Characteristics and impacts of peer assisted learning in university studies in health science: A systematic review

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"apellidos" => "Jerez Yañez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "CESFAM Violeta Parra, Chillán, Región de Ñuble, Chile" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Programa Ayudantes Docentes, Facultad de Medicina, Universidad de Chile, Independencia, Región Metropolitana, Chile" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Educación en Ciencias de la Salud, Facultad de Medicina, Universidad de Chile, Independencia, Región Metropolitana, Chile" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Características e impactos del aprendizaje entre pares en estudios universitarios en ciencias de la salud: una revisión sistemática" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2633 "Ancho" => 2505 "Tamanyo" => 227593 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Flowchart of the selection of works according to the PRISMA protocol." ] ] ] "textoCompleto" => "IntroductionExpository teaching in a classroom has historically been the most used method in education centers. Nevertheless, it is the target of criticism due to its limitations, which include a lack of feedback regarding the students’ learning process, the assumption that all students learn at the same rate, the rapid decline in students’ attention, and the fact that information tends to be forgotten when it is learned passively<a class="elsevierStyleCrossRefs" href="#bib0005">1–3</a>.It has also been described that this traditional method is centered on teaching. Firstly, its aim is the acquisition and reproduction of a repertory of answers or a set of relevant knowledge. Secondly, students learn receptively, that is, by listening, reproducing, and performing certain tasks. The main actor in the process is the teacher and not the student<a class="elsevierStyleCrossRef" href="#bib0020">4</a>.In response to these limitations, new and varied methods have emerged, each with different approaches to the learning process, both for self-directed and in-person learning. One of the approaches that has begun to gain more traction is peer-assisted learning (PAL).Peer-assisted learning is an educational strategy that has been widely defined. It has been described as the acquisition of knowledge and skills through active support among people on the same level, that is, people from similar groups who mutually help one another to learn, while also learning during this process<a class="elsevierStyleCrossRefs" href="#bib0025">5,6</a>. Most of the definitions involve students in formal or deliberate processes, professionals without academic degrees, or educators working together to achieve learning objectives, to mutual benefit<a class="elsevierStyleCrossRef" href="#bib0035">7</a>.There are several terms that characterize the different applications of this strategy. The most commonly used are peer teaching, referring to learning among students on the same level, and near-peer teaching<a class="elsevierStyleCrossRef" href="#bib0040">8</a>, which refers to learning among students on different levels. These strategies have been successfully applied in various disciplines, both theoretical and clinical<a class="elsevierStyleCrossRefs" href="#bib0045">9,10</a>.Among the various advantages regarding this teaching method described in the literature, of note are an increase in tutors’ confidence in their own knowledge and the creation of a less intimidating environment for students, which facilitates asking questions and expressing reflections to the tutors<a class="elsevierStyleCrossRef" href="#bib0055">11</a>.Previous systematic reviews have analyzed the various scenarios in which peer-assisted learning has been used in its various modalities (peer teaching, mentoring, among others) in health sciences degrees<a class="elsevierStyleCrossRefs" href="#bib0060">12–14</a>. Significant benefits have been described for both the tutor and the student; some are quantitative in regard to grades<a class="elsevierStyleCrossRefs" href="#bib0060">12,13</a> and others are qualitative in regard to perceived benefits in the learning process.Although these reviews analyze peer-assisted teaching that has been applied or implemented in different ways<a class="elsevierStyleCrossRef" href="#bib0060">12</a>, they lack an analysis of some key differences, such as those which are peer teaching and near-peer teaching<a class="elsevierStyleCrossRefs" href="#bib0065">13–15</a>; or spontaneous and planned experiences. There is also a lack of exposition of the students’ perspectives; a lack of consideration of the groups’ heterogeneity<a class="elsevierStyleCrossRef" href="#bib0075">15</a>; no data on how the characteristics of these kinds of initiatives actually adapt to local conditions; and a lack of description of the programs’ characteristics, all of which makes these initiatives difficult to replicate in other contexts<a class="elsevierStyleCrossRefs" href="#bib0060">12–15</a>. To date, there are no systematic reviews that describe the aforementioned aspects.Therefore, this review’s aim and its contribution to the literature is to systematically analyze the characteristics and impacts of peer-assisted learning programs conducted as part of undergraduate university studies in the health sciences.MethodsSearch for information and key wordsThis study was conducted in accordance with PRISMA<a class="elsevierStyleCrossRef" href="#bib0080">16</a> declaration guidelines, a series of standards established for improving the quality of systematic reviews and meta-analyses which, in contrast to their predecessor (QUORUM<a class="elsevierStyleCrossRef" href="#bib0085">17</a>), include a greater number of study types.The indexed databases WoS and SCOPUS were used to conduct a literature search which included all articles published from 2010 to 2020 in Spanish or English which described characteristics of peer-assisted learning programs and their impact on learning, according to the PRISMA protocol.The terms combined in order to search in both databases were: peer teaching, higher education, graduate study, undergraduate study, postdoctoral education, program effectiveness, and program evaluation.Selection of articlesOnly the studies that met the following criteria were included:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">a)Empirical or primary studies that reported the effectiveness or lack of effectiveness of peer-assisted learning programs.</li><li class="elsevierStyleListItem" id="lsti0010">b)Studies that involved peer teaching or near-peer teaching.</li><li class="elsevierStyleListItem" id="lsti0015">c)Studies that reported research on in-person higher education.</li><li class="elsevierStyleListItem" id="lsti0020">d)Studies that reported research on health sciences undergraduate degrees and residency or the equivalent.</li><li class="elsevierStyleListItem" id="lsti0025">e)Quantitative studies with adequate definitions, operationalization of concepts, and data analysis.</li><li class="elsevierStyleListItem" id="lsti0030">f)Qualitative studies with adequate definitions of concepts, reliable methods, data analysis, and credible and valid conclusions.</li><li class="elsevierStyleListItem" id="lsti0035">g)Studies available in English and/or Spanish.</li><li class="elsevierStyleListItem" id="lsti0040">h)Regular or systematic initiatives or programs (as part of an organized or non-spontaneous structure or initiative).</li><li class="elsevierStyleListItem" id="lsti0045">i)Articles published between January 2010 and January 2020.</li></ul>This work excluded non-empirical or secondary articles such as reviews, editorials, commentaries, and books; articles not focused on higher education; articles that did not analyze in-person higher education; articles published in languages other than Spanish or English; articles focused on the validation and/or creation of instruments; articles on peer-assisted learning initiatives that were spontaneous in nature; and articles published prior to 2010.For the selection process, four of this review’s authors independently analyzed the titles and abstracts of the works obtained on the initial search, excluding those which were not relevant. Subsequently, each author read the selected works in their entirety in order to determine if they met the inclusion and exclusion criteria. In the event of a discrepancy, the article was discussed and then voted on by four of the researchers. In some cases, a fifth researcher was consulted to decide on whether to include the work.In order to evaluate the biases of the studies included in this review, two of the authors independently reviewed the works and identified biases. In the event of discrepancy, a third author was consulted. The possible biases that were able to be identified in the selected works included the size of the samples analyzed, heterogeneity in the application of the program's methods, loss to follow-up bias for participants who dropped out of the samples, and examiner bias for authors who are part of the development and implementation of the programs.ResultsCharacteristics of the articlesA total of 591 studies identified on the keyword search were obtained from the various databases. After eliminating duplicate results among the databases, a total of 398 articles underwent an initial analysis based on the information provided in the abstracts. This was conducted by four different researchers in order to determine if they met the inclusion or exclusion criteria. Finally, a total of 59 articles were obtained whose full text was analyzed.In the second stage of selection, which consisted of reading the complete texts, 12 articles were excluded for not meeting the established criteria (not pertaining to health sciences or regarding postgraduate education or specialty training). Therefore, a total of 47 studies were included<a class="elsevierStyleCrossRefs" href="#bib0090">18–64</a>. A flowchart illustrating the process can be seen in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Analysis of the resultsIn line with the proposed objectives, after reading the full texts, the selected works were organized into a table which summarized each study’s aims, type (quantitative, qualitative, mixed, cross-cutting, retrospective analyses, etc.), its relevant characteristics, results, and reported impacts on learning.Based on this table, we structured the analysis of results around two main items: (1) characteristics of peer-assisted learning programs and (2) main