Keele University Innovations Project

Evaluation of a pilot project to implement a peer support model within the School of Nursing and Midwifery

Title: Evaluation of a pilot project to implement a peer support model within the school of nursing and midwifery Author: Pauline Walsh (Project lead), Kim Sargeant, Julie Green and Cath Hill Acknowledgements: Keele University for funding via the learning and teaching innovation awards Project team: Kim Sargeant, Julie Green and Cath Hill for all their hard work and contributions Academic staff within the School of Nursing and Midwifery for participating in the pilot Cat Hallam for facilitating the feedback session Leslie Allen for typing

Content list:

Executive summary: This report outlines the implementation and evaluation of a pilot of a peer support model for academic staff, within the school of nursing and midwifery, following a successful application for university innovation project funding. The model encompasses the wider context of a lecturers role in delivering health professional education. Evaluation of staff views was undertaken following a full year pilot to enable the whole process to be undertaken. The results indicate that staff found the peer support model a supportive approach which facilitated communication, sharing of ideas and experience and development of good practice. Some recommendations regarding practicalities and training are highlighted. It is suggested that this model would be beneficial for use in other schools across the university. Background information: Peer review in the academic community has a long history and an associated body of literature of considerable breadth, most of which focuses on peer observation of teaching (HEA 2006, Anderson and Pelcier 2001, Daloz 1999) a fuller review of the literature is provided below. The Peer review model however stems from a view of learning and teaching that is humanistic rather than mechanistic and is designed to enhance learning and teaching via open and rigorous academic debate, simultaneously fostering creative and relevant learning and teaching experiences, and the notion of pedagogic scholarship (D’Andrea and Gosling 2005). The school is committed to personal and professional development of its staff and sees the peer support model as complementing the existing school research and scholarship programme. . The Peer support strategy is a school wide initiative that involves academic staff (Appendix 1) It has the potential to impact positively on learning and teaching at module, programme, group and individual learner and teacher levels. Peer observation of teaching has its limitations Whilst it is common in some institutions for observations to be carried out by senior staff Hammersley-Fletcher and Orsmond (2004) argue that a valuable learning experience can be lost if staff are not themselves engaged in performing the observations of their peers. They suggest that staff can gain as much from observing their colleagues as they can from being observed themselves. Peel (2005) argues that peer observation alone is not sufficient to encourage staff to evaluate their practice and this needs to be combined with reflection and academic discourse if practice is to be

enhanced whilst Cosh (1998) argues that experienced staff are more likely to become defensive to suggestions of change rather than stimulated to improve their performance and as a result peer observation does not encourage professional development.Such limitations provided the rationale for implementing a new model which provides a framework for a more in-depth analysis of learning and teaching practice and improvement in dissemination and sharing of good practice (HEA 2006). Having staff from different subject areas within each group will mean that staff can explore some of the more complex approaches to programme delivery that they may not normally work with thus enabling dissemination of good practice across different subject teams. Staff will be able to offer support to each other in assimilating new skills around blended learning, assessment and practice support. The nursing and Midwifery council require all nurses to maintain a professional portfolio that provides evidence of their professional development and ongoing competence in their field of practice (NMC2006). This includes education as a field of practice and as such those who hold a recordable teaching qualification with the NMC and are engaged in delivering education to nurses, midwives or community practitioners need to meet this requirement. The strategy incorporates Keele University guidelines regarding peer observation of teaching (POT) and aims to contribute to the successful achievement of school targets (Keele 2003). Health lecturers have a multifaceted role which not only emphasises the need for effective classroom teaching and assessment, but also supporting students and mentors in maximising the learning experience whilst on clinical placements. Some aspects, for example the personal tutor or link lecturer role, does not lend itself easily to a standard peer observation. Project implementation: The project was led by the Director of Pre-registration Programmes, who was experienced at implementing innovation projects, working with a small team of lecturers who had put themselves forward due to personal interest in the area. This was an important element of the project as it was felt that the team needed to be enthusiastic about peer support and also that it was not viewed as just a management activity (berk et al 2004, Davys et al 2007 and 2008). None of the lecturers had previously been involved in this type of project and this was considered an ideal opportunity for personal professional development. The first part of the process was to undertake a scoping exercise of different practices in other universities and clarification of the aims of the model. The project was agreed by the school executive committee and written in to the School Plan and Learning and Teaching Plan. It was initially introduced in the third semester of 2007 / 2008, however it was realised that to evaluate it fully staff would need to engage in the process for an academic year to enable all three elements to be experienced. Thus it was decided to undertake a full pilot involving all staff during the academic year 2008/2009. This was introduced to staff through the school staff meeting and one of the monthly scheduled school scholarship sessions. The project timeline was influenced by the need to ensure that a full year was available for staff to engage in a complete cycle of the model (see project plan). This meant that the normal university innovation project time frame was exceeded; however this was agreed with the Director of Learning and Teaching. A report of the interim findings was presented at the university innovations project day and also presented at the national Nurse Education Conference (NET 2009) in September 2009.

