Prompt identification of struggling candidates in near peer-led basic life support training: piloting an online performance scoring system.

BACKGROUND: Bristol Medical School has adopted a near peer-led teaching approach to deliver Basic Life Support training to first year undergraduate medical students. Challenges arose when trying to identify early in the course which candidates were struggling with their learning, in sessions delivered to large cohorts. We developed and piloted a novel, online performance scoring system to better track and highlight candidate progress. METHODS: During this pilot, a 10-point scale was used to evaluate candidate performance at six time-points during their training. The scores were collated and entered on an anonymised secure spreadsheet, which was conditionally formatted to provide a visual representation of the score. A One-Way ANOVA was performed on the scores and trends analysed during each course to review candidate trajectory. Descriptive statistics were assessed. Values are presented as mean scores with standard deviation (x̄±SD). RESULTS: A significant linear trend was demonstrated (P < 0.001) for the progression of candidates over the course. The average session score increased from 4.61 ± 1.78 at the start to 7.92 ± 1.22 at the end of the final session. A threshold of less than 1SD below the mean was used to identify struggling candidates at any of the six given timepoints. This threshold enabled efficient highlighting of struggling candidates in real time. CONCLUSIONS: Although the system will be subject to further validation, our pilot has shown the use of a simple 10-point scoring system in combination with a visual representation of performance helps to identify struggling candidates earlier across large cohorts of students undertaking skills training such as Basic Life Support. This early identification enables effective and efficient remedial support.

Caring for Each Other: A Resident-Led Peer Debriefing Skills Workshop.

Background: Inadequate time and space to process critical incidents contribute to burnout. Residents do not regularly participate in emotional debriefs. An institutional needs assessment revealed only 11% of surveyed pediatrics and combined medicine-pediatrics residents had participated in a debrief. Objective: The primary objective was to increase resident comfort in participation in peer debriefs after critical incidents from 30% to 50% with implementation of a resident-led peer debriefing skills workshop. Secondary objectives included increasing resident likelihood of leading debriefs and comfort in identifying symptoms of emotional distress. Methods: Internal medicine, pediatrics, and medicine-pediatrics residents were surveyed for baseline participation in debriefs and comfort in leading peer debriefs. Two senior residents became trained debrief facilitators and led a 50-minute peer debriefing skills workshop for co-residents. Pre- and post-workshop surveys assessed participant comfort in and likelihood of leading peer debriefs. Surveys distributed 6 months post-workshop assessed resident debrief participation. We implemented the Model for Improvement from 2019 to 2022. Results: Forty-six (77%) and 44 (73%) of the 60 participants completed the pre- and post-workshop surveys. Post-workshop, residents' reported comfort in leading debriefs increased from 30% to 91%. The likelihood of leading a debrief increased from 51% to 91%. Ninety-five percent (42 of 44) agreed that formal training in debriefing is beneficial. Almost 50% (24 of 52) of surveyed residents preferred to debrief with a peer. Six months post-workshop, 22% (15 of 68) of surveyed residents had led a peer debrief. Conclusions: Many residents prefer to debrief with a peer after critical incidents that cause emotional distress. Resident-led workshops can improve resident comfort in peer debriefing.

Evaluation of a virtual, simulated international public health peer-to-peer exchange learning experience.

Introduction: Public Health's (PH) global rise is accompanied by an increasing focus on training the new generation of PH graduates in interdisciplinary skills for multisectoral and cross-cultural engagement to develop an understanding of commonalities in health system issues and challenges in multi-cultural settings. Online teaching modalities provide an opportunity to enhance global health skill development through virtual engagement and peer exchange. However, current teaching pedagogy is limited in providing innovative modes of learning global health issues outside of traditional classroom settings with limited modalities of evidence-informed implementation models. Methods: This study designed, implemented, and evaluated a novel global health online synchronous module as proof of concept that incorporated elements of virtual Practice-based learning (PBL) using a case study approach offered to currently enrolled public health students at the University of Canberra (UC) and a partnering public health university from India, the Indian Institute of Public Health Gandhinagar (IIPH-G). Using constructive learning theory and the Social Determinants of Health framework, four online sessions were designed and implemented in August-September 2022. Formal process and outcome evaluation using a quantitative adapted survey of the validated International Student Experience survey (IES) at session end and findings provided. Results: Over 100 participating public health students from Australia and India provided narrative feedback and quantitative responses from the adapted IES instrument across four key dimensions, namely "motivation," "personal development," intellectual development, and "international perspectives" reporting an overall high mean impact of 4.29 (out of 5) across all four themes seen together. In essence, the sessions supported students to explore global health issues from a different cultural perspective while developing intercultural communication skills and enhancing their global exposure in real-time. Discussions: This innovation, implemented as a proof of concept, provided evidence, and demonstrated the implementation feasibility of a flexible virtual integrated practice-based module that can supplement classroom teaching. It provides participating students with the opportunity to develop intercultural understanding and communication competence as well as support global mindedness by engaging with international peers around focused global health case studies.