findings of the peer-assisted learning programs. In regard to the first item, we selected common characteristics of the programs and conducted a comparison among all of them in terms of the form of the peer-assisted learning (peer teaching or near-peer teaching), teaching method (theoretical class, laboratory, etc.), number of students per group, duration of the peer-assisted learning tutoring sessions, number of weekly sessions, total duration of the program in weeks, selection of tutors out of the totality of candidates, training of the tutors, payment or incentives for peer tutors, and selection of students in the sample analyzed. Concerning the second item, the various results of each work regarding the peer-assisted learning programs were compared and an analysis was conducted on each of them, as will be explained later.Evaluation of biasesAmong the main biases identified, we found a lack of randomization of case-control groups<a class="elsevierStyleCrossRefs" href="#bib0090">18,22,38,41</a>,<a class="elsevierStyleCrossRefs" href="#bib0215">43,54</a>; examiner bias in works in which the authors are also those who carry out the programs<a class="elsevierStyleCrossRefs" href="#bib0095">19,30,32,35</a>; memory bias in the case of retrospective studies<a class="elsevierStyleCrossRefs" href="#bib0095">19,37,55</a>; and the use of non-validated instruments for measuring objectives<a class="elsevierStyleCrossRefs" href="#bib0095">19,27,41</a>.In addition, the sample size of each of the studies was relatively small<a class="elsevierStyleCrossRefs" href="#bib0145">29,30,35,44</a>,<a class="elsevierStyleCrossRef" href="#bib0280">56</a>, limited to a single cohort of students<a class="elsevierStyleCrossRefs" href="#bib0130">26,45,49</a> and lacking medium- or long-term follow-up; thus, making it impossible to verify the impact or positive effects of the programs over time<a class="elsevierStyleCrossRefs" href="#bib0290">58,60</a>.In regard to methods, there was heterogeneity in the training and prior experience of the peer tutors involved. This heterogeneity was determined by no prior training of tutors<a class="elsevierStyleCrossRefs" href="#bib0200">40,48</a>, a lack of standardization of the training<a class="elsevierStyleCrossRef" href="#bib0225">45</a>, no evaluation following the training<a class="elsevierStyleCrossRef" href="#bib0250">50</a>, and no knowledge of the degree of prior experience of peer tutors<a class="elsevierStyleCrossRef" href="#bib0295">59</a>.Characteristics of the peer-assisted learning programsThe main characteristics observed and compiled during the analysis are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>, which describes all works that reported each characteristic and identifies the main differences among them. It is important to highlight that the percentages shown in each category are out of the number of works which reported each specific characteristic, not the total number of selected works.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Below, each characteristic is analyzed in detail.When observing the methods that the various peer-assisted learning programs used, it should be noted that the majority used near-peer teaching (75.7%) compared to peer teaching (24.3%) while the rest of the works (n = 10) did not specify the type of method used. We can also observe that the most used teaching method was the laboratory (43.5%) followed by theoretical classes (39.1%).Another of the characteristic analyzed was the organization of the peer-assisted learning programs. The duration of the sessions must be mentioned; in general, most lasted for more than one hour (74.1%). The majority of peer-assisted learning programs had at least one session per week (70.6%) and the total duration of the programs tended to be 12 weeks or less (72.7%), with a slight trend towards programs which lasted for six weeks or less (40.9%).The next characteristic was the number of students per tutoring session. This variable was categorized as sessions with either more than or fewer than ten students. Both categories had the same number of studies and therefore, there were no significant differences.Another important characteristic was the selection and training of peer tutors. There was a slight trend toward the presence of some selection criterion or mechanism (56.7%) and the vast majority of peer tutors received some type of training (82.8%). In the great majority of studies analyzed, the tutors did not receive any type of incentive or payment for their role in the program (76.5%).In addition, it was observed that works which described statistically significant quantitative results (n = 7) regarding the effectiveness of peer-assisted learning programs tended to use the near-peer teaching method (n = 4) more than the peer teaching method (n = 1).Main findings of peer-assisted learning programsThe most relevant findings identified upon conducting the analysis are presented in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>, which shows the number of works that report each finding. Subsequently, to systematize and deepen the analysis, each finding was classified into three broad categories, which are defined below:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0050">1Role and identity: This finding is related to the impact that peer-assisted learning programs have on the role each individual plays with respect to their peers and/or students, their preparation, their characteristics, general competences<a class="elsevierStyleCrossRef" href="#bib0315">63</a>, and the creation of networks.</li><li class="elsevierStyleListItem" id="lsti0055">2Effectiveness: This finding is related to the impact that peer-assisted learning programs have on students’ learning, demonstrated through some quantitative or qualitative variable.</li><li class="elsevierStyleListItem" id="lsti0060">3Facilitation and experience: This finding is related to the impact the peer-assisted learning interventions have on the students’ subjective learning experience.</li></ul><elsevierMultimedia ident="tbl0010"></elsevierMultimedia>The findings are summarized in the following section according to the above-described categories.Role and identityStudies in this category mainly report peer tutors’ perception regarding their role in peer-assisted learning programs. One of the most relevant findings observed has to do with the fact that 14 works stated that peer tutors reported an improvement in their teaching skills and another 13 reported an improvement in their level of knowledge.Other findings that were not as represented as those mentioned above, but which were no less relevant, highlight one work which described that peer tutors perceived an increase in their motivation to teach; another work reported that the peer tutors’ training improved students’ academic performance; and lastly, a work which noted that students identified the peer tutor as a role model.EffectivenessOne distinctive feature of this category is that its findings relate to both qualitative and quantitative elements identified in the works that were analyzed. Concerning the qualitative findings, 11 works highlight that the students perceived the peer-assisted learning programs as an effective method for learning and another five report that students improved their understanding of the content that was taught.Regarding the effectiveness of peer tutors, three works described that there was no significant difference between sessions taught by professors or peer tutors. When comparing effectiveness of peer tutors with different levels of training, three works reported that peer tutors who had a level closer to that of the students were evaluated better by them.Upon analyzing quantitative findings—in particular the effect on academic performance measured as an improvement in results on academic evaluations—although six studies reported there was a statistically significant improvement, a total of 11 works did not find a statistically significant improvement on academic evaluations when comparing the peer-assisted learning programs to traditional curricula that does not use this teaching method. Therefore, the evidence on this point is inconclusive.Facilitation and experienceThe elements related to the subjective experience regarding the learning process were included in this category. The findings that were observed most frequently were related to the learning environment and each student's confidence.In regard to the environment, 11 works reported that students perceived a positive learning environment; nine works stated that students reported greater comfort when interacting with peer tutors than with professors; and lastly, three works described less anxiety and stress in the learning environment.Regarding confidence, in nine works, students stated they felt more prepared for their future evaluations after participating in peer-assisted learning programs and two works describe an increase in confidence in their knowledge. In addition, in one work, students reported greater motivation for learning. Furthermore, in two works, the students explicitly reported that they would recommend this type of method.Conversely, one work showed that the effect of peer-assisted learning programs on students’ confidence in their knowledge is not conclusive.DiscussionIn regard to the analysis of peer-assisted learning programs’ characteristics, the majority of works that report qualitative benefits have processes for selecting and training the tutors that are incorporated into the program. This is in line with what Gillies<a class="elsevierStyleCrossRef" href="#bib0320">64</a> described regarding the importance of the tutors’ interpersonal skills for effective mediation and conflict resolution among group members. However, these studies do not detail the specific characteristics of the selection and training processes. Additionally, some studies report providing monetary or academic incentives (for example, reference letters) to the tutors, without evaluating impact of those incentives.Another interesting element observed regarding the type of method is that near-peer teaching is used more frequently than peer teaching, which can be interpreted as differences in the participants’ level of knowledge facilitating the learning interaction<a class="elsevierStyleCrossRef" href="#bib0080">16</a> where there is already cognitive congruence<a class="elsevierStyleCrossRef" href="#bib0325">65</a> between both parties.Half of the works reviewed reported that the groups of students comprised ten or more students, despite the