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USE OF MODIFIED PEER
INSTRUCTION SESSIONS IN AN
INTRODUCTORY PATHOBIOLOGY
AND PHARMACOLOGY COURSE
Conflict of Interest
Mary Jo Trout, PharmD
Nicole Borges, PhD
Paul Koles, MD
Special Thanks to:
• Aaron Smith, Academic Technology Analyst
• collected the data
Background
• Introductory course very early in year 2 at
Boonshoft School of Medicine (BSOM)
• Valencia Merrill, Data Collection Specialist
• help make sense of the data
• 4 weeks, basic concepts in pathology &
pharmacology
• “Flipped Classroom” model
• All lectures on-line for study outside class
• All class time devoted to active learning
• Incorporated Peer Instruction strategy
Origin of peer instruction
Peer Instruction Principles
1. Mini-lecture in class: key points
(7-10 min)
2. Concept test (5-8 min)
3. Correctness of answers not
graded
4. Overall participation graded
Lasry et.al. Am J Phys,2008;76(11):1066-9.
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What we changed
Research Question
1. No lecture in class (all
Did attending
pharmacology
Modified Peer
Instruction (MPI)
sessions improve
performance on
pharmacology
high stakes
exams?
content delivered on-line)
2. Entire class time for
application questions (2 hr.)
3. No credit or grade for
participation
Methods 1
All lectures recorded on Quick
Time©
Textbook readings correlated
with lectures
Content domain defined for
each MPI session
Methods 3
Methods 2
Each 2 hour session: 13-18
multiple choice questions
(MCQs)
Sessions were not graded;
attendance not mandatory
Question and answers (but not
discussion) posted after session
Example
After completion of course, data
comparing attendance at
pharmacology MPI sessions
was correlated with
pharmacology exam scores
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Example answer display
Results
Answers after discussion in pairs
Exam 2 mean scores
Exam 1 mean scores
95.00%
95.00%
Exam Scores
85.24%
82.59%
85.00%
80.00%
Exam Scores
90.00%
90.00%
83.45%
85.00%
76.57%
80.00%
75.00%
Attendance
75.00%
Non-attendance
70.00%
Attendance
Non-attendance
70.00%
6.9% higher exam score (p= 0.004)
2.6% higher exam score (p=0.196)
Exam 3 mean scores
95.00%
Exam 4 mean scores
91.16%
95.00%
87.33%
88.10%
90.00%
Exam Scores
Exam Scores
90.00%
85.00%
80.00%
75.00%
Attendance
Non-attendance
81.03%
85.00%
80.00%
75.00%
Attendance
70.00%
Non-attendance
70.00%
3.8% higher exam score (p= 0.084)
7.1% higher exam scores (p= 0.002)
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Final exam mean scores
Attendance
• Not mandatory
95.00%
• No way to control for academic caliber of
Exam Scores
90.00%
students who attended
82.10%
85.00%
• Decreased over time
80.00%
73.93%
• 75% at session 1 25% at session 4
75.00%
Attendance at ≥1 MPI
• 74% attended at least 1 session
Did not attend a MPI
70.00%
• 17% attended all 4 sessions
Attendance at ≥1 MPI: 8.2% higher exam score (p < 0.001)
Performance vs. Attendance
Week 2 exam scores
83.45% for attendees
vs. 76.57% for nonattendees
attendees
18
49
upper
quartile
~36% attendees top
quartile based on end of
yr 1 ranking
Week 4 exam scores
88.1% for attendees
vs. 81.03% for nonattendees
attendees
8
31
upper
quartile
~ 25% attendees top
quartile based on
end of yr 1 ranking
Conclusions
1. Attendance at one or more modified Peer
Instruction pharmacology sessions is
associated with better final exam scores on
pharmacology-based questions.
2. Lack of a mechanism to promote or insure
attendance at MPI sessions probably
diminished learning among those who chose
not to attend.
Limitations
Limited student preparation time potential limited benefit from
discussions
Posting of questions and answers
after the session potentially diluted
effect of attendance
Exam performance not correlated
with precise performance on MPI
questions
Recommendations for next year
Consider methods to promote higher
attendance at MPIs
Increase students’ preparation time for
MPI sessions
Share results of this study with next
year’s class at the beginning of the
course.
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References
• E. Mazur. Peer Instruction: A User’s Manual. Upper
Thanks
for
listening
Saddle River (NJ): Prentice Hall;1997.
• C. H. Crouch, J. Watkins, A. P. Fagen, and E. Mazur,
Any
Questions?
"Peer Instruction: Engaging Students One-on-One, All At
Once," in Research-Based Reform of University Physics,
edited by E. F. Redish and P. J. Cooney (American
Association of Physics Teachers, College Park, MD,
2007), Reviews in PER Vol. 1, <http://www.percentral.org/document/ServeFile.cfm?ID=4990>.
• N. Lasry, E. Mazur, J. Watkins. “Peer Instruction: From
Harvard to the Two-Year College”. Am J Phys, 2008;
76(11)1066-69
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