Online medical education using a Facebook peer-to-peer learning platform during the COVID-19 pandemic: a qualitative study exploring learner and tutor acceptability of Facebook as a learning platform.

BACKGROUND: In recent years, higher education institutions have been moving teaching online, accelerated by the pandemic. The Remote Learning Project (RLP), based at the Norwich Medical School (NMS) in the United Kingdom (U.K.), was a peer-to-peer teaching program developed to supplement medical school teaching during the pandemic. The teaching was delivered through Facebook using peer-to-peer teaching. Tutors were final year medical students, teaching medical student learners in lower years. Tutors and learners perception of peer-to-peer online learning delivered through the Facebook Social Media (SoMe) platform was investigated. METHODS: This qualitative study recruited tutor and learner participants from NMS by email, participation in the study was voluntary. Online semi-structured interviews of both tutors and learners in the remote learning project were conducted. The data was analysed using thematic analysis. RESULTS: Seven participants were interviewed. Five themes were identified; education (learning/teaching), productivity, data security, professionalism, and usability of the platform. Learners enjoyed the asynchronous nature of the platform and both learners and tutors enjoyed the peer-to-peer nature of the RLP, including the ability to immediately and easily answer on Facebook comments. Some learners felt distracted on Facebook, whilst others enjoyed the reminders. The mix of social and professional on the platform was met with caution from tutors. Both learners and tutors enjoyed the familiarity of the platform. CONCLUSIONS: The study found that SoMe may be a credible platform to deliver online peer-to-peer teaching. Educators should consider the ergonomics of SoMe platforms when designing online curriculums. Guidelines for educators should be developed to better guide educators on the effective and safe use of SoMe as a learning tool.

A game-theoretic analysis of Wikipedia's peer production: The interplay between community's governance and contributors' interactions.

Peer production, such as the collaborative authoring of Wikipedia articles, involves both cooperation and competition between contributors. Cooperatively, Wikipedia's contributors attempt to create high-quality articles, and at the same time, they compete to align Wikipedia articles with their personal perspectives and "take ownership" of the article. This process is governed collectively by the community, which works to ensure the neutrality of the content. We study the interplay between individuals' cooperation and competition, considering the community's endeavor to ensure a neutral point of view (NPOV) on articles. We develop a two-level game-theoretic model: the first level models the interactions between individual contributors who seek both cooperative and competitive goals and the second level models governance of co-production as a Stackelberg (leader-follower) game between contributors and the communal neutrality-enforcing mechanisms. We present our model's predictions regarding the relationship between contributors' personal benefits of content ownership and their characteristics, namely their cooperative/competitive orientation and their activity profile (whether creators or curators of content). We validate the model's prediction through an empirical analysis, by studying the interactions of 219,811 distinct contributors that co-produced 864 Wikipedia articles over a decade. The analysis and empirical results suggest that the factor that determines who ends up owning content is the ratio between one's cooperative/competitive orientation (estimated based on whether a core or peripheral community member) and the contributor's creator/curator activity profile (proxied through average edit size per sentence). Namely, under the governance mechanisms, the fractional content that is eventually owned by a contributor is higher for curators that have a competitive orientation. Although neutrality-seeking mechanisms are essential for ensuring that ownership is not concentrated within a small number of contributors, our findings suggest that the burden of excessive governance may deter contributors from participating, and thus indirectly curtail the peer production of high-quality articles.

How "peer-fear" of others' evaluations can regulate young children's cooperation.

Children's cooperation with peers undergoes substantial developmental changes between 3 and 10 years of age. Here we stipulate that young children's initial fearfulness of peers' behaviour develops into older children's fearfulness of peers' evaluations of their own behaviour. Cooperation may constitute an adaptive environment in which the expressions of fear and self-conscious emotions regulate the quality of children's peer relationships.

Depression Socialization in Early Adolescent Friendships: The Role of Baseline Depressive Symptoms and Autonomous Functioning.