fact that the benefits of small groups have been described in the literature<a class="elsevierStyleCrossRef" href="#bib0330">66</a>. Some studies implemented peer-assisted learning in order to reduce education costs<a class="elsevierStyleCrossRef" href="#bib0100">20</a>, which could explain the high number of students per group. However, this relationship and its consequences falls outside the scope of this work’s objectives.Among the characteristics related to the programs’ organization, it was observed that most programs had less than one session per week and the majority of studies had a total program duration of less than one semester. This could be understood due to the high academic workload of health sciences degrees. It is striking that the majority of these programs are carried out as something complementary to each degree's formal curriculum and not part of it.The second focus of our study is an analysis of the main findings identified in the programs. On the one hand, it is noteworthy that students report more confidence in the material; a friendly, positive learning environment; more closeness to the tutors; and feeling better prepared for future evaluations. On the other hand, the tutors reported benefits in their perception of their knowledge and teaching skills, for example. These benefits are related to the concept of cognitive congruence<a class="elsevierStyleCrossRef" href="#bib0325">65</a>. However, there are other elements which facilitate learning and have to do with the interaction between a peer tutor and a student and the environment created in the sessions.Concerning the quantitative effect of peer-assisted learning programs, reflected as improvement on academic evaluations, it is not so clear. At least 11 of the works reviewed report that the effect on academic performance is not conclusive. However, the manner in which this was evaluated differed depending on the study’s context. The majority measured capacity to retain information; OSCE-type evaluations which evaluate practical skills are very infrequent. In addition, the majority of works measured academic performance in the short-term. Effects on long-term learning have not been reported.Though the characteristics and findings are approached separately, we consider them to be closely related, considering that each characteristic will help build the environment where the learning takes place. From this perspective, the analysis of the characteristics serves to determine the reality of peer-assisted learning programs at each university, observe differences, and compare the different outcomes. Moreover, the analysis of each program’s results allows us to compare the benefits of each experience and their impact on learning.The limitations of our review must be noted. Firstly, there is a restriction regarding the databases used: only indexes with greater scientific relevance (WoS and Scopus) were included. EMBASE and ERIC, among others, are not guaranteed to be included in these indexes. Therefore, relevant works may have been excluded or omitted. Secondly, the works selected were limited to those in Spanish and English, excluding literature published in other languages. Lastly, the great degree of heterogeneity among the different studies makes their comparison or a meta-analysis difficult. This highlights the need to incorporate various disciplines into the analysis, which would allow us to compare methods and could provide a more comprehensive vision of learning through this type of experience.ConclusionThis study allows us to draw two main conclusions: first, programs that use peer-assisted learning methods in university health sciences degrees have a positive impact on students which is mainly reflected in the process and the learning experience and in a safer, more tight-knit, and more accessible environment facilitated by the peer tutors. The benefits in terms of academic results are not yet clear and their analysis goes beyond our work’s objective. Second, some characteristics are more common among the programs, but the conditions of each center and program are heterogeneous. Therefore, we believe that it is not possible to determine the impact of each characteristic on the learning process with this information.A possible future analysis of programs with similar scenarios will allow us to: (1) more precisely identify how each characteristic affects students’ and peer tutors’ learning; (2) apply the most important characteristics to future programs in a cross-disciplinary manner and promote positive learning outcomes, thus optimizing each center’s human and financial resources; and (3) improve educational indicators, reduce drop-out rates; and promote the creation of networks.The effect of selecting and training peer tutors, the impact of peer-assisted learning on academic results as measured through standardized evaluations, and their effect on long-term learning are some of the elements that are not present in the reviewed studies, but which would be interesting aspects for future research.FundingThe research has not received specific grants from agencies in the public, commercial, or non-profit sectors.Conflicts of interestThe authors of this work declare that they do not have any conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1641248" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1463246" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1641249" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1463245" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Search for information and key words" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Selection of articles" ] ] ] 6 => array:3 [ "identificador" => "sec0025" "titulo" => "Results" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Characteristics of the articles" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Analysis of the results" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Evaluation of biases" ] 3 => array:2 [ "identificador" => "sec0045" "titulo" => "Characteristics of the peer-assisted learning programs" ] 4 => array:3 [ "identificador" => "sec0050" "titulo" => "Main findings of peer-assisted learning programs" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0055" "titulo" => "Role and identity" ] 1 => array:2 [ "identificador" => "sec0060" "titulo" => "Effectiveness" ] 2 => array:2 [ "identificador" => "sec0065" "titulo" => "Facilitation and experience" ] ] ] ] ] 7 => array:2 [ "identificador" => "sec0070" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0075" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0080" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0085" "titulo" => "Conflicts of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-12-22" "fechaAceptado" => "2021-02-11" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1463246" "palabras" => array:6 [ 0 => "Peer assisted learning" 1 => "Peer teaching" 2 => "Near-peer teaching" 3 => "Students" 4 => "Health science" 5 => "PRISMA" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1463245" "palabras" => array:6 [ 0 => "Aprendizaje asistido por pares" 1 => "Aprendizaje entre pares" 2 => "Aprendizaje entre pares próximos" 3 => "Estudiantes" 4 => "Ciencias de la salud" 5 => "PRISMA" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveSystematically analyse the characteristics and impact of peer assisted learning programmes implemented in undergraduate health education. MethodsFollowing the PRISMA protocol, we searched the electronic indexed databases WoS and SCOPUS; original studies reporting peer assisted learning in health science careers were included in the systematic review. Among them, the studies between 2010 and January 2020 were selected, and information regarding programme structures and principal results was subsequently extracted. ResultsA total of 47 studies were included in the review. The most frequent programme characteristics were the near-peer teaching modality, lecture classes, clinical laboratories and peer tutor training. The main findings identified were benefits in tutors’ confidence and knowledge, better student comprehension and a more comfortable learning environment in comparison with that established by academic tutors. ConclusionPeer assisted learning programmes have shown qualitative benefits in the learning environment, generation of support networks and confidence in knowledge acquired. Nonetheless, quantitative benefits measured as improvements in marks are inconclusive. Future studies are needed to standardise the methodologies used to determine which characteristics are the most positive in the learning process." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivoAnalizar sistemáticamente las características y los impactos de los programas e iniciativas de aprendizaje asistido por pares realizados en estudios universitarios en ciencias de la salud en los cursos de pregrado. MétodosSiguiendo el protocolo PRISMA, se realizó una búsqueda en las bases de datos indexadas en WoS y SCOPUS, con todos los trabajos originales que reportan aprendizaje asistido por pares en estudios universitarios en ciencias de la salud. Se seleccionaron artículos originales entre enero de 2010 y enero de 2020, analizando la información sobre las características de los programas y los principales resultados e impactos de los estudios. ResultadosSe incluyeron 47 estudios en la revisión. Las características de los programas más representadas fueron la utilización de la modalidad aprendizaje entre pares próximos, el uso de clases teóricas, laboratorios clínicos y la capacitación a los tutores pares. Los principales impactos identificados son los beneficios en la confianza y en el conocimiento de los tutores, la mejor comprensión de los contenidos y la mayor comodidad en comparación con los tutores académicos en los estudiantes. ConclusiónLos programas de aprendizaje asistido por pares han demostrado beneficios cualitativos relativos al ambiente de aprendizaje, la generación de redes de apoyo y la confianza en los conocimientos adquiridos. Sin embargo, los beneficios cuantitativos, medidos como mejoría en las calificaciones, no son concluyentes. Se necesitan futuros estudios que busquen indagar sobre las metodologías utilizadas para detectar qué características impactan más positivamente sobre el proceso de aprendizaje." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "⋆" "nota" => "Please cite this article as: Hernández Coliñir J, Molina Gallardo L, González Morales D, Ibáñez Sanhueza C, Jerez Yañez O. Características e impactos del aprendizaje entre pares en estudios universitarios en ciencias de la salud: una revisión sistemática. Rev Clin Esp. 2022;222:44–53." ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2633 "Ancho" => 2505 "Tamanyo" => 227593 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Flowchart of the selection of works according to the PRISMA protocol." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Characteristic \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N (%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Peer-assisted learning method (n = 37)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Near-peer teaching \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Peer teaching \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Teaching method (n = 46)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Laboratory practicum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Theory class \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Exam simulation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">People per group (n = 28)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 10 people \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">> 10 people \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number of sessions (n = 17)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≤ 1 per week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">> 1 per week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Duration of sessions (n = 27)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Up to 1 hour \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">More than 1 hour \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Program duration (n = 22)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1-6 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6-12 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">> 12 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Selection of peer tutors (n = 30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Training of tutors (n = 29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Payment or incentives for tutors (n = 17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Selection of students (n = 31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2795955.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Other: role play (n = 4), case discussion (n = 4), mentoring (n = 3), seminars (n = 2), problem-based learning (n = 2)." ] ] ] "descripcion" => array:1 [ "en" => "Characteristics of the peer-assisted learning programs analysed." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Category \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Key findings \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">References \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Role and identity</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The peer tutors report an improvement in their level of knowledge \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0110">22,25,28,31,35,43,47,49,50,51,54,56,57,59</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The peer tutors report an improvement in their teaching skills \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0110">22,25,29,31,43,47,49,50,51,54,56,57,59</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Peer tutors’ training improves students’ academic performance \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0190">38</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The peer tutor is identified as a role model \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0235">47</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The peer tutors report an increase in their motivation to teach \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0215">43</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Effectiveness</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Students perceive peer teaching as an effective teaching method \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0090">18,32,35,39,41,42,48,50,54,59,60</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The effects of peer-assisted learning on academic performance are not conclusive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0090">18,21,26,33,35,37,39,45,47,54,57</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The effects of peer-assisted learning on academic performance are statistically significant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0120">24,27,52,53,55,60</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Students improved their understanding of the content \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0100">20,24,41,50,61</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Peer tutors with a more similar level of education are more highly evaluated by students compared to peer tutors with more advanced levels \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0160">32,36,58</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">There were no statistically significant differences in the effectiveness of the sessions taught by peer tutors compared to academics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0085">17,28–45</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="8" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Facilitation and experience</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">A positive learning environment is described \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0035">7,11,18,24,27,29,30,45,46,47,48</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Students perceive themselves to be better prepared for evaluations after implementation of the peer-assisted learning program \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0105">21,24,25,26,29,34,37,59,61</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Students perceive themselves to be more comfortable interacting with peer tutors \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0055">11,18,24,25,32,45,48,49</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Students describe less anxiety and stress when interacting with peer tutors \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0055">11,24,26</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Students report an increase in confidence in their knowledge after the tutoring sessions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0035">7,34,49</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Students would recommend the peer-assisted learning method \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0205">41,49</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Students describe a greater motivation to learn \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0230">46</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The effects of peer-assisted learning on students’ confidence in their knowledge are not conclusive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0105">21</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2795954.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Key findings related to the impact of peer-assisted learning." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:66 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Professional Standards for Teaching Mathematics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Commission on Teaching Standards for School Mathematics" 1 => "National Council of Teachers of Mathematics (NCTM)" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1991" "editorial" => "National Council of Teachers of Mathematics" "editorialLocalizacion" => "Reston" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "National Science Education Standards" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "National Research Council" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.17226/4962" "Libro" => array:3 [ "fecha" => "1996" "editorial" => "The National Academies Press" "editorialLocalizacion" => "Washington, DC" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is traditional teaching really all that bad? 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Characteristics and impacts of peer assisted learning in university studies in health science: A systematic review

Características e impactos del aprendizaje entre pares en estudios universitarios en ciencias de la salud: una revisión sistemática

J. Hernández Coliñira, L. Molina Gallardoa, D. González Moralesb,c,

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dgonzalezmorales22@gmail.com

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, C. Ibáñez Sanhuezac, O. Jerez Yañezc

a CESFAM Violeta Parra, Chillán, Región de Ñuble, Chile

b Programa Ayudantes Docentes, Facultad de Medicina, Universidad de Chile, Independencia, Región Metropolitana, Chile

c Departamento de Educación en Ciencias de la Salud, Facultad de Medicina, Universidad de Chile, Independencia, Región Metropolitana, Chile

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Expository teaching in a classroom has historically been the most used method in education centers&#46; Nevertheless&#44; it is the target of criticism due to its limitations&#44; which include a lack of feedback regarding the students&#8217; learning process&#44; the assumption that all students learn at the same rate&#44; the rapid decline in students&#8217; attention&#44; and the fact that information tends to be forgotten when it is learned passively<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">It has also been described that this traditional method is centered on teaching&#46; Firstly&#44; its aim is the acquisition and reproduction of a repertory of answers or a set of relevant knowledge&#46; Secondly&#44; students learn receptively&#44; that is&#44; by listening&#44; reproducing&#44; and performing certain tasks&#46; The main actor in the process is the teacher and not the student<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In response to these limitations&#44; new and varied methods have emerged&#44; each with different approaches to the learning process&#44; both for self-directed and in-person learning&#46; One of the approaches that has begun to gain more traction is peer-assisted learning &#40;PAL&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Peer-assisted learning is an educational strategy that has been widely defined&#46; It has been described as the acquisition of knowledge and skills through active support among people on the same level&#44; that is&#44; people from similar groups who mutually help one another to learn&#44; while also learning during this