The effectiveness of tutor vs peer feedback on formative OSPE practice in undergraduate physiology

Abstract

Objective: To compare the effectiveness and feasibility of tutor feedback and peer feedback for formative Objectively Structured Practical Examination practice among undergraduate Physiology students.

Method: The mixed-method, experimental study was conducted at Combined Military Hospital Multan Institute of Medical Sciences, Multan, Pakistan, from May 13 to July 15, 2024, and comprised second-year medical students in the Physiology module who undertook Objectively Structured Practical Examination practice sessions. They were randomised into control group A and experimental group B. In group A, the students played the role of performer and simulated patient, while the facilitators acted as examiners and reviewers. In group B, the students played the role of performer, simulated patients, examiners and peer reviewers, with the tutor separately and confidentially scoring the performer on each station. Summative scores of the two groups were compared, while inter-rater reliability between tutor and peer grading was assessed using the intraclass correlation coefficient. Using the Likert scale and open-ended questions, a questionnaire was employed to evaluate student perceptions regarding feedback efficacy. Data was analysed using SPSS 26.

Results: Of the 148 students, 72(48.6%) were in group A and 76(51.4%) were in group B. Among which 59% (n=90) participants were females and 41% (n=62f) males, with a mean age of 20 ± 1.2 years. There was no significant difference in summative scores of the two groups (p=0.42). Interrater reliability between tutor and peer scoring showed moderate agreement (intra-class correlation coefficient = 0.54). Both the groups acknowledged the pivotal role of feedback in enhancing Objectively Structured Practical Examination skills, and exam performance, facilitating learning, and boosting confidence and communication. Challenges associated with both feedback models included participation dynamics, feedback quality, assessment transparency and strategies for practice Objectively Structured Practical Examination modulation.

Conclusion: Both tutor-led and peer-assisted feedbacks were effective in elevating Objectively Structured Practical Examination proficiency, fostering error comprehension, and bolstering confidence among Physiology undergraduates. However, maintaining consistent peer feedback quality and ensuring transparent assessment were essential challenges.

Key Words: Formative feedback, Peer feedback, Practice OSPE, Formative OSPE, Inter-rater reliability, Tutor feedback, Physiology, Medical education.