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Peer Learning: Overview, Benefits, and Models

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How do K-12 teachers facilitate effective learning? The best teachers do more than just read from a textbook. They understand that there are many different techniques, theories, and teaching models that can give students a well-rounded education that’s foundational to a lifetime of success and continual improvement.

Effective learning happens in many ways. Some students learn well directly from a teacher. Others are skilled independent learners. Yet, one of the most effective active learning techniques is that of peer learning. Put simply, peer learning is when students teach each other. This type of learning aids retention and encourages communication and collaboration. 

Learn more about peer learning and how a teaching degree from WGU can prepare you to make a difference in the classroom.

What Is Peer Learning?

Peer learning is an education method that helps students solidify their knowledge by teaching each other. One student tutoring another in a supervised environment can result in better learning and retention. Why? Because to teach another, one must first fully understand a concept themselves. Verbalizing a concept and sharing the information with a peer serves to reinforce the knowledge gained. 

Peer learning is best supported by other learning strategies, including the Constructivism Learning Theory and the Connectivism Learning Theory . 

Constructivist learning suggests that knowledge is constructed by each individual student. The new concepts they learn are built upon their existing knowledge and beliefs. Constructivism also proposes that learning is an active process and a social activity. These concepts tie in well with peer learning. 

Next, there’s Connectivism. Introduced in 2005 by George Siemens, the Connectivism Learning Theory focuses on technology as a critical component of connected learning. Today’s social networks allow rapid information transfer, but not every piece of information is equally helpful or enriching. Siemens suggests that being able to distinguish between important and unimportant information is vital. Even young students today are connected to the world and to each other through online means. An understanding of connectivism is especially helpful for K-12 teachers in the digital age. 

Why Is Peer Learning Important?

To thrive in school, in the workplace, and in society, individuals must be able to learn from others and work with them to achieve mutual success. Below are even more reasons why peer learning is important.

Teamwork:   Peer learning fosters teamwork, cooperation, patience, and better social skills. In a cooperative peer learning environment, each student’s strengths can serve to complement the group and enhance learning. Becoming skilled at working with and learning from one's peers can start at a young age in the classroom. 

Better Feedback :  Often, students are not able to recognize the gaps in their own knowledge. But when they learn with their peers, they can see new processes for answering questions and come up with creative, collaborative solutions. Importantly, they will carry these new perspectives, as well as a willingness to seek and accept feedback, with them as they progress in their education. 

Supports Diversity:   Peer learning fosters diversity and depth in a student’s knowledge and opinions. Learning from peers of different backgrounds, views, and ethnicities fosters an environment of mutual respect, gratitude, and progress. It’s the differences between students that add a richness to the learning environment. Supporting diversity through peer learning is part of culturally responsive teaching .   

What Are the Benefits of Peer Learning?

It’s hard to number all the benefits of peer learning, but some of them include new perspectives, more social interaction, and deepened personal learning. See more information on these specific areas below.

New Perspectives for Students:   If a student learns exclusively from the teacher, they may only gain one new perspective. Learning from their peers can add numerous helpful perspectives, nuances, and layers to a student’s knowledge. 

Social Interaction Makes Studying Fun:   By nature, humans are social beings. We long to make connections and be part of a group. The added element of social interaction in peer learning can be exciting and enriching. Students who may be hesitant to interact with the teacher may be more willing to open up to their peers.

Teaching Others Helps Students Learn:  Nothing requires you to feel confident in your own knowledge quite like teaching what you know to someone else. As mentioned, peer learning can help students learn and solidify their own knowledge. Effective teaching requires a deeper level of knowledge on a subject.

Peer Learning Drawbacks

While there are many benefits to peer learning, there are also some drawbacks, including distraction and lack of respect for feedback.

Working in Groups Can Be Distracting: Learning from your peers can be exciting. However, especially for younger students, that excitement can lead to distraction. When working with their friends, some students can easily get off track, misbehave, and focus on anything but learning.

Students Might Not Respect the Feedback of Their Peers:  If a teacher gives feedback, the student is more likely to listen carefully. After all, the teacher is the authority in the classroom and the resident expert on the subject being taught. On the other hand, if one’s peer gives them feedback, it’s easier to disregard it.

Peer Learning Models

Effective peer learning can take place through many different models and strategies. See some of the tried-and-true ways to encourage peer learning.

Proctor Model:  In the proctor model, an older or more experienced student teaches a younger or less experienced peer. In an elementary school, this might mean that students from a higher grade level come and teach kindergarteners. It could also entail having a more skilled student within the class teach their classmate.  

