Peer-Assisted Learning Strategies in Human Anatomy & Physiology

By Hughes, Kathleen S. | The American Biology Teacher, March 2011 | Go to article overview

Peer-Assisted Learning Strategies in Human Anatomy & Physiology

Hughes, Kathleen S., The American Biology Teacher


Peer-assisted strategies foster learning in science courses. This article outlines a cross-year, peer-assisted learning program in a Human Anatomy and Physiology 1 course. The aim of this 2-year study was to implement the program and evaluate it on the basis of student performance and feedback. Former students were hired each year to lead optional discussion sessions. Student attendance was positively correlated with higher course averages and overall grade-point averages yet limited improvement in posttest scores. Students favorably evaluated the program and suggested improvements. Biology educators would benefit from a central interactive database devoted to peer-assisted learning in our discipline.

Key Words: Peer-assisted learning; peer leaders; supplemental instruction; student assessment.


College-level biology courses at the 1000 and 2000 levels are notorious for large enrollments coupled with a wide range in student performance. Filled sections leave many students unable to register for required or recommended courses. Students repeating a biology course deepen this problem, as evidenced by Human Anatomy and Physiology 1 at Columbus State University (CSU). During the spring semesters of 2007 and 2008, repeat students accounted for 41% of students who did not earn a C or better; only 52% of the class passed the course with a C or better. Furthermore, 12% of the students did not complete the course. The percentages mimic national student attrition rates in introductory science courses (Tenney & Houck, 2003).

One step in understanding student attrition and failure is to analyze formative course evaluations. Prior to the final exam in Human Anatomy and Physiology 1, the students earn class-exercise points for submitting supplemental evaluations (created by the author). In order to maintain the anonymity of the evaluations, the students' names are checked off during submission. Evaluations are analyzed after final grades have been submitted. The full-length evaluation is available at (under Comment Wall). Question 6 asks What is your current letter grade in the course? Is this grade lower than your goal? Question 7 follows this up with (If answer to last question is yes) Why do you think your current grade is lower than your goal? Responses by students who self-reported grades of D or F in the spring 2008 course included the following:

* I was overwhelmed with all the information that has to be retained for this course.

* I started off with bad study habits.

* I did not study as much as I needed to.

* I have too much going on and because I've not passed this course in the past, I have set myself up to fail at it.

* In the beginning I did not fully understand how to process the information and how to use all the tools to help my understanding.

Collectively, the comments cite problems with study habits, time management, and inability to organize and process the information. The traditional course schedule left little time to address these concerns during class or one-on-one during office hours. Although student support centers offer services related to these issues, the students would likely benefit from structured advice and learning tools tailored to the course. Encouraging students to approach the educator with questions yielded only limited contact either in person or via e-mail. Because traditional means of encouraging contact were not successful, peer-leader strategies were explored.

Laboratory science courses are a natural setting for student-centered learning approaches. Collaborative learning opportunities routinely arise in these courses in the form of hypothesis-driven projects and group laboratory reports (Bruffee 1998). The scope of implementation can range from one or two lessons to a course based on student-centered learning facilitated by educators. Peer-to-peer learning involves students facilitating conceptual understanding in other students (Tenney & Houck, 2003). Caveats in collaborative learning include miscommunication between peers, transmission of incorrect information, and difficulty staying on topic. A solution is to include peers who have demonstrated success in the course. These students, termed peer leaders, facilitate learning by providing a pressure-free setting supplemental to course lectures.

Peer-assisted learning is widely recognized as effective (Tenney & Houck, 2003). Over the past 10 years, secondary education programs and universities have incorporated this type of student-centered learning in science disciplines (Tariq, 2005). Chemistry, physics, and mathematics courses offered across the country embrace peer-assisted learning and have formed a successful network of interested K-16 educators (Evans et al., 2001; Tien et al., 2002; Johnston & McClelland, 2009). Peer leaders or supplemental instructors are increasingly common in introductory biology courses (Griswold & Gaines, 2005), but the resources available for connecting and sharing strategies are limited, compared with other science disciplines. Thus, it is important to evaluate both the strengths and the weaknesses of peer-assisted learning in biology.

