Evaluating the Effectiveness of EAP
Saturday 18 March 2017
(University of Edinburgh)
Effectiveness of Peer-assisted Learning
in Medical English during Medical
Education
PhD Candidate Neslihan ONDER-OZDEMIR
The University of Sheffield
Dr Erdem AKBAS
Erciyes University
“The peer learning initiative must be seen as a student-led
initiative to maximize the potential of free expression. The less
explicit the involvement by staff, the more likely the student
centred nature of the initiative will be maximized”.
Wadoodi & Crosby (2002, p. 241)
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OVERVIEW



Peer-assisted Learning
Present Research
Pedagogical Implications
Peer-assisted Learning (PAL)

Goldschmid and Goldschmid (1976) suggest that “peer
teaching in higher education today may be classified as sociopsychological, pedagogical, economic and political”
contributions (p. 11, emphasis added) and best used together
with other teaching learning methods (p. 29).
Peer-assisted Learning (PAL)

Here, we mainly will concentrate on the socio-psychological
and pedagogical dimensions as reflection of inductive teaching
methods in the context of large group peer-assisted learning in
medical English course, which was an elective course in the
medical school in Turkey in 2016.
Peer-assisted Learning (PAL)

There are various peer teaching models, i.e., discussion
groups, seminars or “tutoria” led by teaching assistants, the
proctor model.

Our focus will be on a very crowded medical student
learning group (see Goldsmith & Goldschmid, 1976, pp. 1820) and learning cell model (see Goldsmith & Goldschmid,
1976, pp. 20-23) to show how students learn from each other
and from learning experiences.
Present Research

The main three stages stated in the PAL guideline are detailed:

Stage 1- Preparation
Stage 2- What we did during the session
Stage 3- What we did when the session was over


Present Research
Stage 1- Preparation
Stage 1: Preparation (covered 5 steps)
1. Our Target Group in the Medical English Course
(n=248 first-year medical students)
2. Embracing Teaching Milieu
After introduction of PAL, to foster peer participation and
cooperative learning in the course activities, we asked medical
students to decide whether they want to work in groups or they
want to take charge of their learning responsibility on their own.
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Present Research: Participants




Out of 248 medical students, 82 of them were volunteer to
have an active role:
8 first-year undergraduate medical students acted as
medical teachers (Harden & Laidlaw, 2012) under our
supervision (i.e., teaching the most frequent target medical
words in English with the collocations they recalled which
tended to be used in content courses in medicine).
74 medical students were volunteer to report their
reflections as feedback and they were given a survey that
consisted of twelve closed and eight open-ended questions to
assess PAL.
166 medical students listened to the course given by their9
classmates through taking notes to share with each other.
Present Research
Stage 1- Preparation
3. Subject and Session Preparation
4. Plan for Effective Use of Time for the Student Learning
Groups and Learning Cell
To use the time efficiently, promote learner autonomy and active
participation, group works were arranged to foster collaboration
in the informal setting, in other words, outside the classroom.
10
Present Research
Stage 1- Preparation
Group work outside the classroom
Medical teachers (n=8) collaborated with us as EAP/ESP
practitioners to provide feedback for each other’s presentation
to get ready (i.e., course notes)

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Present Research
Stage 1- Preparation


Medical students took charge of their responsibilities both
inside and outside the classroom. However, this does not mean
that they totally replaced our role but the roles were
cooperative in nature.
Our role: Facilitator
12
Present Research
Stage 1- Preparation
5. Classroom and Resources
In the medical school, the teaching facilities included computer,
projection and microphone for the big lecture halls.
Each morning, the staff who are responsible for caring the
lecture halls check the lecture theatres and classrooms, so when
lecturers come, the resources are ready to use.
13
Present Research
STAGE 2: What we did during the Session
1. Establishment of the Ground Rules
 We sent an e-mail to medical students and asked whether there
was a recommendation or objection to encourage all of them to
participate and to make them actively engaged to take in
charge of their learning responsibilities during PAL.