Discussion Seminars:  Discussion seminars are more common at the university level. They’re often held after students learn the material through a lecture or a weekly reading. Through these discussions, students deepen their knowledge and gain additional perspectives.

Peer Support Groups: Sometimes referred to as private study groups, peer support groups are student-led gatherings that are generally held outside of class without teacher support. Peers might meet up to study for a test together or complete a group project.

Peer Assessment Schemes:  Peer assessment schemes can be common in writing courses. For instance, an AP English Language teacher might have students read one another’s essays to provide informal feedback. 

Collaborative Projects: Assigning students to work on collaborative projects can serve them well for their future endeavors in the workplace and society. These projects teach collaboration, the importance of combining skills, and the need to meet deadlines.

Cascading Groups: Cascading groups is a learning method by which students are split into groups that get either progressively larger or smaller. For instance, students might be encouraged to learn about a distinct topic on their own and then share it with a partner. That partnership would then share their knowledge with another partnership and so forth.

Mentoring: A mentor is someone who has experience in a certain area. They guide a student, training them and teaching them the lessons they once had to learn. Peer tutoring is a form of mentoring. Sometimes students who require extra support are assigned a personal peer mentor who works one-on-one with them to help them succeed.

Reciprocal Teaching: In reciprocal teaching, students must develop the skills of questioning, predicting, summarizing, and clarifying. They teach one another using these techniques. They serve to form a sort of scaffolding for peer-led learning.

Jigsaw Method: In the jigsaw method of peer learning, students are split into groups, with each group given a different topic to study. Then, one student from each group is taken to form a collaborative group where multiple concepts are discussed. If there are eight jigsaw groups, then eight topics will ultimately be discussed in one group.

Discover More Learning Models with WGU

Peer learning is an effective way to facilitate deep learning. It also lends itself to many different approaches. The power of a classroom where students come together is that of collaborative learning. Teachers who implement peer learning strategies in their classroom may see higher levels of student performance, satisfaction, and overall engagement.

If you’re ready to learn new teaching methods and prepare to make a difference in the classroom, check out the WGU School of Education . The programs help teachers learn up-to-date teaching methods for the modern learning environment.  

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What is peer-to-peer learning?

Reasons why you need a peer to peer organization, how to introduce peer training as a practice, setting up a peer learning program: 7 steps, future trends in peer learning, peer-to-peer learning fosters employee growth.

Peer to peer learning is a type of mutual learning and training strategy. It involves participants of the same level engaging in collaborative education.

Peer to peer learning is invaluable in many situations. 

While it's usually associated with classrooms, peer learning is also important at work. It creates an engaged workforce that is constantly developing their skills.

Here’s how to introduce peer-to-peer learning in the workplace and the many benefits of doing so. 

Put simply, peer-to-peer learning is when one or more students (or coworkers) teach other students (or coworkers). 

Regardless of whether individuals are students or coworkers, people support each other throughout the learning process. It's important each learner is treated the same no matter their ability.

Peer learning in an educational environment

In an educational setting, students learn from other students, usually through group activities. Instead of a teacher explaining a concept, students engage with one another as equals.

Each student isn’t just responsible for learning what is being taught, but also helping fellow students learn through cooperative learning.

Peer learning in the work environment

Peer learning isn’t just for students at school or college. Colleagues at work can learn from each other through a peer to peer organization. In the same way that students teach each other, employees teach one another. 

As well as employees learning new skills, managers can also benefit. Peer training   empowers managers   to identify knowledge gaps within companies.

It’s important to note that peer learning is not a cut-and-dry concept. Any meaningful collaboration of peers at work can be considered peer learning. 

According to The Expertise Economy,   peer-to-peer learning taps into existing expertise . 

Employees' experiences and knowledge are one of the biggest assets to an organization. And this should be leveraged.

Think of all the knowledgeable and capable employees you hire and interact with on a daily basis. Now think about how much expertise their peers could gain if this knowledge was shared.

Peer learning is especially well-suited to the   way humans learn new information .

It’s easier for us to learn new skills in an environment that includes the four key stages of the ‘Learning Loop’.

These stages are:

• Gaining knowledge
• Applying that knowledge
• Receiving constructive feedback
• Reflecting on skills and lessons learned

Peer-to-peer strategies cover all these stages, making for well-rounded and effective training.