Peer-assisted learning encompasses student tutors who are currently enrolled in the course as well as former students who lead discussion groups and even lab sections (Tariq, 2005). Benefits for the students include increased learning, confidence in the subject, and problem-solving skills (Laoui & O'Donoghue, 2008). Aside from the quantitative measurements, peer learning boosts student engagement and promotes active learning and subject comprehension (Gosser, 2008). Peer leaders hold scheduled outside sessions to focus on problem-solving techniques and learning strategies as well as to answer content questions. Considerations when forming these sessions include the following:

* Are the sessions mandatory?

* Will the peer leaders serve more as supplemental instructors or problem-solving facilitators?

* What is the ratio of peer leaders to students?

* How will the peer leaders be compensated or given credit?

* Are the peer leaders same-year or cross-year students?

Given the wide spectrum of possibilities, the peer-leader program structure depends on the best fit by course. A Science, Technology, Engineering and Mathematics (STEM) mini-grant provided a pilot peer-leader program in the spring 2009 Human Anatomy and Physiology 1 course. The Spring 2010 program was supported by CSU'S College of Letters and Sciences.

The main objectives for the Human Anatomy and Physiology student-centered learning program were to implement a cross-year, peer-assisted program in the course; assess program effectiveness in student learning; and bridge this approach to other introductory biology courses.

* Methods

Peer-Leader Selection

The selection process in the pilot program lasted 6 weeks. Any student who had successfully completed Human Anatomy and Physiology 1 in the previous 2 years was eligible to apply for the peer-leader position. Selection parameters included cumulative GPA, biology course GPA, application review, interview, and faculty recommendations. Two peer leaders were hired each year. Applicants answered a set of questions that included the following:

* Why do you want to be a peer leader?

* What leadership or tutoring experiences will prepare you for this role?

* What will be your strengths and weaknesses in the position?

* How will you handle a student's question to which you don't know the answer?

* If a student comes into the session overly frustrated, what approach will you take?

Cross-Year Peer Training

The author met with the peer leaders before the start of the course to outline objectives and learning outcomes, course materials, learning-session objectives, agreements between educator and assistant, and peer-assisted-learning literature and resources. During the semester, the educator and peer leaders met casually weekly to discuss progress and problems. The peer leaders attended the lectures (3 hours per week) and at least one 2-hour lab session per week. The course included initial student enrollments of 68 in 2009 and 71 m 2010.

Structure of Peer-Assisted-Learning Sessions

The peer leaders led two to four weekly 1-hour sessions. The schedule was structured to allow maximum student participation. During the 2010 course, the students were asked to fill out available times using an online scheduling site. The purpose of the sessions was to support learning of the course material in an interactive environment without the educator being present. Most sessions were led by a single peer leader in 2009 and by one or both peer leaders in 2010. During each session, the peer leader(s) guided the students in answering questions related to course material. Student participation in the peer-leader sessions was voluntary. Peer leaders recorded attendance for analysis after submission of final grades.

Data Collection & Analysis

Collected data included pretest and posttest scores, peer-leader-session participation, final grades, overall GPAs, supplemental student evaluations, and a peer-assistant interview and questionnaire. Data were categorized on the basis of session attendance (<5 sessions vs. [greater than or equal to] 5 sessions). Averages and standard deviations of these data were calculated and analyzed. A t-test was performed in each category to determine statistical significance.

* Results

The author collected data related to final course average, peer-leader-session attendance, student evaluations, overall GPA, and repeat student performance. Thirty peer-leader sessions were attended by at least one student in both 2009 and 2010. The most popular peer-leader sessions were held immediately after the class meeting time. Fortunately, scheduling allowed the after-class sessions to be held in the same lecture room both years. Students did not regularly attend sessions at other times. The peer leaders adjusted the session times during the semester to accommodate students' schedules. For example, the peer leaders offered weekend sessions targeting lab material, though attendance was lower at these weekend sessions. Several students commented that their work schedules prohibited them from attending more sessions.

