gaining a deeper understanding of them. The data revealed tensions in that peers were seen as less threatening than supervisors with the advantage of increasing learners’ appetites for thoughtful ‘intellectual risk taking’. Despite this reported advantage of peer engagement, learners still expressed a preference for feedback from senior teachers as more trusted sources of clinical knowledge. While this study suggests that PAL already contributes to the development of evaluative judgement, further steps could be taken to formalise PAL in clinical placements to improve learners’ capacity to make accurate judgements on the performance of self and others. Further experimental studies are necessary to confirm the best methods of using PAL to develop evaluative judgement. This may include both students and educators as instigators of PAL in the workplace.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Unlike Freire’s (1970) assertion that knowledge is not coins, deposited by the teacher into students.
Bazeley, P. (2013). Qualitative data analysis. London: Sage Publications Ltd.
Boud, D. (2000). Sustainable assessment: Rethinking assessment for the learning society. Studies in Continuing Education, 22(2), 151–167.
Boud, D., & Molloy, E. K. (Eds.). (2013). Effective feedback in higher and professional education. London, UK: Routledge/Taylor & Francis Group.
Burgess, A., McGregor, D., & Mellis, C. (2014). Medical students as peer tutors: a systematic review. BMC Medical Education, 14(1), 115. doi:10.1186/1472-6920-14-115.
Burke, J., Fayaz, S., Graham, K., Matthew, R., & Field, M. (2007). Peer-assisted learning in the acquisition of clinical skills: a supplementary approach to musculoskeletal system training. Medical Teacher, 29(6), 577–582.
Byrne, N., & Cohen, R. (1973). Observational study of clinical clerkship activities. Academic Medicine, 48(October), 919–927.
Carless, D. (2013). Trust and its role in facilitating dialogic feedback. In D. Boud & E. Molloy (Eds.), Feedback in higher and professional education: Understanding and doing it well (pp. 90–103). Milton Park: Routledge.
Cowan, J. (2010). Developing the ability for making evaluative judgements. Teaching in Higher Education, 15(3), 323–334. doi:10.1080/13562510903560036.
Currens, J. B., & Bithell, C. P. (2003). The 2:1 clinical placement model. Physiotherapy, 89(4), 204–218. doi:10.1016/S0031-9406(05)60152-6.
Cushing, A., Abbott, S., Lothian, D., Hall, A., & Westwood, O. M. R. (2011). Peer feedback as an aid to learning—what do we want? Feedback. When do we want it? Now! Medical Teacher, 33(2), e105–e112.
Eva, K. W., & Regehr, G. (2005). Self-assessment in the health professions: A reformulation and research agenda. Academic Medicine, 80(10 Suppl), S46–S54. doi:10.1097/00001888-200510001-00015.
Eva, K. W., & Regehr, G. (2008). “I’ll never play professional football” and other fallacies of self-assessment. Journal of Continuing Education in the Health Professions, 28(1), 14–19. doi:10.1002/chp.
Freire, P. (1970). Pedagogy of the oppressed. New York, NY: Continuum International Publishing Group.
Haines, T., Hemming, K., Girling, A., Hill, A.-M., Bulsara, M., & Deeks, J. (2014). Where should stepped-wedge designs be placed in the evidence hierarchy? Using the “within-wedge” analysis approach to generate evidence of possible bias. BMC Health Services Research, 14(Suppl 2), P54. doi:10.1186/1472-6963-14-S2-P54.
Knobe, M., Münker, R., Sellei, R. M., Holschen, M., Mooij, S. C., Schmidt-Rohlfing, B., & Pape, H.-C. (2010). Peer teaching: A randomised controlled trial using student-teachers to teach musculoskeletal ultrasound. Medical Education, 44(2), 148–155. doi:10.1111/j.1365-2923.2009.03557.x.
Kovach, R. A., Resch, D. S., & Verhulst, S. J. (2009). Peer assessment of professionalism: A five-year experience in medical clerkship. Journal of General Internal Medicine, 24(6), 742–746. doi:10.1007/s11606-009-0961-5.