Here are some of the benefits you can expect to see in a successful peer-to-peer organization: 

• It encourages connectivity and collaboration.   As peers interact with each other, they learn how to work together as a unit as opposed to individually. This develops into a positive workplace culture of sharing.
• It can help to boost employee morale and well-being.   Employees that help their colleagues learn and develop their skills boost self-confidence. This lends itself to an increased sense of belonging and connection.

Unfortunately,   one out of four employees feels like they don't fit in . Fostering that sense of belonging in a peer-to-peer organization is crucial.

• It can increase engagement.   By being teachers, as opposed to just students, employees are more invested in an activity. Rather than taking directives, employees actively want to learn and teach others.
• It can improve retention & productivity.   Workplace learners can learn more efficiently when a peer provides support. Giving them more time to absorb knowledge can help them remember information.
• It helps to ensure new employees feel comfortable.   Connecting an experienced colleague with a new recruit helps them feel more integrated. The new hire can learn new aspects related to the job and organization seamlessly.
• It provides a safe space to ask questions.   Employees feel more freedom to challenge ideas with their peers. They are more likely to raise concerns with a colleague than with a manager or boss.
• It reinforces employees’ existing knowledge.   Many studies have shown the benefits of the learning-by-teaching effect. Colleagues who spend time teaching what they've learned have a better understanding too.

Peer training can happen in numerous parts of an employee’s job. Let’s take a look at how to introduce peer training as a practice in the workplace:

Peer training during onboarding

Onboarding is the first place where employees can participate in peer learning. Let’s look at three ways to implement peer training into onboarding:

• Assign a peer mentor or coach

Pair entry-level employees with a more experienced peer. Having a mentor can help new hires integrate smoothly into a company.

They can connect new employees with other colleagues to cultivate important   workplace relationships .

• Use an onboarding platform

Give your new team member access to a collaborative onboarding learning platform. The platform should share everything from company culture to payroll information. 

Knowing the ins and outs of their new company will help new employees feel that they fit in. It’ll set them up for success and let them hit the ground running on their first day.

• Set up an online workgroup

Online workgroups allow employees, new and old, to create collaborative learning communities. 

These tools boost productivity by helping teams work together more efficiently. The best part is that knowledge is shared via one easily accessible platform.

Peer training in constant performance

You can implement peer training into employees’ day-to-day work lives. Let’s look at three ways to implement peer training in employees’ constant performance:

• Peer learning lunches

Also known as “learn at lunch” or “brown bag” events, lunches make for popular trends in peer training.

In these peer learning sessions, employees aren’t just gaining new information. They’re interacting with their peers in a relaxed, social environment. 

Because of their informality, employees are less intimidated and more open to sharing. In exchange for their participation, employees can look forward to a free lunch. It’s a win-win!

• Social learning tools

Social media isn't just for sharing and liking pictures of family and friends. Platforms like Facebook and Twitter have immense social learning value in the workplace.

Facebook's own   Workplace   is a great tool for collaboration and fostering more interaction. It facilitates online group work, video conferencing, and resource sharing.

• Learning management systems (LMS)

Cloud technology enables peers to work remotely and collaborate together in real-time. Once uploaded, employees have unlimited access to the information they need.

Peer training during reviewing processes

Reviewing processes are a great learning opportunity for employees, and peer training helps to facilitate that. Let’s take a look at three ways to implement peer training during reviewing processes:

• Peer performance feedback

Peer reviews let employees gain a full understanding of their work and the work of their peers. More transparency and feedback adds insight that a manager might not be able to give.

• Group reflection conversations

Set aside time for teams and the peer-to-peer organization as a whole to assess their work, value, and beliefs. Group reflection helps employees build their emotional intelligence. 

• Continuous peer training sessions

Workshops run by experts outside the organization have their value. But ongoing peer interactions are where the real magic happens. 

Ask employees for their input on how they’d like to run the sessions and how often they’d like them to happen. 

Keep up to date with the latest trends in peer learning to keep your peer training sessions relevant and engaging.

Here's how you can set up a peer learning program within the workplace and make sure it's successful in seven steps:

1. Nominate a peer learning facilitator

A facilitator will help the process run smoothly. They should keep the conversation flowing but not be directly involved. It’s important they stay neutral, and there is no authority associated with their role.

2. Create a safe environment to learn from each other

There's no good in setting up a peer training session if no one feels comfortable sharing. 

Everyone should feel they can   speak up and share their experiences . Participants must feel safe to ask questions without feeling embarrassed.

Emphasize the importance of respectful communication. The facilitator can help set up a code of conduct. 