Project timeline The literature: Peer observation has been used within Higher Education for over a decade and much has been written about its value (Berk et al, 2004; Hammersley-Fletcher and Orsmond, 2004). Peer observations are often used summatively as part of a staff development process for assessment of performance, the results of those observations then used as a factor for promotion or securing of tenure. However, when used in a more formative manner peer observation is used to support and encourage staff to continually reassess their skills and develop and improve their effectiveness. Donnelly (2007) suggests that peer activities develop staff confidence in their approach to teaching and develop good practice. This approach of incorporating reflection into the process to encourage reflective practice can enable staff to demonstrate the professional body requirements of reflective practice and ongoing professional development (Nursing and Midwifery Council, 2006). If staff are to continually review their approach to learning and teaching and develop and enhance their skills it can be argued that they need to evaluate the impact they have had on learners and changes they can make. Donnelly (2007) suggests that reflective practice can be a key process in the professional learning of academic staff and can prevent teaching from becoming routine and mundane. The value of observing others teach should not be underestimated. Whilst a lot can be gained from the feedback of a more experienced teacher, the ideas and stimulation that a novice teacher can gain from observing a more experienced colleague can be immense. Literature suggests that often more can be gained from watching others teach than from being observed and this creates an argument for teaching observations to be carried out by peers rather than senior management (Hammersley-Fletcher and Orsmond, 2004. Bell, 2002). However, Cosh (1998) argues that the judgements of others do not develop or improve people’s performance.

Model of Peer Support: Aims of the Peer Support Model: • • • • •

Achieve the institutional peer observation of teaching requirements Facilitate the requirements for professional registration and maintenance of a professional portfolio Foster support to staff implementing innovative and dynamic learning and teaching strategies including inter-professional and case based learning Encourage staff to implement shared learning strategies within programmes Enable staff to reflect on and develop their role in supporting students as a personal tutor and clinical placement link tutor

The peer support model encompasses individual POT, one to one professional reflective practice and small peer support / learning sets with a relevant set of documentation was provided (appendix 2). The groups were made up of staff from different teams across the school providing the opportunity for staff to strengthen working relationships, facilitate innovation and benefit from each others expertise. The school executive committee allocated staff to groups, however staff were given the opportunity to identify if they had any concerns regarding this (no-one identified any issues with the groupings and no alterations were made). The groups met once a semester for discussions which facilitated sharing of good practice or areas of challenge as well as each group member having a POT and reflective practice session (RPS) with a member of the group once during the academic year. At the beginning of each academic year the support group / learning set agree the areas they wish to explore during the meetings and determine the pairings for the POT and reflective practice session. At the end of the process the group should agree a) any areas of good practice to be disseminated more widely across the school or faculty and b) any suggestions for school staff development activities.

Keele School of Nursing and Midwifery Peer Support Model (2008)

By the end of July each year written confirmation that the meetings and individual POT and RPS have taken place should be forwarded to the Chair of the Learning and Teaching Committee. Any detail relating to the content of meetings or feedback to individuals remains confidential in accordance with Keele guidelines.

Evaluation: Evaluation was undertaken using a mixed methods approach to gather feedback from both a quantitative and qualitative perspective. The schools access committee was approached to seek permission to utilise a questionnaire and feedback session with staff. Confidentiality was maintained throughout and participants did not have to engage in the process. Each of the three elements within the model was addressed as a specific section alongside some biographical data relating to their experience within education (appendix 3). Forty three staff were involved in the peer support process (n = 43) itself and as such could be eligible to contribute to its evaluation. Rather than just sending the questionnaire to all staff it was initially implemented using turning point voting technology during a scholarship session, a hard copy was also put in individual post trays in case staff were unable to attend the session, resulting in a total response rate of 58%. Of these respondents 48% had worked in higher education for more than 10 years and only 8% for less than two years, in addition only 4% (one staff member) had not yet completed a formal teaching qualification. Following on from this each peer support group was asked to identify one person to attend a feedback discussion where the issues within the questionnaire could be explored more fully and any areas of feedback that the group wanted to provide could be given. A semi structured discussion format was used to guide the session which was facilitated by an administrator (Appendix 4).

