Exploring peer learning module vs. conventional tutorials: effects on engagement and learning outcomes among first-year medical students | BMC Medical Education

In contemporary higher education, there has been a notable shift towards prioritizing teaching and learning methodologies. The teaching methods play a pivotal role in the lives of medical students for them to be good professionals [20]. There has been a discernible shift in the educational landscape in recent years from the conventional understanding of the teacher as the principal expert, using mostly didactic approaches, to a more modern understanding of the teacher as a learning facilitator. [21] In this changing paradigm, teachers are no longer solely responsible for being the exclusive purveyors of information; instead, they are expected to assist students in identifying resources and paths toward knowledge [20].

Our study showed that the conventional, as well as the newer peer learning module using JT, are effective in improving their performance. It was also found that the performance of the students was much better after the PLM in comparison with the conventional tutorials (Table 1). A study by Sharma S et al., (2019) and a study by Verma SR et al., (2017) support our results which showed an improvement in the performance of the students following JT. [22, 23] On contrary to our findings, some of the studies reported that there were no significant changes in posttest following both the conventional tutorials and JT.[24, 25].

When comparing the categorized pretest marks between the PLM and CT, the chi-squared test showed no statistically significant difference, according to this study. Implying that pretest marks secured by the students are almost similar, emphasizing the topics involved in assessing the teaching learning methods are of similar degree of difficulty. A study by Pai KM et al.,(2014) suggests a similar finding in their study which revealed that there was no discernible difference between the two groups of students with respect to their performance in pre- test [26]. Our study also noted that a significant difference (p-value of 0.001) was found in comparing the categorized marks that students received in the post-test between PLM and CT, demonstrating a markedly increase in students’ performance in post-test score after PLM as opposed to CT. Of the 150 students who completed the pretest, 41 were low performers in the PLM test and 44 were low performers in the CT pretest. Furthermore, two students were exceptional performers in both PLM and CT pretests with the score 10 out of 10. Following PLM and CT, student post-test results improved; out of 150, the low performers were only four. In both PLM & CT group. the number of exceptional performers increased to 44 and 20 in the post test in PLM and CT group respectively.

Perspective feedback of students for the PLM in our study revealed that majority of the students (93%) opined that this newer PLM using JT was highly favorable (Table 4). Moreover, many students expressed a preference for PLM over conventional tutorials. A study by Goolsarran N et al., (2020) suggested that the students felt that participating in JT improved their medical knowledge and enhanced learner satisfaction in comparison with the traditional tutorials which was in alignment with our findings [27]. In the present study, most of the students pronounced that every phase of the approach was crucial, highlighting the usefulness of PLM in supporting teaching and learning activities. Most of them said they were incessantly motivated during the sessions, underscoring JT’s compelling quality. Similar to this finding, after employing the JT, Sanaie et al., [28] saw a significant improvement in students’ self-regulated learning abilities and academic motivation [28]. The current study showed that majority of the students expressed that they developed essential extra skills and /or enhanced the skills that they already possessed, and they also believed that learning objectives were satisfactorily met. Notably, most of them claimed to have a high sense of understanding and mastery of the material, which they attributed to their involvement in Peer learning sessions. Several studies are also in agreement with our study findings that revealed better understanding, learning and knowledge retention by JT [12, 29, 30]. Additionally, in our study, students acknowledged the myriad advantages associated with JT, including how it promotes involvement, strategic planning, problem-solving skills, ingenuity, teamwork, time management, and leadership qualities. Similar findings were noted in a few studies wherein this teaching strategy of PLM using JT helped students become more self-assured [31], improved their communication skills, encouraged peer support, developed logical thinking, sharpened their problem-solving abilities, increased motivation [32], and stimulated critical thinking [31]. A study by Jeppu AK et al., [12] specified that the use of outcome-based learning environments to promote mastery of core academic subjects and the development of critical thinking, cooperation, creativity, and other vital abilities is essential for medical students [12]. In the current study, the students also believed that the PLM using JT needs to be implemented regularly (Table 4).