Students who attended at least six discussion sessions had higher final course averages as well as greater improvement in posttest vs. pretest scores. Table 1 outlines final course grades and session attendance. Students who attended at least five sessions during the semester had a final course average (expressed as a percentage [+ or -] standard deviation) of 82.0 [+ or -] 11.3 (2009) and 81.5 [+ or -] 15.4 (2010). By contrast, students who attended fewer than five sessions had a final course average of 66.3 [+ or -] 15.6 (2009) and 66.5 [+ or -] 19.2 (2010). Collectively, 53% (2009) and 57% (2010) of students passed the course with a C or better. The average overall GPA (4.0 scale) of 2010 students who attended at least five sessions was 3.4 [+ or -] 0.4; that of students who attended 0-4 sessions was 2.8 [+ or -] 0.5 GPA (p = 0.0001).

Pretest and posttest scores were also analyzed. At the beginning of the semester, students took a 10-question multiple-choice pretest; the same test was given at the end of the final course exam. The students did not have access to the questions between the pretest and posttest. There was no significant difference in the pretest scores between 0-4 and 5+ session attendants (2.7 [+ or -] 1.5 vs. 2.1 [+ or -] 0.9 in 2009 and 2.9 [+ or -] 1.3 vs. 2.5 [+ or -] 1.4 in 2010, respectively; Table 1). On average, students improved their scores on the posttest. Students who attended more than four sessions in 2009 improved by 3.7 [+ or -] 2.2 points; students who attended 0-4 sessions improved by 2.5 [+ or -] 2.4 points. There was not a statistically significant difference between the two groups (p = 0.067). The improvement differences based on session attendance were not statistically significant in 2010 either (3.9 [+ or -] 2.3 vs. 2.8 [+ or -] 2.0; p = 0.061).

The number of repeat students in the course fueled the implementation of the peer-leader program. Seven students who did not pass the course under the author's instruction in 2007 repeated it with the author in 2008. Four of these students successfully completed the course in 2008. In the 2008 vs. 2009 comparison, three of the four students successfully completed the course. In the 2009 vs. 2010 comparison, two of the three students successfully completed the course. Collectively, the number of students who unsuccessfully repeated the author's course declined in 2009 and 2010.

The students completed supplemental evaluations at the end of the semester that included a section on the peer-leader program. In 2009, 58 of 63 students who completed the course (92%) submitted the evaluation. In 2010, 64 of 69 students completing the course (93%) submitted the evaluation. T, he results from the questions with ranked scores out of 5 are outlined in Table 2. Overall, the results were positive. The highest averages were in response to the continuation and expansion of the peer-leader program. The lowest average score was in response to I was more confident about the exam(s) after attending the peer-leader sessions. Students were also asked to comment on the strengths and weaknesses of the peer-leader program (Table 3). The most common suggestion was to offer sessions at alternative times.

* Discussion

The data showed a strong positive correlation between session attendance and final course average. What do these results suggest? First, students who chose to attend more sessions are likely motivated to achieve success in the course. This assertion is supported by the overall GPA of the students. The data suggest that we can predict a student's likelihood of attending sessions on the basis of past performance in college-level courses. Taken further, one could argue that the motivated students would succeed in the course even without the sessions. Although that concern cannot be answered by the present study, it is important to consider the student evaluations of the peer-leader sessions. Comments were positive, with only a few suggested improvements. Students gravitated toward the peer element of the program--they were comfortable asking questions of the peer leaders. Given the feedback, future strategies should focus on facilitating student attendance.

Peer-leader sessions were optional in both years, and most sessions had low attendance. The most commonly stated reason for not attending sessions was scheduling conflicts. To alleviate these conflicts, the peer leaders eliminated weekly session times with no student participation and added two additional times, including one on the weekend. The 2010 program included scheduled times based on student input to an online scheduling site. Unfortunately, these measures did not have a noticeable effect on improving attendance. Given the positive learning experiences of the session attendees, it makes sense to consider incorporating the sessions as a general course requirement. Other peer-assisted learning programs successfully incorporate these requirements (Tenney & Houck, 2003). If students signed up for a weekly discussion session during registration, they would have a better opportunity to plan around work and personal obligations.

