Peer Instruction as an Easy-to-Implement and Effective Active Learning Strategy
This easy-to-implement instructional strategy leads to improved performance and engagement.
by Shelton K. Givens, PharmD, PGY1 Pharmacy Practice Resident, Baptist Memorial Hospital – North Mississippi
Since the formation of universities over 900 years ago, didactic instruction has consisted primarily of a lecturer speaking to a large group of students. Though it remains popular, its efficacy as a method of education has been called into question. There is concern that didactic methods (like lectures) limit the development of skills needed to be successful in the workplace and wastes precious face-to-face time on information that could be more efficiently learned from a textbook. Some studies have found that traditional instructional methods are inferior to active learning methods in science, technology, engineering, and mathematics disciplines. Specifically, active learning has been shown to increase student performance on examinations and decrease failure rates.1 Given these compelling findings, active learning strategies are frequently used in health professions education.
Some of the most commonly adopted active learning methods are team-based learning (TBL) and problem-based learning (PBL). However, these pedagogies may not be feasible in all settings since they may require changes to instructional spaces, like rearranging seats and tables, to accommodate group interactions. Additionally, these pedagogies may be too unstructured for some students who prefer to have more direction. Moreover, some students may be overshadowed by more outspoken team members.
Another active learning strategy that can be used in large groups is “think-pair-share.” This involves an instructor posing a question, students thinking to themselves, pairing to discuss the concept with a nearby peer, and sharing what was discussed with the larger group. This allows students to have time to think critically, discuss with others, and increase their understanding in an environment where it is okay to make mistakes.2 However, think-pair-share lacks the extrinsic motivation students often desire, such as assessment points contributing to grades. This lack of motivation may lead students to use their “pair” time to discuss things off-topic or to scroll social media on their phones.
Bridging these two forms of active learning is an alternative form of instruction that gets students talking to one another and provides extrinsic motivation: peer instruction. Peer instruction has four components: class preparedness, ConcepTests, peer discussion, and instructor explanation. Class preparedness involves providing students with materials in advance of the class session that enable them to develop a baseline understanding of the topic. ConcepTests are application-focused multiple-choice tests that are posed to students during, and often throughout, the class session. The ConcepTests are used to assess students' understanding of the material they were provided during the “class preparedness” step and require them to apply what they have learned to new scenarios. After each question, if the percentage of correct responses to the ConcepTests does not meet a predetermined threshold, such as 70%, peer discussion between students begins. This discussion, similar to a “think-pair-share,” involves students reviewing the ConcepTest with peers nearby and discussing their thought processes. Following the discussion, students are then given a second opportunity to answer the ConcepTest, again as individuals. This is different from a team-based learning group readiness test, which would require the entire group to select a consensus answer choice. Lastly, the instructor provides an explanation to the class if needed. The teaching strategy is different from think-pair-share as individual student responses are recorded and the ConcepTest is a graded assessment, thus motivating student participation not only to be prepared for class but also to engage in the discussion to improve their score. In addition, by analyzing the results of the ConcepTests, the instructor can evaluate both the class’s overall understanding of the material and the individual student’s.
Peer instruction has been shown to be effective in medical education, with improved student scores on quizzes and increased student engagement.3 Peer instruction has also been used in pharmacy education.4 A recent study sought to determine the effectiveness of peer education by measuring student performance on ConcepTests used during first-, second-, and third-year courses in a Doctor of Pharmacy curriculum. On average, performance on the ConcepTests increased by 40% after the students discussed the material when compared to their baseline (pre-discussion) scores. The change in performance was somewhat smaller in the first professional year course, with 39.2% of students changing their answers from incorrect responses to the correct response following peer discussion. This is compared to 44.9% improvement during second-year courses and 45.7% improvement in third-year courses. One potential explanation is the less developed critical thinking skills of less experienced students. As students hone these crucial skills over their time in pharmacy school, they may be able to have more meaningful discussions with peers during the discussion step, thus improving their performance.
Beyond the potential performance improvements on the ConcepTest through peer instruction, peer instruction may offer other benefits. Peer instruction is a relatively simple way to implement active learning, as it does not necessitate the change in infrastructure that more traditional group-based activities often require. It can be used to assess understanding in large and small groups. With the availability of inexpensive game-like learning platforms and student response systems, responses to ConcepTests can be quickly collected and recorded for grading purposes. In terms of time, the instructor can quickly review ConcepTest responses and give immediate feedback or emphasize muddy points during the explanation step as needed. Peer instruction is an easy-to-implement active learning strategy any teacher can use in any class to improve student performance and engagement.
References
1. Freeman S, Eddy SL, McDonough M, et al. Active learning increases student performance in science, engineering, and Mathematics. Proceedings of the National Academy of Sciences. 2014;111(23):8410–5. doi:10.1073/pnas.1319030111
2. Lightner J, Tomaswick L. Active Learning -- Think, Pair, Share [Internet]. Kent State University Center for Teaching and Learning; 2017 [cited 2023 Sept 24].
3. Schuller MC, DaRosa DA, Crandall ML. Using Just-in-Time Teaching and Peer Instruction in a Residency Program’s Core Curriculum: Enhancing Satisfaction, Engagement, and Retention. Academic Medicine 2015; 90(3): 384-391. | DOI: 10.1097/ACM.0000000000000578
4. Straw AM, Cole JW, McGuire K. Peer instruction as an alternative active learning pedagogy across the pharmacy curriculum. Am J Pharm Educ 2023; 87(8): 100090. doi:10.1016/j.ajpe.2023.100090