Quality assurance of peer-assisted learning by measuring academic performance of health sciences extended curriculum students





Peer-assisted learning, Extended curriculum programme, PAL, ECP, Academic performance, Assessment


Peer-assisted learning (PAL) has numerous benefits in medical curricula. In the extended curriculum programme (ECP) at a university in South Africa, remedial interventions, such as same year/level PAL, were implemented to improve academic success. This article focuses on the measures to ensure the quality of PAL as an intervention for the academic under-preparedness of ECP students. After the midterm assessment results had been verified, the academically strongest ECP students were appointed as tutors (n=10) for the remainder of the student cohort (n=31). Structured, informal PAL activities were implemented as an academic intervention between consecutive assessments. Analysis of the pre- and post-intervention results showed a statistically significant difference for the whole study population as an increase of 6.1% was recorded in post-intervention results. Nine of the ten PAL groups showed an increase in the combined group results, the highest increase being 15.1%. Although the tutor group did not show a statistically significant difference between pre- and post-intervention results, 80% of the tutors experienced a positive effect on their academic progress by scoring higher post-intervention results. The results showed that same year/level PAL interventions can assist under-prepared ECP students to be academically successful with advantages for the tutors and tutees.


Download data is not yet available.


Batchelder, A.J., Rodrigues, C.M., Lin, L.Y., Hickey, P.M., Johnson, C. & Elias, J.E. 2010. The role of students as teachers: Four years’ experience of a large-scale, peer-led programme. Medical Teacher, 32(7): 547–551. http://dx.doi.org/10.3109/0142159X.2010.490861.

Blohm, M., Lauter, J., Branchereau, S., Krautter, M., Köhl-Hackert, N., Jünger, J., Herzog, W. & Nikendei, C. 2015. “Peer-assisted learning’’ (PAL) in the skills-lab – an inventory at the medical faculties of the Federal Republic of Germany. GMS Zeitschrift für Medizinische Ausbildung, 32(1): document 10. DOI: 10.3205/zma000952.

Boughey, C. 2005. Epistemological access to the university: an alternative perspective. South African Journal of Higher Education, 19(3): 230–242. http://dx.doi.org/10.4314/sajhe.v19i3.25516.

Boughey. C. 2010. Understanding teaching and learning at foundation level: A ‘critical’ imperative? In C. Hutchings & J. Garraway (Eds.). Beyond the university gates: provision of extended curriculum programmes in South Africa. Proceedings of the January 2009 Rhodes University Foundation Seminar Hosted by Professor Chrissie Boughey. Grahamstown, South Africa: Rhodes University.

Bulte, C., Betts, A., Garner, K. & Durning, S. 2007. Student teaching: Views of student near-peer teachers and learners. Medical Teacher, 29(6): 583–590. http://dx.doi.org/10.1080/01421590701583824.

Burke, J., Fayaz, S., Graham, K., Matthew, R. & Field, M. 2007. Peer-assisted learning in the acquisition of clinical skills: A supplementary approach to musculoskeletal system training. Medical Teacher, 29(6): 577–582. http://dx.doi.org/10.1080/01421590701469867.

Capstick, S. 2004. Benefits and shortcomings of peer assisted learning (PAL) in higher education: an appraisal by students. Available at https://www.bournemouth.ac.uk/sites/default/files/asset/document/stuart-capstick.pdf [Accessed 6 September 2020].

Cornwal, M. 1979. Students as teachers: peer teaching in higher education. Doctoral thesis. Amsterdam: University of Amsterdam.

Dandavino, M., Snell, L. & Wiseman, J. 2007. Why medical students should learn how to teach. Medical Teacher, 29(6): 558–565. http://dx.doi.org/10.1080/01421590701477449

Dawson, P., Van der Meer, J., Skalicky, J. & Cowley, K. 2014. On the effectiveness of supplemental instruction: A systematic review of supplemental instruction in peer-assisted study sessions literature between 2001 and 2010. Review of Educational Research, 84(4): 609–639. https://doi.org/10.3102/0034654314540007.

Denscombe, M. 2010. The good research guide for small-scale social research projects. London: McGraw-Hill Education: Open University Press.

Department of Education (DoE). 2001. National plan for higher education. Pretoria: Department of Education.