There is mixed evidence for depression socialization, a process by which friends affect each other's level of depressive symptoms. The current study examined whether adolescents' baseline depressive symptoms and three dimensions of autonomous functioning (autonomy, peer resistance, and friend adaptation) make adolescents more or less sensitive to depression socialization, and how these dimensions of autonomous functioning were connected. In this preregistered, two-wave longitudinal study, participants completed questionnaires on depressive symptoms, autonomy, and peer resistance and participated in a task to assess friend adaptation. Participants were 416 Dutch adolescents (Mage = 11.60, 52.8% girls) across 230 close friend dyads. In contrast to expectations, results showed no significant depression socialization nor significant moderation. Furthermore, autonomy and peer resistance were related but distinct constructs, and not related to friend adaptation. These findings suggest that there is no depression socialization in early adolescence, regardless of level of autonomous functioning.

Social networks are shaped by culturally contingent assessments of social competence.

Cultural outsiders, like immigrants or international students, often struggle to make friends. We propose that one barrier to social connection is not knowing what it means to be socially competent in the host culture. First-year students at a U.S. business school (N = 1328) completed a social network survey and rated their own social competence and that of several peers. International students were rated by peers as less socially competent than U.S. students, especially if they were from nations more culturally dissimilar to the U.S. International students' self-reported competence ratings were uncorrelated with peers' judgments. Social network analysis revealed international students were less central to their peer networks than U.S. students, although this gap was reduced if peers evaluated them as socially competent. Peer-reported competence mediated the effects of international student status on social network centrality. Since learning local norms takes time, we suggest inclusivity will require host communities to define social competence more broadly.

Predicting change in neural activity during social exclusion in late childhood: The role of past peer experiences.

A painful experience affecting many children is social exclusion. The current study is a follow-up study, investigating change in neural activity during social exclusion as a function of peer preference. Peer preference was defined as the degree to which children are preferred by their peers and measured using peer nominations in class during four consecutive years for 34 boys. Neural activity was assessed twice with a one-year interval, using functional MRI during Cyberball (MageT1 = 10.3 years, MageT2 = 11.4 years). Results showed that change in neural activity during social exclusion differed as a function of peer preference for the a-priori defined region-of-interest of the subgenual anterior cingulate cortex (subACC), such that relatively lower history of peer preference was associated with an increase in activity from Time1 to Time2. Exploratory whole brain results showed a positive association between peer preference and neural activity at Time2 in the left and right orbitofrontal gyrus (OFG). These results may suggest that boys with lower peer preference become increasingly sensitive to social exclusion over time, associated with increased activity in the subACC. Moreover, lower peer preference and associated lower activity within the OFG may suggest decreased emotion regulation as a response to social exclusion.

Experience of enhanced near-peer support for new medical graduates of an Irish university: a phenomenological study.

CONTEXT: Factors contributing to the stressful transition from student to doctor include issues with preparedness for practice, adjusting to new status and responsibility, and variable support. Existing transitional interventions provide inconsistent participation, responsibility and legitimacy in the clinical environment. Enhanced support by near peers for new doctors may ease the transition. Irish medical graduates of 2020 commenced work early, creating an unprecedented period of overlap between new graduates and the cohort 1 year ahead. OBJECTIVE: To explore the experience of commencing practice for these new doctors with this increased near-peer support. DESIGN: We used interpretive phenomenological analysis as our methodological approach, informed by the cognitive apprenticeship model, to explore the experience of enhanced near-peer support at the transition to practice. Participants recorded audio diaries from their commencement of work, and a semistructured interview was conducted with each, after 3 months, concerning their experience of their overlap with the previous year's interns. SETTING: University College Cork, one of six medical schools in Ireland. PARTICIPANTS: Nine newly qualified medical doctors. MAIN OUTCOME MEASURES: An exploration of their experience of transition to clinical practice, in the context of this enhanced near-peer support, will inform strategies to ease the transition from student to doctor. RESULTS: Participants felt reassured by having a near-peer in the same role and safe to seek their support. This empowered them to gradually assume increasing responsibility and to challenge themselves to further their learning. Participants perceived that commencing work before the annual change-over of other grades of doctor-in-training enhanced their professional identities and improved patient safety. CONCLUSIONS: Enhanced near-peer support for new doctors offers a potential solution to the stressful transition to practice. Participants were legitimate members of the community of practice, with the status and responsibility of first-year doctors. Furthermore, this study reinforces the benefit of asynchronous job change-over for doctors-in-training.

Relative likeability and relative popularity as sources of influence in children's friendships.