We highlighted the significance of regular attendance and
punctuality to the session.
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Present Research
STAGE 2: What we did during the Session
2. The Application of Peer Learning: Medical Students as
Medical teachers
We monitored this peer learning process. Our role and medical
students’ roles altered in the student learning groups and learning
cell to foster confidence through encouraging them.
As a whole class, each medical student assisted each other to
make their decision on their target medical words to teach.
15
Present Research
STAGE 2: What we did during the Session
2. The Application of Peer Learning: Medical Students as
Medical teachers
 Group work inside the classroom
 Taking notes while medical teachers were teaching (n=166)

Reporting their reflections as feedback and they were given a
survey that consisted of twelve closed and eight open-ended
questions while listening to the medical teachers (n=74).
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Present Research
STAGE 2: What we did during the Session
2. The Application of Peer Learning: Medical Students as
Medical teachers
 Because in medical English courses, we read current
publications from high impact journals, they were familiar
with the most frequent words.
 Each medical teacher chose 3 target medical English words,
making 24 words in all, after discussing with their classmates
and with us.
 Medical English words were used frequently in the medical
research articles while taking medical English courses as well
as in the content courses in Turkish.
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Sample Course Notes Prepared by Medical
Teachers
Sample target words with collocations, which was taught by
medical teachers (see Appendix 1 for in-house material
samples)
Staining
«***Staining technique: In microscopy, we may not see
everything because of they are transparent or very small. We may
deal with this problem using chemical dyes. This process is
staining.»
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Sample Course Notes Prepared by Medical
Teachers
Sample target words with collocations, which was taught by
medical teachers
exacerbate (v):
 -Data from prospective cohort studies published in 2000-2011
suggest that sugar-sweetened beverages probably exacerbate
the risk of type 2 diabetes.1
 - The authors noted the study provides the first experimental
evidence that secondhand smoke can exacerbate allergic
responses.2
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Sample Course Notes Prepared by Medical
Teachers
Two Confusing words
Epidemic vs Pandemic
«An epidemic is the slow spread of infectious disease to a large
number of people in a given population within a short period of
time, usually two weeks or less.
A pandemic is an epidemic of infectious disease that has spread
through human populations across a large region; for instance
multiple continents, or even worldwide. However, a
widespread endemic disease that is stable in terms of how many
people are getting sick from it is not a pandemic. Further, flu
pandemics generally exclude recurrences of seasonal flu.»
…
Present Research
STAGE 3: What we did when the Session was
Over

Medical students shared the course notes with each other (e.g.,
medical teachers, medical students who were the audience)
and also

Prepared the reflection reports to provide feedback to see the
effect of PAL on the medical students.
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SURVEY RESULTS
Questions
Missing
Strongly
Agree
Agree
Disagree
Strongly
Disagree
1. scaffolded me to learn medical vocabulary in English.
11.4%
36- 48.6%
28- 37.8% 912.1%
0
0
2. was an enjoyable learning process.
0
40%54%
22- 29.7% 11- 14.8%
1–
%1.4%
0
3. was an opportunity to learn medical vocabulary
clearly.
0
30 - 40.5%
29 39.2%
13 - 17.6%
2–
2.7%
0
4. was an opportunity to learn complicated medical
vocabulary.
0
28- 37.8%
28- 37.8% 16 - 21.6%
11.4%
11.4%
5. was beneficial to have high marks from the medical
English examination.
0
39 - 52.7%
26 35.1%
0
0
6. has a social aspect because I learnt with my
classmates.
0
33 - 44.6%
29- 39.2% 11- 17.6%
1%1.4%
0
7. increased my confidence.
0
15 - 20.3%
25 33.8%
18 - 24.3%
14 - 18.9%
22.7%
8. My classmates’ teaching medical words in English
decreased my anxiety to express myself.
11.4%
19- 25.7%
24- 32.4% 18- 24.3%
11- 17.6%
11.4%
9. was a better preparation for me for the medical
English examinations rather than studying on my own.
11.4%
39 - 52.7%
25- 33.8% 79.5%
22.7%
0
10. improved my study skills.
0
21- 28.4%
25- 33.8% 22- 29.7%
56.8%
11.4%
11. increased my awareness to understand the
expectations from the medical English course.
11.4%
32- 43.2%
18- 24.3% 2027%
34%
0
12. decreased my anxiety related with medical English
course.
0
35- 47.3%
19- 25.7% 13- 17.6%
79.5%
0
PAL…
Partially
Agree
9 - 12.1%
Reflective Reports
Some data from open-ended questions: We asked whether
medical students find PAL beneficial?
About the benefits of PAL: Some responses