Department of Education (DoE). 2006. Funding for foundational provision in formally approved programmes: 2007/8 to 2009/10. Available at http://www.heda.co.za/Valpac_Help/06circularA.htm [Accessed 20 October 2020].

Festinger, L., Riecken, H.W. & Schachter, S. 1956. When prophecy fails: a social and psychological study of a modern group that predicted the destination of the world. New York, NY: Harper. https://doi.org/10.1037/10030-000

Hermann-Werner, A., Gramer, R., Erschens, R., Nikendei, C., Wosnik, A., Griewatz, J., Zipfel, S. & Junne, F. 2017. Peer-assisted learning (PAL) in undergraduate medical education: an overview. Journal of Evidence and Quality in Health Care, 121: 74–81. https://doi.org/10.1016/j.zefq.2017.01.001

Hudson, N.J. & Tonkin, A.L. 2008. Clinical skills education: outcomes of relationships between junior medical students, senior peers and simulated patients. Medical Education, 42(9): 901–908. https://doi.org/10.1111/j.1365-2923.2008.03107.x

Hughes, T.C., Jiwaji, Z., Lally, K., Lloyd-Lavery, A., Lota, A., Dale, A., Janas, R. & Bulstrode, C.J. 2010. Advanced Cardiac Resuscitation Evaluation (ACRE): A randomised single-blind controlled trial of peer-led vs. expert-led advanced resuscitation training. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 18: 3. http://dx.doi.org/10.1186/1757-7241-18-3

Jünger, J., Schäfer, S., Roth, C., Schellberg, D., Friedman Ben-David, M. & Nikendei, C. 2005. Effects of basic clinical skills training on objective structured clinical examination performance. Medical Education, 39(10): 1015–1020. http://dx.doi.org/10.1111/j.1365-2929.2005.02266.x

Kassab, S., Abu-Hijleh, M.F., Al-Shboul, Q. & Hamdy, H. 2005. Student-led tutorials in problem based learning: Educational outcomes and students’ perceptions. Medical Teacher, 27(6): 521–526. http://dx.doi.org/10.1080/01421590500156186

Knobe, M., Münker, R., Sellei, R.M., Holschen, M., Mooij, S.C., Schmidt-Rohlfing, B., Niethard, F.U. & Pape, H.C. 2010. Peer teaching: A randomised controlled trial using student teachers to teach musculoskeletal ultrasound. Medical Education, 44(2): 148–155. http://dx.doi.org/10.1111/j.1365-2923.2009.03557.x

Lincoln, M.A. & McAllister, L.L. 1993. Peer learning in clinical education. Medical Teacher, 15(1): 17–26. http://dx.doi.org/10.3109/01421599309029007

Lockspeiser, T.M., O’Sullivan, P., Teherani, A. & Muller, J. 2008. Understanding the experience of being taught by peers: The value of social and cognitive congruence. Advances in Health Sciences Education, 13(3): 361–372. http://dx.doi.org/10.1007/s10459-006-9049-8

Mabila, T.E., Malatje, S.E., Addo-Bediako, A., Kazeni, M.M.M. & Mathabatha, S.S. 2006. The role of foundation programmes in science education: The UNIFY programme at the University of Limpopo, South Africa. International Journal of Educational Development, 26(3): 295–304. http://dx.doi.org/10.1016/j.ijedudev.2005.08.004

Meertens, R. 2016. Utilisation of a peer assisted learning scheme in an undergraduate diagnostic radiography module. Radiography, 22(1): e69–e74. http://dx.doi.org/10.1016/j.radi.2015.08.004

Peets, A.D., Coderre, S., Wright, B., Jenkins, D., Burak, L., Leskosky, S. & McLaughlin, K. 2009. Involvement in teaching improves learning in medical students: a randomized cross-over study. BMC Medical Education, 9: article 55. http://dx.doi.org/10.1186/1472-6920-9-55

Ryan, R.M. & Deci, E.L. 2000. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1): 68–78. http://dx.doi.org/10.1037/0003-066X.55.1.68

Schmidt, H.G. 1989. The rationale behind problem-based learning. In H.G. Schmidt, M. Likin Jr, M.W. de Vries & J.M. Greep (Eds.). New directions for medical education (pp. 105–111). New York, NY: Springer. https://doi.org/10.1007/978-1-4612-3472-2_8

Scott, I. 2009. First-year experience as terrain of failure or platform for development? Critical choices for higher education. In B. Leibowitz, A. van der Merwe & S. van Schalkwyk (Eds.). Focus on first-year success: perspectives emerging from South Africa and beyond (pp. 17–37). Stellenbosch: SUN Press.