Results: Overall the results demonstrate that the majority of staff felt the peer support model was a valuable exercise with 68% of respondents stating it had positively enhanced their personal professional development. Respondents in the main did not want to have the specific feedback utilized within appraisal systems as indicated within the table below, with only 12% having a positive response which replicates evidence from other studies (Shortland 2004, Davys et al 2008). Appling et al (2001) suggests that POT should be a voluntary process to support and enhance teaching effectiveness with a focus on formative evaluation but that there is a fear amongst faculty members that such information may be used for punitive purposes.

Q: Feedback from peer support activity should be used within the appraisal system

48%

20%

20%

12% 0% Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

Interestingly 64% felt the peer support activities contribute to improving the quality of the student experience, which refutes assertions by Cosh (1998) that the judgments of others do not develop or improve people’s performance. One explanation for this might be that it is a peer support model rather than just a teaching observation encompassing a more holistic approach. 76% of respondents indicated that they felt able to disclose things that concerned them during the peer support meetings. The model encourages staff to undertake observation of others as well as having their own teaching observed which as indicated in the graph below was felt to be beneficial. Q: I have benefitted from observing others teach?

40%

36% 20%

4% Strongly Agree

Agree

Neutral

Disagree

0% Strongly Disagree

However the question relating to preparation for the role of observer identified that respondents were less positive about this aspect as 36% were neutral and 28% disagreed. 82% of respondents indicated that their reflective activity was around their teaching in the classroom, this was a little surprising as the role of the lecturer within the school is multifaceted, however, this may have been influenced by the fact that many staff is involved in implementing new curricula which have included a number of learning and teaching approaches new to the experience of the school. Some of the key findings from this were further explored in a feedback discussion group made up of a representative from each group. The discussions supported the results of the questionnaire in terms of general support for the model. Some issues around practicalities were identified as groups sometimes found difficulty in arranging meetings due to individual commitments and found that usually one member of the group took responsibility for trying to arrange meetings. Once meetings were arranged they proved more beneficial when conducted away from the work area so that they had a more relaxed feel and staff felt able to discuss areas of concern and share good practice. Observations / discussion: The model of peer support has been successfully implemented within the School of Nursing and Midwifery and has continued into the academic year 2009/2010. The results indicate that the model provides a valuable contribution to effective staff development within the school in a way that POT alone would not accomplish. The literature surrounding peer review supports the approach adopted within the peer support model as it is important to ensure that staff feel they are in a safe environment to share and develop (Donnelly 2007 and Landmark et al 2004) It is interesting to note that even though the respondents had a high proportion of staff who have over ten years experience engagement in the process was still seen as valuable and beneficial, demonstrating the need for lifelong learning and ongoing professional development. An added benefit from the model is the development stronger working relationships with colleagues that are not normally involved in their subject area resulting in the development of some cross team working and shared learning for students. This is an important element of success as the department of Health and NMC have an increasing agenda for inter-professional learning. The need to enhance staff preparation for the role of observer is evident and training opportunities will be explored within the university. Some practical issues have been identified relating to areas like, clarity within documentation, which will be amended for use within future processes. Conclusions and recommendations: The project has demonstrated that the model of peer support is an effective mechanism that is valued by staff and it is proposed that it continues to be implemented within the school. The project team have presented the model at the Keele university innovations conference as well as a national conference (NET 2009) and intend to seek publication in a relevant journal. The following recommendations have been made: 1. Provide staff training regarding conducting peer observation of teaching 2. Amend documentation in light of feedback. 3. Disseminate across faculty and university.