The Exploratory factor analysis of the feedback questionnaire reveals Jigsaw learning approach has influence on students’ engagement, skill development, and motivation. Each component is a crucial component of the educational experience for the students and offers insightful information for the next instructional plans (Table 5).

The Jigsaw exercise has shown a strong correlation with increased student motivation, according to their feedback. This result is consistent with previous research that indicates collaborative learning settings might improve intrinsic motivation by encouraging peer responsibility and active engagement [33]. Motivation is emphasized heavily because motivated students are more likely to put in the time and effort necessary for studying, which improves academic performance.

Students reported that the Jigsaw method helped them improve key competencies, contributing significantly to their skills development. High loadings on items related to participation, leadership, teamwork, and problem-solving suggest that students not only perceived skill development as a direct outcome of their participation but also recognized its broader relevance in their future careers. This finding is particularly significant in the context of medical and nursing education, where teamwork and communication skills are integral to effective clinical practice [34].

Engagement captures aspects related to students’ involvement and understanding of the topics covered. Engaged learners are more likely to retain information and develop a deeper understanding of complex subjects, which is vital in the medical field where comprehensive knowledge is essential [35]. The Jigsaw method encourages students to take ownership of their learning, fostering a sense of agency that is often lacking in traditional lecture-based formats.

Students offered a variety of perspectives on conventional tutorials, stressing both benefits and issues. They valued the ability to cover the complete subject in the conventional instructional format as well as the time-saving element. They were unhappy with what they considered it to be monotonous, calling it “boring” and “not interesting.” A study by Pahwa et al., (2022) revealed a similar finding in which the students felt that the traditional method of teaching made them passive [36]. Participants also expressed similar concerns about being assessed by others and a perceived lack of active participation from students in our study which echoes with other studies [36]. These revelations highlight how crucial it is to consider the opinions and experiences of students while assessing and improving medical education teaching strategies.

Students also gave feedback regarding the peer learning JT. They thought that the environment was conducive to collaborative learning as they stated, “Interactions were good”. They also felt the active involvement and participation as they quoted, “Was active throughout the session”. Additionally, students indicated a perceived improvement in this area by highlighting the positive effects of the peer learning module on their communication skills as they stated, “Able to improve my communication skills”. A study by Tran VD et al., (2012) showed similar opinions of students for JT in which students felt that their communication skills improved and experienced active participation [1, 37]. Participants recognized the importance of group discussions in promoting learning, pointing out that they learned something from the discussions that they might not have learned from solitary study as they asserted, “Was able to learn something which I would have missed when I read by myself”.

Participants did, however, also point out areas that needed improvement. The apparent lack of time allotted for discussion was one issue that was raised, indicating the need for longer sessions or improved time management techniques to enable more in-depth topic analysis. Students also mentioned, “Some group members are hesitant and not effective in explaining” this showed that here have also been issues with some group members’ ability to effectively convey concepts, which could leave the rest of the group with knowledge gaps. “If a student fails to explain, other members tend to lose that part of topic.” Participants also highlighted the interconnectedness of collaborative learning by expressing concern that other group members may find it difficult to understand a particular aspect of the material if a student fails to present it well. The incomplete participation of all group members or the poor performance of some individuals, which subsequently affects the group’s success, is another problem that these studies draw attention to [1, 38, 39]. This disadvantage can be overcome by a trained facilitator helping the respective group.

The effectiveness of conventional tutorials compared to peer learning modules in enhancing student learning experiences was explored in this study. Though they were deemed boring with little active participation, tutorials were found to effectively cover concepts and save time. On the other hand, peer learning modules promoted active participation, interaction, and communication skills but had drawbacks including little time for debate and differing degrees of efficacy among group members. This emphasizes how crucial it is to strike a balance between engagement and efficiency to maximize learning.

Limitations of the study

The data for this study was gathered just at one institution, limiting the applicability of the findings to other places and settings. The research depended on self-reported data, which is susceptible to biases due to personal preference and type of learner. Moreover, the questionnaire format may not have thoroughly encapsulated the diverse experiences and viewpoints of the students about PLM & CT.