Kruger, J., & Dunning, D. (1999). Unskilled and unaware of it: How difficulties in recognizing one’s own incompetence lead to inflated self-assessments. Journal of Personality and Social Psychology, 77(6), 1121–1134. doi:10.1037/0022-35188.8.131.521.
Krych, A. J., March, C. N., Bryan, R. E., Peake, B. J., Pawlina, W., & Carmichael, S. W. (2005). Reciprocal peer teaching: Students teaching students in the gross anatomy laboratory. Clinical Anatomy, 18(4), 296–301. doi:10.1002/ca.20090.
Ladyshewsky, R. K. (2013). The role of peers in feedback processes. In D. Boud & E. K. Molloy (Eds.), Feedback in higher and professional education: Understanding and doing it well (pp. 174–189). Abingdon, Oxon: Routledge.
Langendyk, V. (2006). Not knowing that they do not know: Self-assessment accuracy of third-year medical students. Medical Education, 40(2), 173–179. doi:10.1111/j.1365-2929.2005.02372.x.
Levine, R., Kelly, P., & Karakoc, T. (2007). Peer evaluation in a clinical clerkship: Students’ attitudes, experiences, and correlations with traditional assessments. Academic Psychiatry, 31(1), 19–24.
Lockyer, J. (2003). Multisource feedback in the assessment of physician competencies. The Journal of Continuing Education in the Health Professions, 23(1), 4–12.
Lurie, S. J., Nofziger, A. C., Meldrum, S., Mooney, C., & Epstein, R. M. (2006). Temporal and group-related trends in peer assessment amongst medical students. Medical Education, 40(9), 840–847. doi:10.1111/j.1365-2929.2006.02540.x.
Miles, M. B., Huberman, A. M., & Saldana, J. (2014). Qualitative data analysis (third.). Thousand Oaks, California: Sage Publications.
Moineau, G., Power, B., Pion, A.-M. J., Wood, T. J., & Humphrey-Murto, S. (2011). Comparison of student examiner to faculty examiner scoring and feedback in an OSCE. Medical Education, 45(2), 183–191.
Molloy, E. K. (2009). Time to pause: Feedback in clinical education. In C. Delany & E. K. Molloy (Eds.), Clinical education in the health professions. Sydney: Elsevier.
Ngo, K. (2011). “Bull-dogging” for the RACP exams. Australian Medical Student Journal, 2(1), 9.
Nicol, D. (2013). Resituating feedback from the reactive to the proactive. In D. Boud & E. Molloy (Eds.), Feedback in higher and professional education: Understanding and doing it well (pp. 34–49). Milton Park: Routledge.
Nicol, D., Thomson, A., & Breslin, C. (2014). Rethinking feedback practices in higher education: A peer review perspective. Assessment & Evaluation in Higher Education, 39(1), 102–122. doi:10.1080/02602938.2013.795518.
Nnodim, J. O. (1997). A controlled trial of peer-teaching in practical gross anatomy. Clinical Anatomy, 10(2), 112–117.
Nofziger, A. C., Naumburg, E. H., Davis, B. J., Mooney, C. J., & Epstein, R. M. (2010). Impact of peer assessment on the professional development of medical students: A qualitative study. Academic Medicine, 85(1), 140–147.
Papinczak, T., Young, L., & Groves, M. (2007a). Peer assessment in problem-based learning: A qualitative study. Advances in Health Sciences Education, 12(2), 169–186.
Papinczak, T., Young, L., Groves, M., & Haynes, M. (2007b). An analysis of peer, self, and tutor assessment in problem-based learning tutorials. Medical Teacher, 29(5), e122–e132. doi:10.1080/01421590701294323.
Raat, J., Kuks, J., & Cohen-Schotanus, J. (2010). Learning in clinical practice: Stimulating and discouraging response to social comparison. Medical Teacher, 32(11), 899–904. doi:10.3109/0142159X.2010.497820.
Rogoff, B. (1990). Apprenticeship in thinking: Cognitive development in social context. New York, NY: Oxford University Press.