The present study contrasts two forms of peer status as sources of friend influence: Relative likeability and relative popularity. Participants included 310 children (142 boys, 168 girls), ages 9 to 12, in stable reciprocated friendships. Peer nominations were collected at two time points, 8 to 14 weeks apart. After removing overlapping variance through residualization, partners in each friend dyad were categorized into roles on the basis of relative (to the partner) popularity and relative (to the partner) likeability. Dyadic analyses compared more- and less-liked friends and more- and less-popular friends in terms of their influence over physical aggression, relational aggression, prosocial behavior, and academic achievement. Higher initial relational aggression, prosocial behavior, and academic achievement among more-liked partners predicted greater increases in the same among less-liked partners, but not the reverse. Unexpectedly, physical aggression among less-liked partners predicted increases in physical aggression among more-liked partners. More popular friends did not influence less popular friends on any of these variables, although (also unexpectedly) less-popular friends influenced the academic achievement of more-popular friends. Taken together, the findings suggest that during the pre- and early adolescent years, relative influence within a friendship tends to be apportioned on the basis of likeability, not popularity.

Aggressive behavior in adolescent: The importance of biopsychosocial predictors among secondary school students.

Introduction: Overt aggression is a common type of aggression observed among adolescents, which is apparent and outward confrontational acts manifested physically and verbally, such as fighting and shouting. It has become a major public health concern, as it results in detrimental health impacts like injury, mental health, and social problems. Methods: An observational study was conducted among 16-year-old school students to determine their biopsychosocial predictors, using stratified proportionate population sampling. Pre-tested surveys were distributed to measure students' aggression, biological, psychological, and social factors. Results: A total of 463 students from four public secondary schools participated in the study, with a median aggression score was 23.00 (IQR=12.00). The significant predictors of aggression from multivariate analysis were Malay race, frequent dessert intakes, attitude towards aggression, low family income, and peer deviant affiliation (F [8, 244] = 15.980, p < 0.001, adjusted R 2 = 0.290). Discussion: Adolescent aggression determinants are collectively impacted as a result of biological, psychological, and social predictors and need to be focused on in interventional strategies.

No Signs of Inclusive Fitness or Reciprocal Altruism in Advantageous Inequity Aversion.

Advantageous inequity aversion (i.e., the tendency to respond negatively to unfairness that benefits oneself) usually develops in 6-8-year-olds. However, little is known about the selection pressures that might have shaped this phenomenon. Using data collected from 120 4-8-year-old Finnish children, we tested two evolutionary explanations for the development of advantageous inequity aversion: reciprocal altruism (i.e., benefiting from sharing when the roles are likely reversed in the future) and inclusive fitness (i.e., benefiting from sharing with biological relatives that carry the same alleles). We first successfully replicated a previous experiment, showing that 6-8-year-olds display advantageous inequity aversion by preferring to throw away a resource rather than keep it for themselves. Here, this behavior was also displayed in 5-year-olds. Using a novel experiment, we then asked children to distribute five erasers between themselves, a sibling, a peer, and a stranger. That is, an equal distribution was only possible if throwing away one eraser. We found no support for advantageous inequity aversion being shaped by either inclusive fitness or reciprocal altruism. Future studies could investigate costly signaling and adherence to social norms to avoid negative consequences as ultimate explanations for advantageous inequity aversion.

Mental toughness in the Football Association Women's Super League: Relationships with playing experience, perceptions of club infrastructure, support mechanisms and self-esteem.

Previous research reports a positive association between possession of mental toughness (MT) and high performance in sportspersons. However, the extent to which MT is related to playing experiences and appreciation of club environment in elite women's football has received only limited research attention. Accordingly, the present study investigated MT in the context of the English Football Association Women's Super League (WSL). Specifically, this paper examined relationships between level of MT and external (playing experience, perceptions of club infrastructure, and appreciation of support mechanisms) and internal (self-esteem) factors. A sample of 63 elite female professional football players from the WSL, aged between 18 and 35 years (mean = 25.87, SD = 4.03), completed self-report measures. To objectively validate self-ratings, congruence between self and peer-rated was assessed. This revealed a strong degree of consistency. Subsequent analysis found positive correlations between MT, playing experience (number of years playing football, NoY; and highest level of football achieved, HLA), and External Support. Additionally, Self-Esteem correlated positively with MT, NoY, HLA, and External Support. Moderation analysis found MT interacted with NoY and predicted greater levels of Self-Esteem. Players with lower and mean MT, and more years as a professional were more likely to possess higher Self-Esteem (vs. less years). These outcomes indicated important relationships between MT, External Support, and Self-Esteem. Accordingly, WSL clubs can potentially apply the results of this study to enhance positive player mindset.