One unexpected benefit of the program was to the peer leaders themselves. One peer leader changed her career goals as a result of the experience. She was on a pre-pharmacy tract; now she wants to pursue a career teaching science. She was hired as a tutor in the Math and Science Learning Center while finishing her biology degree. After she graduated, she was offered a position assisting in introductory biology labs. It is encouraging to see the far-reaching effects on the enrolled students as well as the peer leaders. For example, one student volunteered to serve as an informal same-year peer leader in Human Anatomy and Physiology 2. She said the peer leaders made an impact on her in Human Anatomy and Physiology 1, and she wanted to continue the effort in the second semester. She created and distributed study guides to the class and helped organize study sessions. She then served as one of two peer leaders in the Spring 2010 Human Anatomy and Physiology 1 course.

Session format is crucial to the success of any peer-leader program. The first sessions of each semester were dedicated to time management, study skills, and note-taking advice. Students, especially those who admitted to limited academic study in the past, responded favorably to these sessions. The later sessions focused on material from the lectures and labs. The students were encouraged to ask questions about the material, and the peer leaders often led review sessions of the material. Unfortunately, students' enthusiasm toward the sessions waned as the semester progressed. Future adaptations include incorporating more group-centered case studies and problems to supplement the course material (Tariq, 2005). The Peer-Led Team Learning website ( is an excellent resource for strategies to create this program in a science classroom (Gosser, 2008).

A critical point of consideration is how to fund the peer-leader program. A crucial element in seeking funding is to outline measurable outcomes and collect quantitative and qualitative data. Administrators are unlikely to support the program if they cannot assess it and see improvements from it. This 2-year study was supported at the college level and through a STEM initiative; however, a permanent program requires a consistent source of funding. Some universities fund the program through a student fee, while other programs offer course-credit opportunities for peer leaders.

Peer-assisted learning programs are associated with improved student performance and engagement. Students who attended five or more peer-leader sessions had significantly higher final course averages and overall GPAs. Thus, the future challenges for the author are to entice more students to take advantage of the program and to assess its impact. Educators who incorporate peer-assisted learning face many decisions and logistical problems specific to our discipline. Unfortunately, there are limited peer-assisted learning resources related to biology. Currently, there is not a central, active online resource tailored only to biology instructors. An open-access website with blogs, reports, and interactive planning tools would benefit biology educators seeking to implement or improve peer-assisted learning.

DOI: 10.1525/abt.2011.73.3.5

* Acknowledgments

This work was supported by CSU College of Letters and Sciences and the CSU STEM Initiative: A Comprehensive Plan for Success as a part of the University System of Georgia STEM grant funding.


Bruffee, K. (1998). Collaborative Learning: Higher Education, Interdependence, and the Authority of Knowledge, 2nd Ed. Baltimore, M D: Johns Hopkins University Press.

Evans, W., Flower, J. & Holton, D. (2001). Peer tutoring" in first-year undergraduate mathematics. International Journal of Mathematical Education in Science and Technology, 32,161-173.

Gosser, D.K. (2008). Report on peer-led team learning (PLTL)--PLTL national dissemination: building a national network--introduction. Progressions: The Peer-Led Team Learning Project Newsletter, 9(2). [Online.] Available at

Griswold, J. & Gaines, M. (2005). Peer-led team learning: introductory biology. Progressions: The Peer-Led Team Learning Project Newsletter, 7(1). [Online.] Available at

Johnston, J. & McClelland, G. (2009). To teach is to learn twice: do undergraduate science teachers improve their physics understanding by becoming peer leaders? [Presented at the 2009 Science Learning and Teaching Conference, Heriot-Watt University, Edinburgh.]