References Anderson, L and O Pellicer, L. (2001) Teacher Peer Assistance and Review; A Practical Guide for Teachers and Administrators. Corwin Press. Thousand Oakes California Appling, S., Naumann, P. and Berk, R. (2001) Using a faculty evaluation triad to achieve evidence based teaching. Nursing and Health CarePerspectives: Vol. 22, No. 5, pp. 247–251 Bell, M. (2002) Peer Observation of Teaching in Australia. www.itsn.ac.uk/genericcentre Berk, R.A., Naumann, P.L., Appling, S.E. (2004) Beyond Student Ratings: Peer Observation of Classroom and Clinical Teaching. International Journal of Nursing Education Scholarship. 1(1):126 Cosh, J. (1998) Peer observation in higher education- A reflective approach. Innovations in Education and Training International. 35(2):171-176 D’Andrea, V and Gosling, D. (2005) Implementing Teaching and Learning in Higher Edocation; A Whole Instituion Approach. Berkshire. England. McGaraw Hill Education. OU Press Daloz, L (1999) Mentor; Guiding the journey of adult learners. (2nd Ed) San Francisco Jossey Bass Davys D, Mckenna J & Tickle E (2008) Peer Observation in professional development: Occupational therapists' perceptions. International Journal of Therapy and Rehabilitation Vol 15 No 6. pp 245-253. Davys, D., Jones, V. (2007) Peer observation: A tool for continuing professional development. International Journal of Therapy and Rehabilitation. 14(11): 489-493Donnelly R. (2007) Perceived Impact of Peer Observation of Teaching in Higher Education. International Journal of Teaching and Learning in Higher Education. 19(2):117-129 Hammersley-Fletcher, L., Orsmond, P. (2004) Evaluating our peers: is peer observation a meaningful process?. Studies in Higher Education. 29(4):489-503 Higher Education Academy (2006) National Professional Stadards Framework for Teaching and supporting Learning in Higher Education. London HEA Landmark, B., Wahl, A., Bøhler, A. (2004) Group supervision to support competency development in palliative care in Norway. International Journal of Palliative Nursing. 10(11): 542-548 Nursing and Midwifery Council )2006) PREP Handbook London NMC Peel, D. (2005) Peer observation as a transformatory tool? Teaching in Higher Education. 10(4):489-504 Shortland S (2004) Peer Observation: a tool for staff development of compliance? Journal of Further and Higher Education 28 (2) pp 210-28.

Appendices

Appendix 1 – School of Nursing and Midwifery Peer Support Strategy

Appendix 2 - Peer support documentation

Appendix 3 – Questionnaire

Appendix 4 – Summary of questionnaire results

Appendix 5 – Feedback session discussion areas

Appendix 1

KEELE UNIVERSITY SCHOOL OF NURSING AND MIDWIFERY ACADEMIC PEER SUPPORT STRATEGY BACKGROUND The School of Nursing and Midwifery academic peer support strategy has been developed in the wider context of support for the scholarship of learning and teaching. The strategy incorporates Keele University guidelines regarding peer observation of teaching (POT) and aims to facilitate achievement of the School’s learning and teaching plan. Health lecturers have a multifaceted role which not only inalized the need for effective classroom teaching and assessment, but also supporting students and practice mentors in inalized the learning experience whilst on clinical placements. Some aspects, for example the personal tutor or link tutor role, does not lend itself easily to a straightforward peer observation. Thus a system of peer review which includes observation of teaching is required. The proposed peer support model outlined below should be read in conjunction with the principles of POT as outlined in the Keele guidelines. The purposes of POT are: • To contribute to the provision of high quality educational experience for students • To enhance the importance attached to good teaching • To encourage all staff to reflect on the effectiveness of their own teaching and identify their developmental needs. • To foster discussion and dissemination of best practice • To increase staff awareness of the whole student experience • To identify any weaknesses so that they can be remedied. Keele Guidelines 2003 In addition to the above some additional points which relate to the needs of the school are: • To meet the requirements for professional registration and maintenance of a professional portfolio • To foster support to staff implementing innovative and dynamic learning and teaching strategies including Inter-professional and case based learning. • To encourage staff to implement shared learning strategies within programmes • To enable staff to reflect on and develop their role in supporting students as a personal tutor and clinical placement link tutor Peer support model The peer support model encompasses individual POT, one to one professional reflective practice and small peer support / learning sets. The intention is that groups which are made up of staff from different teams across the school will meet once a trimester. This will provide the opportunity for staff to develop an understanding of each others subject areas / teams as well as inalized sharing of best practice. In addition to these meetings each member of staff will also undergo one POT and one supported reflective practice session (RPS) from a member of the learning set per year. At the beginning of each academic year the support group / learning set will agree the areas they wish to explore during the meetings. And determine the pairings for the POT and reflective practice session. At the end of the process the group should agree a) any areas of good practice to be disseminated more widely across the school or faculty and b) any suggestions for school staff development activities. By the end of July each year written confirmation that the meetings and individual POT and RPS have taken place should be forwarded to the Chair of the Learning and Teaching Committee. Any detail relating to the content of meetings or feedback to individuals remains confidential in accordance with Keele guidelines.