process<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; Most of the definitions involve students in formal or deliberate processes&#44; professionals without academic degrees&#44; or educators working together to achieve learning objectives&#44; to mutual benefit<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">There are several terms that characterize the different applications of this strategy&#46; The most commonly used are peer teaching&#44; referring to learning among students on the same level&#44; and near-peer teaching<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#44; which refers to learning among students on different levels&#46; These strategies have been successfully applied in various disciplines&#44; both theoretical and clinical<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Among the various advantages regarding this teaching method described in the literature&#44; of note are an increase in tutors&#8217; confidence in their own knowledge and the creation of a less intimidating environment for students&#44; which facilitates asking questions and expressing reflections to the tutors<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Previous systematic reviews have analyzed the various scenarios in which peer-assisted learning has been used in its various modalities &#40;peer teaching&#44; mentoring&#44; among others&#41; in health sciences degrees<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#8211;14</span></a>&#46; Significant benefits have been described for both the tutor and the student&#59; some are quantitative in regard to grades<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a> and others are qualitative in regard to perceived benefits in the learning process&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Although these reviews analyze peer-assisted teaching that has been applied or implemented in different ways<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#44; they lack an analysis of some key differences&#44; such as those which are peer teaching and near-peer teaching<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#8211;15</span></a>&#59; or spontaneous and planned experiences&#46; There is also a lack of exposition of the students&#8217; perspectives&#59; a lack of consideration of the groups&#8217; heterogeneity<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#59; no data on how the characteristics of these kinds of initiatives actually adapt to local conditions&#59; and a lack of description of the programs&#8217; characteristics&#44; all of which makes these initiatives difficult to replicate in other contexts<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#8211;15</span></a>&#46; To date&#44; there are no systematic reviews that describe the aforementioned aspects&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Therefore&#44; this review&#8217;s aim and its contribution to the literature is to systematically analyze the characteristics and impacts of peer-assisted learning programs conducted as part of undergraduate university studies in the health sciences&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Search for information and key words</span><p id="par0050" class="elsevierStylePara elsevierViewall">This study was conducted in accordance with PRISMA<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> declaration guidelines&#44; a series of standards established for improving the quality of systematic reviews and meta-analyses which&#44; in contrast to their predecessor &#40;QUORUM<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#41;&#44; include a greater number of study types&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The indexed databases WoS and SCOPUS were used to conduct a literature search which included all articles published from 2010 to 2020 in Spanish or English which described characteristics of peer-assisted learning programs and their impact on learning&#44; according to the PRISMA protocol&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The terms combined in order to search in both databases were&#58; peer teaching&#44; higher education&#44; graduate study&#44; undergraduate study&#44; postdoctoral education&#44; program effectiveness&#44; and program evaluation&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Selection of articles</span><p id="par0065" class="elsevierStylePara elsevierViewall">Only the studies that met the following criteria were included&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a&#41;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Empirical or primary studies that reported the effectiveness or lack of effectiveness of peer-assisted learning programs&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b&#41;</span><p id="par0075" class="elsevierStylePara elsevierViewall">Studies that involved peer teaching or near-peer teaching&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">c&#41;</span><p id="par0080" class="elsevierStylePara elsevierViewall">Studies that reported research on in-person higher education&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">d&#41;</span><p id="par0085" class="elsevierStylePara elsevierViewall">Studies that reported research on health sciences undergraduate degrees and residency or the equivalent&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">e&#41;</span><p id="par0090" class="elsevierStylePara elsevierViewall">Quantitative studies with adequate definitions&#44; operationalization of concepts&#44; and data analysis&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">f&#41;</span><p id="par0095" class="elsevierStylePara elsevierViewall">Qualitative studies with adequate definitions of concepts&#44; reliable methods&#44; data analysis&#44; and credible and valid conclusions&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">g&#41;</span><p id="par0100" class="elsevierStylePara elsevierViewall">Studies available in English and&#47;or Spanish&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">h&#41;</span><p id="par0105" class="elsevierStylePara elsevierViewall">Regular or systematic initiatives or programs &#40;as part of an organized or non-spontaneous structure or initiative&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">i&#41;</span><p id="par0110" class="elsevierStylePara elsevierViewall">Articles published between January 2010 and January 2020&#46;</p></li></ul></p><p id="par0115" class="elsevierStylePara elsevierViewall">This work excluded non-empirical or secondary articles such as reviews&#44; editorials&#44; commentaries&#44; and books&#59; articles not focused on higher education&#59; articles that did not analyze in-person higher education&#59; articles published in languages other than Spanish or English&#59; articles focused on the validation and&#47;or creation of instruments&#59; articles on peer-assisted learning initiatives that were spontaneous in nature&#59; and articles published prior to 2010&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">For the selection process&#44; four of this review&#8217;s authors independently analyzed the titles and abstracts of the works obtained on the initial search&#44; excluding those which were not relevant&#46; Subsequently&#44; each author read the selected works in their entirety in order to determine if they met the inclusion and exclusion criteria&#46; In the event of a discrepancy&#44; the article was discussed and then voted on by four of the researchers&#46; In some cases&#44; a fifth researcher was consulted to decide on whether to include the work&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">In order to evaluate the biases of the studies included in this review&#44; two of the authors independently reviewed the works and identified biases&#46; In the event of discrepancy&#44; a third author was consulted&#46; The possible biases that were able to be identified in the selected works included the size of the samples analyzed&#44; heterogeneity in the application of the program&#39;s methods&#44; loss to follow-up bias for participants who dropped out of the samples&#44; and examiner bias for authors who are part of the development and implementation of the programs&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Characteristics of the articles</span><p id="par0130" class="elsevierStylePara elsevierViewall">A total of 591 studies identified on the keyword search were obtained from the various databases&#46; After eliminating duplicate results among the databases&#44; a total of 398 articles underwent an initial analysis based on the information provided in the abstracts&#46; This was conducted by four different researchers in order to determine if they met the inclusion or exclusion criteria&#46; Finally&#44; a total of 59 articles were obtained whose full text was analyzed&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In the second stage of selection&#44; which consisted of reading the complete texts&#44; 12 articles were excluded for not meeting the established criteria &#40;not pertaining to health sciences or regarding postgraduate education or specialty training&#41;&#46; Therefore&#44; a total of 47 studies were included<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#8211;64</span></a>&#46; A flowchart illustrating the process can be seen in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Analysis of the results</span><p id="par0140" class="elsevierStylePara elsevierViewall">In line with the proposed objectives&#44; after reading the full texts&#44; the selected works were organized into a table which summarized each study&#8217;s aims&#44; type &#40;quantitative&#44; qualitative&#44; mixed&#44; cross-cutting&#44; retrospective analyses&#44; etc&#46;&#41;&#44; its relevant characteristics&#44; results&#44; and reported impacts on learning&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Based on this table&#44; we structured the analysis of results around two main items&#58; &#40;1&#41; characteristics of peer-assisted learning programs and &#40;2&#41; main findings of the peer-assisted learning programs&#46; In regard to the first item&#44; we selected common characteristics of the programs and conducted a comparison among all of them in terms of the form of the peer-assisted learning &#40;peer teaching or near-peer teaching&#41;&#44; teaching method &#40;theoretical class&#44; laboratory&#44; etc&#46;&#41;&#44; number of students per group&#44; duration of the peer-assisted learning tutoring sessions&#44; number of weekly sessions&#44; total duration of the program in weeks&#44; selection of