Observational analysis of near-peer and faculty tutoring in problem-based learning groups.

CONTEXT: Near-peer and faculty staff tutors may facilitate problem-based learning (PBL) through different means. Near-peer tutors are thought to compensate for their lack of subject matter expertise with greater adeptness at group facilitation and a better understanding of their learners. However, theoretical explanations of tutor effectiveness have been developed largely from recollections of tutor practices gathered through student evaluation surveys, focus groups and interviews. A closer look at what happens during PBL sessions tutored by near-peers and faculty members seems warranted to augment theory from a grounded perspective.

METHODS: We conducted an observational study to explore interactional practices during PBL tutorials at our medical school, at which near-peer tutoring of Year 2 students is an established practice. Between October 2014 and May 2015, video-recordings were made of nine purposively sampled tutor groups using three tutor types (near-peer, clinical faculty and basic science faculty staff) across three systems-based units. An investigator team comprising a Year 2 student, a Year 4 student and a behavioural scientist independently analysed the videos until their observations reached saturation and then met face to face to discuss their detailed field notes.

RESULTS: Through constant comparison, narratives of tutor practices and group dynamics were generated for each of the nine tutor groups, representing the collective impressions of the members of the investigator team.

CONCLUSIONS: Variation was greater within than across tutor types. Tutors' practices idiosyncratically and sometimes substantially diverged from PBL principles, yet all tutors attempted to convey authority or 'insider' status with respect to the short- and long-term goals of medical education. Students prompted these status demonstrations by expressing gratitude, asking questions and exhibiting analogous status demonstrations themselves. Understanding the socio-cognitive nature of tutoring from a grounded perspective may provide a means to develop faculty staff of all types to better meet learner needs in a principled fashion.