*M.S.: Medical Student
M.S.4: Our friends who acted as medical teachers studied hard to
teach as a part of [medical English] and we will study based on
the notes they shared.
M.S.7: My confidence increased [when I saw my classmates
teaching us] and I also wanted to act as a medical teacher.
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Reflective Reports
About the benefits of PAL: Some responses
M.S.11: Our motivation to help each other in the courses
increased.
M.S.12: The cooperation, course note sharing among us
increased. Also, the PAL is beneficial to us to support each other.
M.S.16: Facilitated our learning.
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Reflective Reports
About the benefits of PAL: Some responses
M.S.21: The PAL activity showed us that we can help each other
in many subjects to move forward while we are studying and
working.
M.S.30: While learning medical words, it was very enjoyable.
M.S.37: My classmates’ presentations and their interest [as
medical teachers] took my attention a lot and this reflected on me.
I listened to them with enjoyment.
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Reflective Reports
About the benefits of PAL: Some responses
M.S.40: We were more social and exchanging ideas. Also, while
our classmates were teaching, they increased our vocabulary
knowledge.
M.S.49: Because we discussed the collocations of the target
words [through associating with the content medical courses in
Turkish], we collaborated.
M.S.50: We learnt how we can support each other clearly and
willingly.
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Reflective Reports
About the benefits of PAL: Some responses
M.S.51: Reciprocal earning was good. Questions that did not
spring to our mind or any aspect that was not understood were
asked by our classmates and students were more active than the
ESP practitioners during the PAL session.
M.S.58: PAL was a good way to prepare for the examinations all
together.
M.S.61: Medical English course became more interesting.
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Reflective Reports
About the benefits of PAL: Some responses
M.S.66: More students participated actively thus the course was
more effective and beneficial.
M.S.73: [With PAL] we learnt a new learning strategy.
…..
…..
…..
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Pedagogical Implications

PAL helped us a lot to observe medical students, their
behaviour and team work closely. We monitored the group
activities and progress made and checked whether the work
was performed during the activities and at the end to facilitate
their role.
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Pedagogical Implications

In addition to intellectual gains, some personal skills, such as
communication, social interaction, cooperation, critical
thinking, group trust building, higher level of thinking,
confidence, self-esteem, respect, empathy could be sociopsychological dimensions of peer teaching given that friends,
colleagues and classmates may have important effect on us.
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Pedagogical Implications


Because education is considered as an active discovery of the
reality (Piaget, 1970), as for pedagogical aspect, active,
interactive and participating learning as well as lowered
anxiety and immediate feedback were present in peer teaching
(Topping, 1996) in contrast to the traditional teaching
contexts.
Thus, in this session, students’ responsibilities involved being
very active as a group through teaching to other groups, which
provided a milieu in which students felt engaged and had some
ownership of the session (Edmunds & Brown, 2010).
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Pedagogical Implications

Medical students were able to carry out a task in a way that
collaboration replaced competition.

Peer teaching can also an effective contribution to
accountability, assessment and enhancement of the learning
outcomes in medical English education (Colvin, 2007) if
performed properly.
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Pedagogical Implications
As an added value, medical students sometimes may feel
hesitant to talk to some of the medical specialists due to the
distant some specialists put in the department.
Peer learning
 may help medical students to find answer for their questions.
 enhanced course satisfaction, positive effect on the medical
students’ personal and professional development
 is reciprocal learning because not only peers but also we, as
EAP/ESP practitioners, have had cognitive gains.
 fosters the development of critical thinking Gokhale (1995)

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REFERENCES
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Colvin, J. W. (2007). Peer tutoring and social dynamics in
higher education. Mentoring & Tutoring, 15(2), 165-181.
Edmunds, S., & Brown, G. (2010). Effective small group
learning: AMEE Guide No. 48. Medical Teacher, 32(9), 715726.
Gokhale, A. A. (1995). Collaborative learning enhances
critical thinking.
Goldschmid, B., & Goldschmid, M. L. (1976). Peer teaching
in higher education: A review. Higher Education, 5(1), 9-33.
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REFERENCES

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Harden, R. M., & Laidlaw, J. M. (1992). Effective continuing
education: the CRISIS criteria. Medical Education, 26(5), 407422.
Piaget, J. (1970). Science of Education and Psychology of
Child. New York: Orion Press.
Topping, K. J. (1996). The effectiveness of peer tutoring in
further and higher education: A typology and review of the
literature. Higher education, 32(3), 321-345.
Wadoodi, A., & Crosby, J. R. (2002). Twelve tips for peerassisted learning: a classic concept revisited. Medical Teacher,
24(3), 241-244.
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Questions are welcome
PhD Candidate Neslihan ONDER-OZDEMIR
Dr Erdem AKBAS
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