tutors out of the totality of candidates&#44; training of the tutors&#44; payment or incentives for peer tutors&#44; and selection of students in the sample analyzed&#46; Concerning the second item&#44; the various results of each work regarding the peer-assisted learning programs were compared and an analysis was conducted on each of them&#44; as will be explained later&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Evaluation of biases</span><p id="par0150" class="elsevierStylePara elsevierViewall">Among the main biases identified&#44; we found a lack of randomization of case-control groups<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;22&#44;38&#44;41</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">43&#44;54</span></a>&#59; examiner bias in works in which the authors are also those who carry out the programs<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;30&#44;32&#44;35</span></a>&#59; memory bias in the case of retrospective studies<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;37&#44;55</span></a>&#59; and the use of non-validated instruments for measuring objectives<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;27&#44;41</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">In addition&#44; the sample size of each of the studies was relatively small<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">29&#44;30&#44;35&#44;44</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">56</span></a>&#44; limited to a single cohort of students<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#44;45&#44;49</span></a> and lacking medium- or long-term follow-up&#59; thus&#44; making it impossible to verify the impact or positive effects of the programs over time<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">58&#44;60</span></a>&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">In regard to methods&#44; there was heterogeneity in the training and prior experience of the peer tutors involved&#46; This heterogeneity was determined by no prior training of tutors<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">40&#44;48</span></a>&#44; a lack of standardization of the training<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">45</span></a>&#44; no evaluation following the training<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">50</span></a>&#44; and no knowledge of the degree of prior experience of peer tutors<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">59</span></a>&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Characteristics of the peer-assisted learning programs</span><p id="par0165" class="elsevierStylePara elsevierViewall">The main characteristics observed and compiled during the analysis are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#44; which describes all works that reported each characteristic and identifies the main differences among them&#46; It is important to highlight that the percentages shown in each category are out of the number of works which reported each specific characteristic&#44; not the total number of selected works&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0170" class="elsevierStylePara elsevierViewall">Below&#44; each characteristic is analyzed in detail&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">When observing the methods that the various peer-assisted learning programs used&#44; it should be noted that the majority used near-peer teaching &#40;75&#46;7&#37;&#41; compared to peer teaching &#40;24&#46;3&#37;&#41; while the rest of the works &#40;n&#8239;&#61;&#8239;10&#41; did not specify the type of method used&#46; We can also observe that the most used teaching method was the laboratory &#40;43&#46;5&#37;&#41; followed by theoretical classes &#40;39&#46;1&#37;&#41;&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Another of the characteristic analyzed was the organization of the peer-assisted learning programs&#46; The duration of the sessions must be mentioned&#59; in general&#44; most lasted for more than one hour &#40;74&#46;1&#37;&#41;&#46; The majority of peer-assisted learning programs had at least one session per week &#40;70&#46;6&#37;&#41; and the total duration of the programs tended to be 12 weeks or less &#40;72&#46;7&#37;&#41;&#44; with a slight trend towards programs which lasted for six weeks or less &#40;40&#46;9&#37;&#41;&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">The next characteristic was the number of students per tutoring session&#46; This variable was categorized as sessions with either more than or fewer than ten students&#46; Both categories had the same number of studies and therefore&#44; there were no significant differences&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Another important characteristic was the selection and training of peer tutors&#46; There was a slight trend toward the presence of some selection criterion or mechanism &#40;56&#46;7&#37;&#41; and the vast majority of peer tutors received some type of training &#40;82&#46;8&#37;&#41;&#46; In the great majority of studies analyzed&#44; the tutors did not receive any type of incentive or payment for their role in the program &#40;76&#46;5&#37;&#41;&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">In addition&#44; it was observed that works which described statistically significant quantitative results &#40;n&#8239;&#61;&#8239;7&#41; regarding the effectiveness of peer-assisted learning programs tended to use the near-peer teaching method &#40;n&#8239;&#61;&#8239;4&#41; more than the peer teaching method &#40;n&#8239;&#61;&#8239;1&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Main findings of peer-assisted learning programs</span><p id="par0200" class="elsevierStylePara elsevierViewall">The most relevant findings identified upon conducting the analysis are presented in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#44; which shows the number of works that report each finding&#46; Subsequently&#44; to systematize and deepen the analysis&#44; each finding was classified into three broad categories&#44; which are defined below&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">1</span><p id="par0205" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Role and identity&#58;</span> This finding is related to the impact that peer-assisted learning programs have on the role each individual plays with respect to their peers and&#47;or students&#44; their preparation&#44; their characteristics&#44; general competences<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">63</span></a>&#44; and the creation of networks&#46;</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">2</span><p id="par0210" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Effectiveness&#58;</span> This finding is related to the impact that peer-assisted learning programs have on students&#8217; learning&#44; demonstrated through some quantitative or qualitative variable&#46;</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">3</span><p id="par0215" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Facilitation and experience&#58;</span> This finding is related to the impact the peer-assisted learning interventions have on the students&#8217; subjective learning experience&#46;</p></li></ul></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0220" class="elsevierStylePara elsevierViewall">The findings are summarized in the following section according to the above-described categories&#46;</p><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Role and identity</span><p id="par0225" class="elsevierStylePara elsevierViewall">Studies in this category mainly report peer tutors&#8217; perception regarding their role in peer-assisted learning programs&#46; One of the most relevant findings observed has to do with the fact that 14 works stated that peer tutors reported an improvement in their teaching skills and another 13 reported an improvement in their level of knowledge&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Other findings that were not as represented as those mentioned above&#44; but which were no less relevant&#44; highlight one work which described that peer tutors perceived an increase in their motivation to teach&#59; another work reported that the peer tutors&#8217; training improved students&#8217; academic performance&#59; and lastly&#44; a work which noted that students identified the peer tutor as a role model&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Effectiveness</span><p id="par0235" class="elsevierStylePara elsevierViewall">One distinctive feature of this category is that its findings relate to both qualitative and quantitative elements identified in the works that were analyzed&#46; Concerning the qualitative findings&#44; 11 works highlight that the students perceived the peer-assisted learning programs as an effective method for learning and another five report that students improved their understanding of the content that was taught&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Regarding the effectiveness of peer tutors&#44; three works described that there was no significant difference between sessions taught by professors or peer tutors&#46; When comparing effectiveness of peer tutors with different levels of training&#44; three works reported that peer tutors who had a level closer to that of the students were evaluated better by them&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">Upon analyzing quantitative findings&#8212;in particular the effect on academic performance measured as an improvement in results on academic evaluations&#8212;although six studies reported there was a statistically significant improvement&#44; a total of 11 works did not find a statistically significant improvement on academic evaluations when comparing the peer-assisted learning programs to traditional curricula that does not use this teaching method&#46; Therefore&#44; the evidence on this point is inconclusive&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Facilitation and experience</span><p id="par0250" class="elsevierStylePara elsevierViewall">The elements related to the subjective experience regarding the learning process were included in this category&#46; The findings that were observed most frequently were related to the learning environment and each student&#39;s confidence&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">In regard to the environment&#44; 11 works reported that students perceived a positive learning environment&#59; nine works stated that students reported greater comfort when interacting