Peer Tutoring 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 demands of 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 July 2003 Phase 2 A revised peer tutoring scheme August 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 increased confidence

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 communication among 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 -K nowledge and skills for handling role conflict -I nterest 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