Learning Partnership:
The experience of peer tutoring among
nursing students
LOKE, Alice Yuen
Chow Lai Wan, Filomena
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Peer tutoring
 Peer
tutoring refers to senior learners
teaching learners who are studying at the
lower level, and can foster a deeper
understanding of a subject matter.
– (Clarke & Feltham 1990)
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Benefits of peer tutoring system
 Students
who engage in interaction with
their peers in learning, would be compelled
to externalize their thoughts, and make their
queries related to topics and subjects
explicit.
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 Peer
tutors are better than teachers at
understanding their problems, are more
interested in their lives and personalities,
and are less authoritarian, yet more focus on
assessment.
• (Moust & Schmidet 1994)
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 The
situation of peer tutoring provides
opportunities to students to discover their
inadequacies, to correct misunderstandings,
and encourage openness to others’ ideas.
 The
process of peer tutoring will foster deep
approach to learning that may contribute to
higher academic achievement.
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 Peer
tutoring scheme is popular in
mathematics teaching, reading class,
teaching of children with autism (Kamps et
al 1994), primary schools (Greenwood 91,
Kohler & Greenwood 1990), social work
and medical education.
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Study aim
Through the incorporation of a peer-tutoring
scheme among nursing students:
 to
facilitate ‘lateral & cooperative learning’
 to improve the depth of understanding in
subject matters among students.
 to develop interpersonal and life-long
learning
skills
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Subjects recruitment
 12
students from year III were recruited as
peer tutors
 14
students from year II taking the subject
‘Maternity and Infant Care’ were invited to
join the scheme as peer tutees
 Participation
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was voluntary
Training
Before implementation of peer tutoring
system, all student peer tutors received:
 Workshop
 Manual
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on Peer Tutoring
for Student Peer Tutors
Facilitating role of teachers
 as
a resource person
 monitor
of peer tutoring activities
 provide
subject materials
 available
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to help when needed
Action research activities
 Weekly
tutoring sessions through out the
term
 interim
meetings between student tutors and
teachers
 individual
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interviews of peer tutors
Action research:
Weekly tutoring sessions
Students were required to record each tutorial
session:
 including
objectives of learning,
expectations, discussed subject matters,
questions raised, set learning objectives for
next tutorial session.
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Action research:
Interim evaluation
In the format of a group discussion:
 clarification of the role and responsibilities
of tutors
 identify problems to be solved
 identify issues for improvement
 evaluate
one’s own learning focusing on
intellectual and personal development.
 resolve any difficulties encountered
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Issues identified - interim
 Tutees
do not prepare for sessions
 time management
 passive in learning
 convenient time
 suitable venue
 role clarification
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Action research:
interview
 Individual
interview s were conducted at the
end of the term to evaluate their learning
focusing on intellectual and personal
development
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Data collected
 Group
interviews
 Individual interviews
 Students GPA (for comparison)
 Reflective journals (mid-term and end of
term)
 Learning approach questionnaires (pre &
post)
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Results
Group and individual interview:
Difficulties encountered
 Issues identified - interim
Benefits (mainly among tutors)
 1. Intellectual gain
 2. Mutuality in learning
 3. Sharpening interpersonal skills
 4. Social gain
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
5. Personal growth
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1. Intellectual gain
 deepening
knowledge
 more systematic in search for information
 acquiring skills in studying for tests and
preparing for clinical
 theory and practice integration
 improve critical thinking ability
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 “I
have to revise the subject content well
before tutoring, it is embarrassing if I
cannot answer their questions”
 “she
(the tutee) does not know how to ask
questions, so I have to read through the
subject materials to set objectives for the
tutoring session”
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I
become more systematic in learning since
I have to organize the materials before
hand, and to express myself clearly to help
them understand”
 “sometimes textbook knowledge cannot
answer all our questions, and I have to
reflect on my own experience, and I learn
to integrate theory and practice”
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 “In
order to make it not too dull, I have to
use my own clinical experience to illustrate
the material that I want to clarify”
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2. Mutuality in learning
 Seeking
answers and information together
 sharing
of previous clinical experience, an
important sources for help for many tutees
 tutors
gain more than tutees?
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 “when
we encountered some practical
problems, and I don’t know the answers,
we may seek answers to questions
separately and share with the answers
each others.
 “In trying to make the subject more
interesting, I seek answers from different
resources , such as web-site, peers, and
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textbooks
to
find
extra
information”
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 ‘The
questions raised by the tutees
stimulate me to look for answers, in the
process of trying to explain to them, I
learned more about the subject through
revision.’

‘We both benefited from the experience. I
took the opportunity to do my revision’.
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3. Sharpening Interpersonal skills
 Communication
 interpersonal
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skills
conflict management
 ‘I
learned how to ask questions to
stimulate thinking, and how to give
explanation or answer questions
systematically and clearly.’
 “I
realized that I become a good listener,
and could better understand their problems,
since I have just went through the
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experiences”.
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 “I
am more tactful in handling what I used
to call ‘stupid’ questions”.
 ‘We
even rearrange other engagement and
have tutorial on Saturday and Sunday. I
learn to be more organized’
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4. Social gain
 expanding
 share
circle of friends
their worries and concerns
 Establish
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mutual sense of trust
 “It
is not easy to know fellow schoolmates
from other class, this provide me with
opportunity to get to know others and it is
nice to have a little sister”
 “peer
tutoring activities allow me more
opportunity to get together with classmates
from lower class”
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 We
start off with lots of conflicts, but near
the end, we are like friends, and she even
called me when she has encounter problems
(personal as well as academic).
 We
even talked about our concerns about
future job opportunity or why we study in
degree nursing program.