School Executive Committee will identify proposed peer support groupings, of no more than 6 members of staff, which encompass all subjects / teams within the School. These will be amended and finalized following feedback from staff. The school is implementing a staff development programme around pedagogic scholarship and research which will use two Wednesday afternoons a month. Thus time will be available for peer support groups to meet during the remaining Wednesdays or at other times as agreed by the individual group The attached documentation should support this process and provide some guidance for staff.

Appendix 2 Form 1

School of Nursing & Midwifery

Peer Observation of Teaching

Lecturer Name………………………………………………… Observer Name……………………………………………….. Date of Observation………………………Venue…………………………………. Title of session observed…………………………………………………………… Award………………………………………..Branch………………………………… Module title…………………………………………………………………………….. Number of students……………. Type of session (lecture, tutorial etc)……………………………………………..

Observer’s feedback following observation: Strengths:

Areas for development:

Any areas for shared good practice:

Personal Critical Reflection:

Lecturer signature Date

Observers signature Date Lecturer’s copy.

Form 2

Peer Observation of Teaching. Observer’s prompts and notes: Teaching session Beginning of session (if appropriate) Is there a clear start to session? Is there any recap on the learning from the previous session? Is the previous session linked to the current one or is it made apparent where it fits within the module? Are the intended learning outcomes revealed?

Delivery of session Is interest and enthusiasm of students encouraged? Is the pace appropriate for all student learning? What modes of delivery are used? – are they appropriate and varied? How well are they managed? Are all students included in the session?

Use of learning resources Is a range of learning resources used? How effective are they? Are handouts available to the students in an appropriate format? Do learning resources enhance learning for all students?

Communication Is the communication of ideas relevant, clear and a level appropriate for all students? Is there opportunity for students to clarify their understanding? How is this done? What strategies are used to maintain attention and refocus students? Are these appropriate? Are there opportunities for students to think, question and communicate their ideas? What methods are used to encourage student

Yes No

Notes

participation? How effective is the questioning technique? Is appropriate use being made of praise?

Assessment of Learning Is learning checked throughout the session? Are the important learning points reinforced throughout the session? Are students given exercises, tasks or reflections to consolidate their learning? Are students aware of the purpose of any exercises given? Are students given the opportunity to practise relevant skills (if appropriate)?

Close of Session Is the session drawn to a satisfactory conclusion? Does the conclusion link to the work to be covered in the next session? Are important points reinforced? Are the intended learning outcomes revisited to check coverage? Are the students advised of additional follow up reading to consolidate their learning?

Any additional comments:

Observer’s copy. Please use these notes to complete the feedback paperwork for the lecturer.

Peer Support Group Record of Activity

Names:

Meeting Date / sign

Meeting Date / sign

Meeting Date / sign

Peer Observation of Teaching Date / sign

Areas of good practice/ future staff development:

Reflective Practice Session Date / sign

Appendix 5 PEER SUPPORT FEEDBACK SESSION. THEMES:

PROCESS. Please discuss the process of engaging with the peer support model. Include within this your views regarding the ease of organising meetings and the suitability of the documentation. FUNCTION. How did your peer group function? Please comment on the following areas: • Did anyone take the lead in organising the group meetings? • Did everyone engage in all aspects of the process? • What were the general feelings of group members towards the process? DISCUSSION AREAS. Please indicate the key areas that your peer group discussions explored.

TEAM DYNAMICS. Please comment on how well your group worked as a team. • Comment on whether group members had worked closely together prior to group allocations. • Were new members seamlessly integrated into your group? OUTPUT/EFFECTS. Was best practice identified within the group? Has your practice or that of your fellow peer group members changed in any way as a result of the process of peer support? In what way does the peer support process improve the quality of the student experience?

BENEFITS TO INDIVIDUALS. Do you feel that the process of peer support has been beneficial? If so, how?

THE FUTURE. Do you feel that the peer support model should carry on? • Please give your views on the benefits of this peer support model as opposed to the Keele University requirement for teaching observation.

What improvements could be made to the process? What type of further training would help to prepare staff to fully engage in the peer support model? • Please consider this in relation to undertaking the role of observer and facilitating reflective discussion. The questionnaire indicates that only 27% of respondents felt that student evaluations should not form part of the teaching observation. Discuss.