The hidden curriculum in near-peer learning: An exploratory qualitative study
Introduction
Increasingly, the roles of health professional as teachers are becoming formalised in professional standards (McKenna and French, 2011, Williams et al., 2014, Marton et al., 2014). In that context, much has been written in recent years about near-peer, or peer-assisted learning, particularly that involving senior peers teaching juniors in health professional literature. Near-peer teaching usually involves senior students teaching junior students from the same education program. Studies of near-peer teaching models and their outcomes have been described in disciplines such as medicine (Marton et al., 2014, Aba Alkhail, 2015, Fermedge et al., 2014, Naeger et al., 2013), nursing (McKenna and French, 2011, Brannagan et al., 2013), and paramedic education (Williams et al., 2014, Williams et al., 2015) and even across disciplines (McLelland et al., 2013).
A range of benefits of near-peer teaching have consistently been described, in particular for peer teachers. For peers engaged in teaching organised programs, experiences have led to increased confidence in teaching capabilities (McKenna and French, 2011, Naeger et al., 2013, Williams et al., 2015, Ten Cate and Durning, 2007, Evans and Cuffe, 2009), as well as consolidating their own prior knowledge (McKenna and French, 2011, Aba Alkhail, 2015, McLelland et al., 2013, Ten Cate and Durning, 2007, Evans and Cuffe, 2009). For the learner in a peer teaching relationship, benefits have been described through the creation of more comfortable learning environments (Ten Cate and Durning, 2007) that evoke less anxiety (McKenna and French, 2011), having more resources to support their learning (Fermedge et al., 2014) and having role models on whom to develop their own professional roles (Ten Cate and Durning, 2007). It has been suggested that the social proximity or cognitive congruence of peers to the experiences of learners may assist their understanding of learners' difficulties, along with their ability to relate better to learners, than academic staff (Bennett et al., 2015).
Section snippets
Methods
At the authors' university, peer-assisted learning programs have existing in clinical skills teaching in nursing and paramedicine since 2009 and 2011 respectively. In the Bachelor of Nursing, all final year students undertake a core unit on teaching in health care. This unit covers educational theory and practice, with one of the unit requirements involving these students teaching vital signs to first year students in clinical skills laboratories. Each near-peer teacher develops a lesson plan
Results
The focus group discussions raised many aspects constituting unintended or hidden curricula, that is, valuable learning beyond the intended outcomes of the near-peer teaching experience. Across both disciplines, these were around four key themes: identifying with their peers, the course and related expectations, clinical placements, and managing difficult situations. Overall, these encounters were found to have an influence on junior students' beginning professional identities and socialisation.
Discussion
This study examined the learning and teaching within near-peer teaching in undergraduate nursing and paramedic education occurring beyond that intended within the curriculum. While we had observed that such activities occurred during near-peer encounters, students in the focus groups provided valuable descriptions that enabled analysis. Clearly, there is a hidden curriculum that operates within these near-pear teaching and learning relationships. The hidden curriculum refers to learning that
Conclusion
Near-peer teaching is often employed in the health professions in clinical skills teaching. However, within these encounters operates a hidden curriculum that also provides powerful learning opportunities, particularly for junior students. Yet, little is known about this aspect. Strategies to harness the positive aspects, and mitigate less desirable behaviours and attitudes, are important considerations for those implementing near-peer teaching. Further research is required to further explore
Acknowledgements
The authors acknowledge the participation of the nursing and paramedic students in this study. No funding was received to support this study.
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