Dr Susan Way and her team recently completed a project supported by the CEL Fusion Investment Fund. The aim of the project was to evaluate the experience of Peer Facilitated Learning (PFL) delivered through group presentations and engagement in discussion by second year student midwives. Understanding from academics regarding the assessment process and assisting in the application of knowledge to current midwifery practice was also evaluated.

The Health and Wellbeing 2 unit has 80% of the teaching delivered by groups of students to their peers. Academics assess their contribution to PFL and help with its application to current midwifery practice. Evaluating the impact and effectiveness of this approach would be invaluable to inform future improvement.

Students co-created the Bristol On-Line questionnaire content via contributions from a workshop. This ensured the questions reflected the needs of the students in terms of evaluating the unit of learning, assessment and provision of feedback to peers and academics. The design of the unit enabled students to plan, develop and facilitate within their groups creative ways of sharing their learning with peers. Within this they were able to draw on evidence relating to their topic area which was then applied to professional practice assisted by the midwife academics present at their presentation.

This innovative method of assessment and feedback is now supported by an initial evidence base that can be disseminated across the faculty, university and to a wider audience both nationally and globally. Principal pedagogic achievements of your project consist of the following:

Review of transferable learning from theory experience into practice activity.

Team working is a key component of practising as a midwife. In clinical practice we cannot necessarily choose who we work with. With this in mind, students were allocated to their groups by the Unit Leader and involved mixing students from different NHS Trusts. This meant students were allocated to groups with people they had not traditionally studied with in class or practice. Within their group they had to get to know, negotiate and possibly advocate and definitely listen and learn from each other. It was anticipated that the group would have to draw on individual strengths and preferences of group members whilst supporting each other in areas where confidence and experience needed enhancing.

When evaluating the unit via the survey developed by their peers, students were asked to provide three factors that they thought made a group work effectively. Four main themes emerged:

1 Communication

Comments included the importance of listening and replying to messages

2 Sharing out the work

It was important to share out the work taking into account people’s strengths and different skill sets. People needed to be organised and everyone must be involved.

3 Commitment to doing the work

It was noted that putting in equal effort and everyone pulling their weight was important. If someone was struggling then you had to be prepared to help them out early.

4 Personal qualities

Factors such as enthusiasm, kindness, patience and understanding were seen as useful qualities for the group to function effectively.

In respect of working with peers they were unfamiliar with, the majority of students responded in the survey by agreeing or strongly agreeing that they liked working in a group and with new people they did not know well.

Review student engagement and impact of PFL in their collective progression towards being knowledgeable, reflective, registered practitioners

Prior to students undertaking this undergraduate unit in year 2, they would only have been engaged in presenting individual work to their peers. This is the first unit that they are required to work as a group to create a presentation that lasts 30 minutes followed by a 15 minute discussion with peers and assessors. In clinical practice midwives often have little control over the work they are allocated for the day so with this understanding the students were allocated their topic for the presentation. When students were asked about how they viewed this approach, all who responded to the survey either agreed or strongly agreed that they liked being given the subject matter and liked exploring it in-depth. Respondents agreed or strongly agreed with the range of topic areas, which included consideration of global influence and impact. All agreed that midwives should learn about subjects affecting midwifery, which was outside of their everyday scope of practice.

Enhanced understanding regarding the impact from the perspective of the student and academic of assessing group presentations to peers followed by academic application to practice.

One focus group of four academics was used to elicit qualitative feedback about their experience of planning, delivering and / or assessing the group presentations and then applying the content to a global perspective to contemporary clinical practice. Student feedback was collected via the on-line survey.

The headlines from the focus group included the notion of achieving valuable reciprocal learning for all. Academics believed that the students engaged in the process wholeheartedly and the learning and the quality of information produced was excellent. This was despite initially being aware that there was some resistance from students to peer facilitated learning.

Academics expressed that at times, when applying the learning to the global aspects of clinical practice they were ‘thinking on their feet’ and felt that for some, they needed to be better prepared. Lessons learnt also came from the academics about the practicalities of running the unit that can be implemented for the next cohort, such as guidance on the amount of literature students need to use and organisation and format of the discussions.

Student feedback from the on-line survey elicited that there was an almost even split between the agreeing that they liked the tutor-led discussion versus either disagreeing or strongly disagreeing that they liked it. This most likely reflects the focus group discussion about being more prepared.

Proactive engagement in group working and learning

Students were asked to provide three tips they would give to students who were about to start the unit. The range of responses highlighted how students became proactive in their learning and identified some key factors that helped or hindered this approach.

1 Making the work manageable

Making a plan and sticking to it was seen as important in getting the work done. Work needed to be divided into equal loads, taking into account people’s strengths. Working hard throughout the allocated unit time was commented on, which involved being organised.

2 Working together as a group

This involved the need to meet face-to-face on occasions and not just rely on electronic forms of communication. However, it was noted in several comments, because the presentation was being marked, if members of the group were not ‘pulling their weight’ then others just had to get on and do the work for them. This reflected that the assessment grade was about the presentation content and delivery and not about individual effort within the group.

3 Assessment performance

It was important to have time to practice the presentation before the day and that students needed to know the subject well in order to lead a discussion afterwards. A comment was also made to keep things simple and not do any ‘fancy’ power point fonts or colours, it just wastes time.

It was evident that the project will positively influence the student learning experience. The next cohort of students has now commenced this unit. As part of the introduction day, students were given the ‘tips’ collated from the survey, which were suggested by their peers. Having heard the message from their peers, who have recently been through this process, it is hoped that this will encourage them to work effectively as a group.

In year 3, students have further exposure to group work which culminates in a group presentation – Service Improvement Project unit. This time the groups are configured from across two Departments in the Faculty, resulting in small groups of multi-professional students. As well as working with a group of students they have not met before, they will also have to quickly understand the professional roles their colleagues are studying for in order to produce a cohesive and relevant service improvement project that everyone in the group will sign up to and develop. For more information about the project, please contact the investigators Dr Susan Way, Dr Jen Leamon or Dr Catherine Angell.