Slabbert, R. & Friedrich-Nel, H. 2015. Extended curriculum programme evolution: a road map to academic success. South African Journal of Higher Education, 29(1): 45–59. https://hdl.handle.net/10520/EJC172799. https://doi.org/10.20853/29-1-458

Snell, L. 2011. The resident-as-teacher: It’s more than just about student learning. Journal of Graduate Medical Education, 3(3): 440–441. http://dx.doi.org/10.4300/JGME-D-11-00148.1

Solomon, P. & Crowe, J. 2001. Perceptions of student peer tutors in a problem-based learning programme. Medical Teacher, 23(2): 181–186. https://doi.org/10.1080/01421590500156186

Soriano, R.P., Blatt, B. & Coplit, L. 2010. Teaching medical students how to teach: a national survey of students-as-teachers programs in US medical schools. Academic Medicine, 85(11): 1725–1731. http://dx.doi.org/10.1097/ACM.0b013e3181f53273

Tai, J., Molloy, E., Haines, T. & Canny, C. 2016. Same-level peer-assisted learning in medical clinical placements: a narrative systematic review. Medical Education, 50(4): 469–484. http://dx.doi.org/10.1111/medu.12898

Tang, T.S., Hernandez, E.J. & Adams, B.S. 2004. ‘’Learning by teaching’’: A peer-teaching model for diversity training in medical school. Teaching and Learning in Medicine, 16(1): 60–63. http://dx.doi.org/10.1207/s15328015tlm1601_12

Ten Cate, O. & Durning, S. 2007. Peer teaching in medical education: twelve reasons to move from theory to practice. Medical Teacher, 29(6): 591–599. http://dx.doi.org/10.1080/01421590701606799

Topping, K.J. 2005. Trends in peer learning. Educational Psychology, 25(6): 631–645. http://dx.doi.org/10.1080/01443410500345172

Topping, K.J. & Ehly, S.W. 2001. Peer assisted learning: A framework for consultation. Journal of Educational and Psychological Consultation, 12(2): 113–132. http://dx.doi.org/10.1207/S1532768XJEPC1202_03

Vygotsky, L.S. 1978. Mind in society: the development of higher psychological processes. Cambridge, MA: Harvard University Press.

Walberg, H.J. 1998. Foreword. In K. Topping & S. Ehly (Eds.). Peer-assisted learning (pp. ix–xii). Mahwah, NJ: Lawrence Erlbaum Associates Publishers.

Weyrich, P., Schrauth, M., Kraus, B., Habermehl, D., Netzhammer, N., Zipfel, S., Jünger, J., Riessen, R. & Nikendei, C. 2008. Undergraduate technical skills training guided by student tutors – analysis of tutors’ attitudes, tutees’ acceptance and learning progress in an innovative teaching model. BMC Medical Education, 8: article 18 http://dx.doi.org/10.1186/ 1472-6920-8-18

Weyrich, P., Celebi, N., Schrauth, M., Möltner, A., Lammerding-Köppel, M. & Nikendei, C. 2009. Peer-assisted versus faculty staff-led skills laboratory training: A randomised controlled trial. Medical Education, 43(2): 113–120. http://dx.doi.org/10.1111/j.1365-2923.2008.03252.x

Williams, B. & Reddy, P. 2016. Does peer-assisted learning improve academic performance? A scoping review. Nurse Education Today, 42: 23–29. http://dx.doi.org/10.1016/j.nedt.2016.03.024



How to Cite

Slabbert, R., & du Plessis, J. (2021). Quality assurance of peer-assisted learning by measuring academic performance of health sciences extended curriculum students. Perspectives in Education, 39(2), 95-112. https://doi.org/10.18820/2519593X/pie.v39.i2.8



Research articles