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 ‘We
are just like friends, and she shared
with me her unhappy events in clinical, and
trusted me enough in not telling the
teachers, and this make me feel that we
have developed a trusting and close
relationship.’
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5. Personal Growth
 gaining confidence
 reflective thinking
 taking active parts in learning, independent
 sense of responsibility
 sense of belonging
 flexible & accommodating, more understanding,
ability to listen with patience
 maturation
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 “I
am more confident and now more ready
to ask questions in class”
 “Her
questions have stimulate me to reflect
on many questions that I do not ask before.’
‘I reflect on my own performance, and will
try
to
prepare
better
for
next
time.’
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
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 “learning
become interesting and fun since
they don't feel they are not pressure for tests
while reviewing the subject matter”
 ‘I
learnt that study is not just for passing
exam but to gain knowledge’.
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 “I
learn to communicate with people, and
to deal with problems with flexibility”
 ‘I
feel the obligation and responsibility to
teach and learn. I feel teachers are serious
about our learning and that I am part of the
team.’
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 ‘I
become more independent in learning, I
will read before next class, and take
responsibility of my own learning.’
 ‘I
am now more serious in learning, and
take the responsibility in my own learning
and take active part in it.’
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I
learn to be more accommodating of
‘immature’ behaviors. I tried to get her
back to learning activities with skill.’
 ‘I
become more understanding of each
others’ needs, and try be more flexible about
time arrangement’.
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 ‘She
was just like me when I was in that
stage, as my own shadow, I will not blame
her for being that way, and will guide her to
take take responsibilities in leaning, be
more active, be more series, and broaden
own perspectives and nursing knowledge.’

 ‘I
feel that I have to be her role model, and
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become more mature myself.’
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Discussion (1)
 The
study shows that student tutors can make
cognitive gains in relation to the tutored
subject, such as developing their understanding
of and confidence in the subject by applying
their knowledge in practical contexts.
 To
teach something- in a tutorial setting, as
opposed to a didactic lecture setting, demands
that one really come to grips with it- in order
to render it meaningful to the learner.
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Discussion (2)
 Student
tutoring also gives opportunity to
develop many of the professional
‘transferable’ skills increasingly in demand
by employers, such as communication,
interpersonal and organizational and
organizational skills.
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Discussion (3)
 Peer
tutors developed their communication
skills, problem solving technique, reflective
thinking and simultaneously serve the needs
of their peers and also gain in their
confidence to solve their own problems and
needs.
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Discussion (4)
 The
findings of the study shows that peer
tutoring provided a strong interactive
communication and the developed a trusting
and supportive relationship which is not
only career enhancing but also an important
source of student support.
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Discussion (5)
 As
peer tutors have no official assessment
function, they are in better position to solicit
much higher disclosure of difficulties by
tutees.
 Peer tutors are more likely to give advice in a
concrete form, contextualized in a recent
example from their own experience, rather
than in a more general or abstract form a
university educator might use to address the
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whole class.
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Conclusion (1)
 From
the interview data, it appears that the
aim of improving students’ communication
skills was achieved. However, it is difficult
to determine whether the tutoring
experience was the only or even the main
cause of this improvement.
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Conclusion (2)
 The
potential for peer tutoring raising
aspiration is perhaps ‘ best seen as an
element of a more comprehensive program’.
 It can be argued that peer tutoring merely
serves to bring to the surface needs that
traditional teaching tends to overlook.
 This is only one among many experiences
aimed at helping students think positively
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about their future.
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Conclusion (3)
 The
quality of tutoring from a peer tutor
may not be as good as that from a
professional teacher (although this should
not be assumed), the need for monitoring
and quality control cannot be overstated.
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Conclusion (4)
 The
value of student tutoring has to be seen
in the wider context of the work of the
teachers and the strategic approach that
encourages an appetite for continuing
learning.
 Tutoring schemes that are simply bolted on
to existing practice rarely prove an effective
tool for promoting learning and personal
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development.
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Conclusion (5)
Positive aspect of peer tutoring system:
 In the increasingly competitive world
environment it is imperative that higher
education institution prepare well-equipped
graduates. Problem solving and an ability
to work effectively in a collaborative
context are skills which are expected of
graduates.
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Conclusion (6)
 Peer
tutoring is usually a relatively small
component of a wide range of teaching and
learning strategies deployed in higher
education, so the extent to which it is
realistic to expect associated gains to be
measurable, widespread, maintained and
generalized is debatable.
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Conclusion (7)
 The
activity of tutoring provides students
with opportunity for case analysis and
deepens their knowledge, and reflect about
matters of wider concern.
 The
tutoring relationship between students
is reciprocal in that students in both ends
could gain from the tutoring and learning
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experience.
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Conclusions (8)
 With
peer tutoring scheme, students are
better prepared for life-long learning skills
& self-learning and development.
 University
graduates are expected to be able
to analyze and communication effectively to
solve real-world problem
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Conclusion (9)
 Peer
tutoring system could be implemented
to other education programs to facilitate
deep learning, reflective thinking and higher
academic and professional achievements.
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Limitations
 Self-selected
sample: students who might be
more active in learning
 The
amount of peer tutoring takes place
heavily relies upon the personality of tutors,
commitment (Clarke & Feltham 1990), and
their approach to problem solving and
knowledge influence the effectiveness of
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tutoring.
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Limitations (2)
 Results
of these interviews may reflect
nothing more than a 'Hawthorne Effect’:
 Whenever a group of students is monitored
throughout an experiment within the
curriculum. Favorable attitudes may arise
simply because of the attention being paid
to students as a consequence of starting any
initiative.
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
(Saunders 1992)
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Limitations (3)
 The
initiative was confined to nursing
students, and more information is needed
about the evaluation of peer tutoring
experience as gained by students taking
other courses or subjects.
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