Facilitating Active Collaborative Learning in Medical Education; a Literature Review of Peer Instruction Method

Figures & data

Figure 1 The seven steps of the Peer Instruction Workflow. Audience Response System (ARS).

Figure 2 Just-in-Time Methodology; pre-class, during class, and post-class steps.

Figure 3 Example of how Concept Test results can be applied in Peer Instruction.

Table 1 Research Studies in the Application of Peer-Instruction in Medical Schools

Research Study	Subject Taught	Medical College/ Region	Study Outcomes
Rao and DiCarlo, 2000^Citation35	Physiology	Wayne State School of Medicine, USA	The percentage of correct answers increased significantly (P < 0.05) after discussion for both recall and intellectual questions.
Trout et al, 2014^Citation36	Pharmacology	Wright State University, Boonshoft School of Medicine	Students who had attended at least one Peer Instruction (PI) session achieved a highly statistically significant improvement of 8.2% in their examination score compared with those who had not attended any PI sessions (82.1% versus 73.9%).
Versteeg et al, 2018^Citation37	Physiology	Leiden University Medical Center, Netherlands	The results of the study revealed that both PI and Self-explanation (SE) groups significantly improved their post-test scores (p < 0.0001), with PI outperforming SE by 35% compared with 23% (p = 0.006).
Marina-Gonzalez et al, 2018^Citation38	Cardiovascular and respiratory function in health and disease (CRF) module	University College of London (UCL)	PI improved in-class problem-solving skills Examination scores revealed that the PI group achieved similar results to those in the previous cohort who attended traditional flipped classroom tutorials.
Marina-Gonzalez et al, 2018^Citation38	Diseases of the Digestive System (DDS) Module	Universidad de La Laguna (ULL), Tenerife, Spain	Examination scores showed that students achieved a higher number of correct answered questions and averaged scores with the PI module, as compared with the traditional lecture module.
Passeri and Mazuri, 2019^Citation39	Pre-clinical subjects	A Brazilian Medical School	The PI group demonstrated better performance in both examinations than the control group, with retention of basic science knowledge increasing by 15%.

Rao SP, DiCarlo SE. Peer instruction improves performance on quizzes. Advan Physiol Educ. 2000;24(1):51–55. doi:10.1152/advances.2000.24.1.51

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Trout MJ, Borges N, Koles P. Modified peer instruction improves examination scores in pharmacology. Med Educ. 2014;48(11):1112–1113. doi:10.1111/medu.12590

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Versteeg M, van Blankenstein FM, Putter H, Steendijk P. Peer instruction improves comprehension and transfer of physiological concepts: a randomized comparison with self-explanation. Advan Health Sci Educ. 2018;24(1):151–165. doi:10.1007/s10459-018-9858-6

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Marina-Gonzalez N, Hernandez-Guerra M, Quintero E. Peer instruction transforms the medical science classroom. University College of London: Teaching & Learning Case Studies; 2018. Available from: https://www.ucl.ac.uk/teaching-learning/case-studies/2018/sep/peer-instruction-transforms-medical-science-classroom. Accessed September 26, 2023.

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Passeri SM, Mazur E. Peer instruction-based feedback sessions improve the retention of knowledge in medical students. Rev Brasil Educ Méd. 2019;43(3):155–162. doi:10.1590/1981-52712015v43n2rb20180230

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