with peer tutors than with professors&#59; and lastly&#44; three works described less anxiety and stress in the learning environment&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">Regarding confidence&#44; in nine works&#44; students stated they felt more prepared for their future evaluations after participating in peer-assisted learning programs and two works describe an increase in confidence in their knowledge&#46; In addition&#44; in one work&#44; students reported greater motivation for learning&#46; Furthermore&#44; in two works&#44; the students explicitly reported that they would recommend this type of method&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall">Conversely&#44; one work showed that the effect of peer-assisted learning programs on students&#8217; confidence in their knowledge is not conclusive&#46;</p></span></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0270" class="elsevierStylePara elsevierViewall">In regard to the analysis of peer-assisted learning programs&#8217; characteristics&#44; the majority of works that report qualitative benefits have processes for selecting and training the tutors that are incorporated into the program&#46; This is in line with what Gillies<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">64</span></a> described regarding the importance of the tutors&#8217; interpersonal skills for effective mediation and conflict resolution among group members&#46; However&#44; these studies do not detail the specific characteristics of the selection and training processes&#46; Additionally&#44; some studies report providing monetary or academic incentives &#40;for example&#44; reference letters&#41; to the tutors&#44; without evaluating impact of those incentives&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">Another interesting element observed regarding the type of method is that near-peer teaching is used more frequently than peer teaching&#44; which can be interpreted as differences in the participants&#8217; level of knowledge facilitating the learning interaction<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> where there is already cognitive congruence<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">65</span></a> between both parties&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">Half of the works reviewed reported that the groups of students comprised ten or more students&#44; despite the fact that the benefits of small groups have been described in the literature<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">66</span></a>&#46; Some studies implemented peer-assisted learning in order to reduce education costs<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#44; which could explain the high number of students per group&#46; However&#44; this relationship and its consequences falls outside the scope of this work&#8217;s objectives&#46;</p><p id="par0285" class="elsevierStylePara elsevierViewall">Among the characteristics related to the programs&#8217; organization&#44; it was observed that most programs had less than one session per week and the majority of studies had a total program duration of less than one semester&#46; This could be understood due to the high academic workload of health sciences degrees&#46; It is striking that the majority of these programs are carried out as something complementary to each degree&#39;s formal curriculum and not part of it&#46;</p><p id="par0290" class="elsevierStylePara elsevierViewall">The second focus of our study is an analysis of the main findings identified in the programs&#46; On the one hand&#44; it is noteworthy that students report more confidence in the material&#59; a friendly&#44; positive learning environment&#59; more closeness to the tutors&#59; and feeling better prepared for future evaluations&#46; On the other hand&#44; the tutors reported benefits in their perception of their knowledge and teaching skills&#44; for example&#46; These benefits are related to the concept of cognitive congruence<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">65</span></a>&#46; However&#44; there are other elements which facilitate learning and have to do with the interaction between a peer tutor and a student and the environment created in the sessions&#46;</p><p id="par0295" class="elsevierStylePara elsevierViewall">Concerning the quantitative effect of peer-assisted learning programs&#44; reflected as improvement on academic evaluations&#44; it is not so clear&#46; At least 11 of the works reviewed report that the effect on academic performance is not conclusive&#46; However&#44; the manner in which this was evaluated differed depending on the study&#8217;s context&#46; The majority measured capacity to retain information&#59; OSCE-type evaluations which evaluate practical skills are very infrequent&#46; In addition&#44; the majority of works measured academic performance in the short-term&#46; Effects on long-term learning have not been reported&#46;</p><p id="par0300" class="elsevierStylePara elsevierViewall">Though the characteristics and findings are approached separately&#44; we consider them to be closely related&#44; considering that each characteristic will help build the environment where the learning takes place&#46; From this perspective&#44; the analysis of the characteristics serves to determine the reality of peer-assisted learning programs at each university&#44; observe differences&#44; and compare the different outcomes&#46; Moreover&#44; the analysis of each program&#8217;s results allows us to compare the benefits of each experience and their impact on learning&#46;</p><p id="par0305" class="elsevierStylePara elsevierViewall">The limitations of our review must be noted&#46; Firstly&#44; there is a restriction regarding the databases used&#58; only indexes with greater scientific relevance &#40;WoS and Scopus&#41; were included&#46; EMBASE and ERIC&#44; among others&#44; are not guaranteed to be included in these indexes&#46; Therefore&#44; relevant works may have been excluded or omitted&#46; Secondly&#44; the works selected were limited to those in Spanish and English&#44; excluding literature published in other languages&#46; Lastly&#44; the great degree of heterogeneity among the different studies makes their comparison or a meta-analysis difficult&#46; This highlights the need to incorporate various disciplines into the analysis&#44; which would allow us to compare methods and could provide a more comprehensive vision of learning through this type of experience&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conclusion</span><p id="par0310" class="elsevierStylePara elsevierViewall">This study allows us to draw two main conclusions&#58; first&#44; programs that use peer-assisted learning methods in university health sciences degrees have a positive impact on students which is mainly reflected in the process and the learning experience and in a safer&#44; more tight-knit&#44; and more accessible environment facilitated by the peer tutors&#46; The benefits in terms of academic results are not yet clear and their analysis goes beyond our work&#8217;s objective&#46; Second&#44; some characteristics are more common among the programs&#44; but the conditions of each center and program are heterogeneous&#46; Therefore&#44; we believe that it is not possible to determine the impact of each characteristic on the learning process with this information&#46;</p><p id="par0315" class="elsevierStylePara elsevierViewall">A possible future analysis of programs with similar scenarios will allow us to&#58; &#40;1&#41; more precisely identify how each characteristic affects students&#8217; and peer tutors&#8217; learning&#59; &#40;2&#41; apply the most important characteristics to future programs in a cross-disciplinary manner and promote positive learning outcomes&#44; thus optimizing each center&#8217;s human and financial resources&#59; and &#40;3&#41; improve educational indicators&#44; reduce drop-out rates&#59; and promote the creation of networks&#46;</p><p id="par0320" class="elsevierStylePara elsevierViewall">The effect of selecting and training peer tutors&#44; the impact of peer-assisted learning on academic results as measured through standardized evaluations&#44; and their effect on long-term learning are some of the elements that are not present in the reviewed studies&#44; but which would be interesting aspects for future research&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Funding</span><p id="par0325" class="elsevierStylePara elsevierViewall">The research has not received specific grants from agencies in the public&#44; commercial&#44; or non-profit sectors&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflicts of interest</span><p id="par0330" class="elsevierStylePara elsevierViewall">The authors of this work declare that they do not have any conflicts of interest&#46;</p></span></span>"
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          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1463245"
          "palabras" => array:6 [
            0 => "Aprendizaje asistido por pares"
            1 => "Aprendizaje entre pares"
            2 => "Aprendizaje entre pares pr&#243;ximos"
            3 => "Estudiantes"
            4 => "Ciencias de la salud"
            5 => "PRISMA"
          ]
        ]
      ]