The power of peer networking for improving STEM faculty job applications: a successful pilot programme.

To attain a faculty position, postdoctoral fellows submit job applications that require considerable time and effort to produce. Although mentors and colleagues review these applications, postdocs rarely receive iterative feedback from reviewers with the breadth of expertise typically found on an academic search committee. To address this gap, we describe an international peer-reviewing programme for postdocs across disciplines to receive reciprocal, iterative feedback on faculty applications. A participant survey revealed that nearly all participants would recommend the programme to others. Furthermore, our programme was more likely to attract postdocs who struggled to find mentoring, possibly because of their identity as a woman or member of an underrepresented population in STEM or because they changed fields. Between 2018 and 2021, our programme provided nearly 150 early career academics with a diverse and supportive community of peer mentors during the difficult search for a faculty position and continues to do so today. As the transition from postdoc to faculty represents the largest 'leak' in the academic pipeline, implementation of similar programmes by universities or professional societies would provide psycho-social support necessary to prevent attrition of individuals from underrepresented populations as well as increase the chances of success for early career academics in their search for independence.

The correlation between social media use, peer influence, and sexual behaviour among adolescents.

Objectives: To assess the correlation among social media use, peer influence and sexual risk behaviour among school going adolescents. Method: The cross-sectional study was conducted from April to July 2022 after approval from the ethics review board of Stikes, Hang Tuah, Surabaya, Indonesia, and comprised grade 11 students of either gender at the Senior High School 1, Hang Tuah, Surabaya. Data was collected using social media and peer influence questionnaires. Data was analysed using SPSS version 23. RESULTS: Of the 134 participants, 79(59%) were males, and 91(67.9%) were aged 17 years. Highly frequent social media usage was reported by 81(60.4%) subjects, getting influenced by peers by 82(61.2%) and sexual risk behaviour by 88(65.7%). Social media usage and peer influence were significantly associated with sexual behaviour (p<0.05). CONCLUSIONS: A significant relationship was noted of sexual behaviour with social media usage and peer influence.

Analysis of factors related to behaviours to prevent sexual assault of teenage girls.

Objectives: To analyse the factors associated with the behaviour of teenage girls in terms of preventing a sexual assault. Method: The descriptive, cross-sectional, correlational study was conducted in April 2021 at a senior high school in Cibitung, Bekasi, Indonesia, after approval from the ethics review committee of the Faculty of Nursing, Universitas Airlangga. The sample comprised class X-XII students aged 15- 19 years. Data was collected using a questionnaire. Data was analysed with logistic regression test using SPSS 20. RESULTS: Of the 139 subjects, 52 (37.4%) were aged 16 years, 58 (41.7%) were in class XII. Significant relationship of behaviour to prevent sexual assault was found with knowledge (p=0.008), attitude (p=0.010) and peer interaction (p=0.007). CONCLUSIONS: Preventing sexual assault behaviour among girls was found to be related to knowledge, attitude and peer interaction.

Teaching Professional Peer Review With the Use of Simulation.

BACKGROUND: Quality improvement practices such as peer review and just culture are important components of patient safety initiatives, and health professions students should be introduced to these practices during their education. PURPOSE: The purpose of this study was to evaluate a peer-review simulation learning experience using just culture principles in a graduate-level, online nursing education program. METHODS: The students rated their learning experience with high, positive scores in all 7 domains on the Simulation Learning Experience Inventory. Responses to the open-ended question indicated that the students thought the experience provided opportunities for deep learning, increased confidence, and enhanced critical thinking skills. CONCLUSION: A peer-review simulation program using just culture principles provided a meaningful learning experience for graduate-level students in an online nursing education program.

Peer network in math anxiety: A longitudinal social network approach.

Regardless of age, math anxiety (i.e., adverse affective reactions in situations involving math) is associated with lower math achievement. Previous studies have investigated the role of adult figures (e.g., parents, teachers) in the development of children's math anxiety. However, given the importance of peer relationships during adolescence, we examined friendship selection and social influence on children's math anxiety using longitudinal peer network analyses. Throughout the academic semester, we found that children became more similar to their peers in math anxiety levels but did not form new peer networks based on their levels of math anxiety. These findings highlight the importance of peers' emotional reactions to math, which could influence future academic achievement and career aspirations considerably.