Laoui, T., & O'Donoghue, J. (2008). Development of a support environment for first year students taking" materials science/engineering. Research in Science & Technological Education, 26, 93-110.

Tariq, V.N. (2005). Introduction and evaluation of peer-assisted learning in first-year undergraduate bioscience. Bioscience Education, 6,1-19.

Tenney, A. & Houck, B. (2003). Peer-led team learning in introductory biology and chemistry courses: a parallel approach. Journal of Mathematics and Science: Collaborative Explorations, 6,11-20.

Tien, L.T., Roth, V. & Kampmeier, J.A. (2002). Implementation of a peer-led team learning instructional approach in an undergraduate organic chemistry course. Journal of Research in Science Teaching, 39, 606-632.

KATHLEEN S. HUGHES is Associate Professor of Biology at Columbus State University, 't225 University Avenue, Columbus, GA 31907; e-mail:

Table 1. Student performance and peer-leader-session attendance.

                                   0-4 Sessions ([+ or -] SD)

                                    2009                 2010

Number of Students                   45                   52

Final Course Average         66.3 [+ or -] 15.6   66.5 [+ or -] 19.2
Pretest Score (out of 10)     2.7 [+ or -] 1.5     2.9 [+ or -] 1.3
Posttest Score (out of 10)    5.2 [+ or -] 2.1     5.7 [+ or -] 1.9
Posttest-Pretest              2.5 [+ or -] 2.2     2.8 [+ or -] 2.0

                                   5+ Sessions ([+ or -] SD)

                                    2009                 2010

Number of Students                   18                   17

Final Course Average         82.0 [+ or -] 11.3   81.5 [+ or -] 15.4
Pretest Score (out of 10)     2.1 [+ or -] 0.9     2.5 [+ or -] 1.4
Posttest Score (out of 10)    5.8 [+ or -] 2.0     6.4 [+ or -] 1.8
Posttest-Pretest              3.7 [+ or -] 2.2     3.9 [+ or -] 2.3

Notes: *  p < 0.01, ([dagger]) p < 0.001, compared to 0-4
session-attendance data from same year.

Table 2. Peer-leader evaluation results.

 Agree     Agree   Undecided   Disagree   Strongly Disagree
   5         4         3          2               1

                                          AVG Score ([+ or -] SD)


The peer leader helps me                  4.3 [+ or -] 0.99
understand the course

The peer leader provides tools            4.3 [+ or -] 1.14
to help me learn the course

I am more confident about the             3.75 [+ or -] 1.07
exam(s) after attending a
peer-leader session.

Based on my experience, I                 4.5 [+ or -] 0.97
would encourage other students
to engage in peer-leader

I recommend that the                      4.63 [+ or -] 0.67
cross-year peer-assisted
learning program continue in
future semesters.

I welcome the implementation              4.63 [+ or -] 0.64
of peer leaders in other

 Agree     Agree   Undecided   Disagree       No Opinion
   5         4         3          2               0

                                          AVG Score ([+ or -] SD)


The peer leader helps me                   3.9 [+ or -] 0.9
understand the course

The peer leader provides tools             3.9 [+ or -] 1.1
to help me learn the course

I am more confident about the              3.5 [+ or -] 1.1
exam(s) after attending a
peer-leader session.

Based on my experience, I                  4.2 [+ or -] 0.9
would encourage other students
to engage in peer-leader

I recommend that the                       4.4 [+ or -] 0.9
cross-year peer-assisted
learning program continue in
future semesters.

I welcome the implementation               4.4 [+ or -] 0.8
of peer leaders in other

Table 3. Student assessment of peer-leader program.

Helpful Techniques/               Suggested
Information                       Improvements

Made information easy to under-   More sessions/different
stand and learn; teaching style   times

Tips and hints to remember        More specific information

They broke things down            Review session of each
step-by-step                      week's topics

Chapter outlines/study guides     More effort to get
                                  students to participate

Answering questions               More peer leaders

Personal reference in lab as      More emphasis on lab
needed                            sessions

Hearing the information again     More structured sessions

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