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Systematically analyse the characteristics and impact of peer assisted learning programmes implemented in undergraduate health education&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Following the PRISMA protocol&#44; we searched the electronic indexed databases WoS and SCOPUS&#59; original studies reporting peer assisted learning in health science careers were included in the systematic review&#46; Among them&#44; the studies between 2010 and January 2020 were selected&#44; and information regarding programme structures and principal results was subsequently extracted&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A total of 47 studies were included in the review&#46; The most frequent programme characteristics were the near-peer teaching modality&#44; lecture classes&#44; clinical laboratories and peer tutor training&#46; The main findings identified were benefits in tutors&#8217; confidence and knowledge&#44; better student comprehension and a more comfortable learning environment in comparison with that established by academic tutors&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Peer assisted learning programmes have shown qualitative benefits in the learning environment&#44; generation of support networks and confidence in knowledge acquired&#46; Nonetheless&#44; quantitative benefits measured as improvements in marks are inconclusive&#46; Future studies are needed to standardise the methodologies used to determine which characteristics are the most positive in the learning process&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Analizar sistem&#225;ticamente las caracter&#237;sticas y los impactos de los programas e iniciativas de aprendizaje asistido por pares realizados en estudios universitarios en ciencias de la salud en los cursos de pregrado&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Siguiendo el protocolo PRISMA&#44; se realiz&#243; una b&#250;squeda en las bases de datos indexadas en WoS y SCOPUS&#44; con todos los trabajos originales que reportan aprendizaje asistido por pares en estudios universitarios en ciencias de la salud&#46; Se seleccionaron art&#237;culos originales entre enero de 2010 y enero de 2020&#44; analizando la informaci&#243;n sobre las caracter&#237;sticas de los programas y los principales resultados e impactos de los estudios&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 47 estudios en la revisi&#243;n&#46; Las caracter&#237;sticas de los programas m&#225;s representadas fueron la utilizaci&#243;n de la modalidad aprendizaje entre pares pr&#243;ximos&#44; el uso de clases te&#243;ricas&#44; laboratorios cl&#237;nicos y la capacitaci&#243;n a los tutores pares&#46; Los principales impactos identificados son los beneficios en la confianza y en el conocimiento de los tutores&#44; la mejor comprensi&#243;n de los contenidos y la mayor comodidad en comparaci&#243;n con los tutores acad&#233;micos en los estudiantes&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Los programas de aprendizaje asistido por pares han demostrado beneficios cualitativos relativos al ambiente de aprendizaje&#44; la generaci&#243;n de redes de apoyo y la confianza en los conocimientos adquiridos&#46; Sin embargo&#44; los beneficios cuantitativos&#44; medidos como mejor&#237;a en las calificaciones&#44; no son concluyentes&#46; Se necesitan futuros estudios que busquen indagar sobre las metodolog&#237;as utilizadas para detectar qu&#233; caracter&#237;sticas impactan m&#225;s positivamente sobre el proceso de aprendizaje&#46;</p></span>"
        "secciones" => array:4 [
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            "identificador" => "abst0025"
            "titulo" => "Objetivo"
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          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#8902;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Hern&#225;ndez Coli&#241;ir J&#44; Molina Gallardo L&#44; Gonz&#225;lez Morales D&#44; Ib&#225;&#241;ez Sanhueza C&#44; Jerez Ya&#241;ez O&#46; Caracter&#237;sticas e impactos del aprendizaje entre pares en estudios universitarios en ciencias de la salud&#58; una revisi&#243;n sistem&#225;tica&#46; Rev Clin Esp&#46; 2022&#59;222&#58;44&#8211;53&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2633
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
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            "rol" => "short"
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Flowchart of the selection of works according to the PRISMA protocol&#46;</p>"
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      1 => array:8 [
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        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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        "detalles" => array:1 [
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        "tabla" => array:2 [
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Characteristic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Peer-assisted learning method &#40;n&#8239;&#61;&#8239;37&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Near-peer teaching&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peer teaching&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Teaching method &#40;n&#8239;&#61;&#8239;46&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Laboratory practicum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Theory class&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Exam simulation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">People per group &#40;n&#8239;&#61;&#8239;28&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 10 people&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 10 people&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Number of sessions &#40;n&#8239;&#61;&#8239;17&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804; 1 per week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 1 per week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Duration of sessions &#40;n&#8239;&#61;&#8239;27&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Up to 1 hour&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">More than 1 hour&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Program duration &#40;n&#8239;&#61;&#8239;22&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1-6 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6-12 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 12 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Selection of peer tutors &#40;n&#8239;&#61;&#8239;30&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Training of tutors &#40;n&#8239;&#61;&#8239;29&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Payment or incentives for tutors &#40;n&#8239;&#61;&#8239;17&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Selection of students &#40;n&#8239;&#61;&#8239;31&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            0 => array:3 [
              "identificador" => "tblfn0005"
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            ]
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        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the peer-assisted learning programs analysed&#46;</p>"
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            "identificador" => "at0015"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Category&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Key findings&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">References&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Role and identity</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The peer tutors report an improvement in their level of knowledge&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;25&#44;28&#44;31&#44;35&#44;43&#44;47&#44;49&#44;50&#44;51&#44;54&#44;56&#44;57&#44;59</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The peer tutors report an improvement in their teaching skills&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;25&#44;29&#44;31&#44;43&#44;47&#44;49&#44;50&#44;51&#44;54&#44;56&#44;57&#44;59</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peer tutors&#8217; training improves students&#8217; academic performance&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The peer tutor is identified as a role model&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">47</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The peer tutors report an increase in their motivation to teach&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Effectiveness</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Students perceive peer teaching as an effective teaching method&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;32&#44;35&#44;39&#44;41&#44;42&#44;48&#44;50&#44;54&#44;59&#44;60</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The effects of peer-assisted learning on academic performance are not conclusive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;21&#44;26&#44;33&#44;35&#44;37&#44;39&#44;45&#44;47&#44;54&#44;57</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The effects of peer-assisted learning on academic performance are statistically significant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#44;27&#44;52&#44;53&#44;55&#44;60</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Students improved their understanding of the content&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;24&#44;41&#44;50&#44;61</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peer tutors with a more similar level of education are more highly evaluated by students compared to peer tutors with more advanced levels&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">32&#44;36&#44;58</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">There were no statistically significant differences in the effectiveness of the sessions taught by peer tutors compared to academics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;28&#8211;45</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Facilitation and experience</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A positive learning environment is described&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;11&#44;18&#44;24&#44;27&#44;29&#44;30&#44;45&#44;46&#44;47&#44;48</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Students perceive themselves to be better prepared for evaluations after implementation of the peer-assisted learning program&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;24&#44;25&#44;26&#44;29&#44;34&#44;37&#44;59&#44;61</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Students perceive themselves to be more comfortable interacting with peer tutors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;18&#44;24&#44;25&#44;32&#44;45&#44;48&#44;49</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Students describe less anxiety and stress when interacting with peer tutors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;24&#44;26</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Students report an increase in confidence in their knowledge after the tutoring sessions&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Students would recommend the peer-assisted learning method&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Students describe a greater motivation to learn&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">The effects of peer-assisted learning on students&#8217; confidence in their knowledge are not conclusive&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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Article information

ISSN: 22548874
Original language: English

DOI:10.1016/j.rceng.2021.02.006

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