Sadler, D. R. (1989). Formative assessment and the design of instructional systems. Instructional Science, 18(2), 119–144. doi:10.1007/BF00117714.
Sargeant, J., Armson, H., Chesluk, B., Dornan, T., Eva, K., Holmboe, E., & van der Vleuten, C. (2010). The processes and dimensions of informed self-assessment: A conceptual model. Academic Medicine: Journal of the Association of American Medical Colleges, 85(7), 1212–1220.
Sargeant, J., Mann, K. V., van der Vleuten, C. P., & Metsemakers, J. F. (2009). Reflection: A link between receiving and using assessment feedback. Advances in Health Sciences Education, 14(3), 399–410. doi:10.1007/s10459-008-9124-4.
Sargeant, J., McNaughton, E., Mercer, S., Murphy, D., Sullivan, P., & Bruce, D. A. (2011). Providing feedback: Exploring a model (emotion, content, outcomes) for facilitating multisource feedback. Medical Teacher, 33(9), 744–749.
Schönrock-Adema, J., Heijne-Penninga, M., van Duijn, M. A., Geertsma, J., & Cohen-Schotanus, J. (2007). Assessment of professional behaviour in undergraduate medical education: Peer assessment enhances performance. Medical Education, 41(9), 836–842. doi:10.1111/j.1365-2923.2007.02817.x.
Sevenhuysen, S., Nickson, W., Farlie, M. K., Raitman, L., Keating, J. L., Molloy, E., & Haines, T. (2013). The development of a peer assisted learning model for the clinical education of physiotherapy students. Journal of Peer Learning, 6(1), 30–45.
Sharma, N., Cui, Y., Leighton, J. P., & White, J. S. (2012). Team-based assessment of medical students in a clinical clerkship is feasible and acceptable. Medical Teacher, 34(7), 555–561. doi:10.3109/0142159X.2012.669083.
Speyer, R., Pilz, W., Van Der Kruis, J., & Brunings Wouter, J. (2011). Reliability and validity of student peer assessment in medical education: A systematic review. Medical Teacher, 33(11), e572–e585. doi:10.3109/0142159X.2011.610835.
Stegmann, K., Pilz, F., Siebeck, M., & Fischer, F. (2012). Vicarious learning during simulations: Is it more effective than hands-on training? Medical Education, 46(10), 1001–1008. doi:10.1111/j.1365-2923.2012.04344.x.
Tai, J., Canny, B., Haines, T., & Molloy, E. (2015). Identifying opportunities for peer learning: An observational study of medical students on clinical placements. Manuscript Submitted for Publication.
Tai, J., Haines, T. P., Canny, B. J., & Molloy, E. K. (2014). A study of medical students’ peer learning on clinical placements : What they have taught themselves to do. Journal of Peer Learning, 7, 57–80.
Topping, K., & Ehly, S. (1998). Introduction to peer-assisted learning. In K. Topping & S. Ehly (Eds.), Peer-assisted learning (pp. 1–23). Mahwah, NJ: Lawrence Erlbaum Associates Publishers.
Vygotsky, L. S. (1978). Mind in society : the development of higher psychological processes. Cambridge, MA: Harvard University Press.
Yu, T., Wilson, N., & Singh, P. (2011). Medical students-as-teachers: A systematic review of peer-assisted teaching during medical school. Advances in Medical Education and Practice, 2, 157–172.
Zaidi, Z., Jaffery, T., Shahid, A., Moin, S., Gilani, A., & Burdick, W. (2012). Change in action: Using positive deviance to improve student clinical performance. Advances in Health Sciences Education, 17(1), 95–105. doi:10.1007/s10459-011-9301-8.
Special thanks to the medical students and clinical supervisors who agreed to be observed and participate in the research.
About this article
Cite this article
Tai, J.HM., Canny, B.J., Haines, T.P. et al. The role of peer-assisted learning in building evaluative judgement: opportunities in clinical medical education. Adv in Health Sci Educ 21, 659–676 (2016). https://doi.org/10.1007/s10459-015-9659-0