3. Set up networking events

Networking events aren't all about exchanging business cards. They can be a great source of new perspectives and ideas.

Set up happy hour meetups, industry seminars, or office mixers. These sharing events will help form trust and build connections amongst colleagues.

4. Pair seasoned employees with new recruits

Identify seasoned employees to create peer-to-peer learning content for new employees. It’ll give the newcomers a chance to learn their jobs hands-on and to integrate into the company.

5. Identify common reasons to learn from each other

Finding the commonality between experiences helps employees relate to one another.

Employees might be surprised to learn their colleagues have struggled with a similar problem. This drives a desire to learn how they overcame the issue.

6. Encourage diverse perspectives

Bringing together employees from different backgrounds fosters an   open-minded, global company culture . This can make them better equipped to see situations from many perspectives.

7. Keep track of comprehension

Ask your peer learners for suggestions and feedback on the lessons they have learned. Make a note of learners’ consumption of the educational content. You can use this information to improve future peer training programs.

In today's world, it's not viable for every employee to fend for themself. Gone are the days of each person being an island. 

The global pandemic has turned many of our worlds upside down. Pre-COVID-19, you may have discussed a project with your colleague at their desk. Or you'd hash out a problem over a bite to eat.

Unfortunately, many of us are now limited to Zoom calls. But we are still social creatures who crave that sense of community. Our desire to learn from others hasn't changed. 

What needs to change is the way we do it. 

New and actionable workforce skills are in high demand in the modern world. The   rise of virtual teams   means employees need new skills to get their work done.

The McKinsey Global Survey   shows the urgency for addressing growing skills. 69% of organizations do more skill-building now than before the pandemic . 

This shows a growing need for effective and affordable educational approaches.

New trends in peer learning give employees the chance to   learn from each other remotely   and in person. This enhances skill transformation and promotes meaningful collaboration in the workplace.

Peer-to-peer learning creates a collaborative environment among employees. New recruits are able to learn from seasoned employees. 

In return, seasoned employees are able to further solidify their own knowledge through peer teaching.

Implementing peer learning can also help your employees and organization adapt to a changing world.

Wanting to learn more about peer learning and foster employee growth at your organization?   Consider working with BetterUp   to grow both as an individual and in your organization.

Maggie Wooll

Maggie Wooll is a researcher, author, and speaker focused on the evolving future of work. Formerly the lead researcher at the Deloitte Center for the Edge, she holds a Bachelor of Science in Education from Princeton University and an MBA from the University of Virginia Darden School of Business. Maggie is passionate about creating better work and greater opportunities for all.

Peer vs. colleague? Learn the difference for smoother sailing

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• Published: 02 December 2022

School-based peer education interventions to improve health: a global systematic review of effectiveness

• Steven Dodd 1   na1 ,
• Emily Widnall 2   na1 ,
• Abigail Emma Russell 3 ,
• Esther Louise Curtin 4 ,
• Ruth Simmonds 5 ,
• Mark Limmer 1 &
• Judi Kidger 2  

BMC Public Health volume  22 , Article number:  2247 ( 2022 ) Cite this article

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Introduction

Peer education, whereby peers (‘peer educators’) teach their other peers (‘peer learners’) about aspects of health is an approach growing in popularity across school contexts, possibly due to adolescents preferring to seek help for health-related concerns from their peers rather than adults or professionals. Peer education interventions cover a wide range of health areas but their overall effectiveness remains unclear. This review aims to summarise the effectiveness of existing peer-led health interventions implemented in schools worldwide.

Five electronic databases were searched for eligible studies in October 2020. To be included, studies must have evaluated a school-based peer education intervention designed to address the health of students aged 11–18-years-old and include quantitative outcome data to examine effectiveness. The number of interventions were summarised and the impact on improved health knowledge and reductions in health problems or risk-taking behaviours were investigated for each health area separately, the Mixed Methods Appraisal Tool was used to assess quality.

A total of 2125 studies were identified after the initial search and 73 articles were included in the review. The majority of papers evaluated interventions focused on sex education/HIV prevention ( n  = 23), promoting healthy lifestyles ( n  = 17) and alcohol, smoking and substance use ( n  = 16). Papers mainly reported peer learner outcomes (67/73, 91.8%), with only six papers (8.2%) focussing solely on peer educator outcomes and five papers (6.8%) examining both peer learner and peer educator outcomes. Of the 67 papers reporting peer learner outcomes, 35/67 (52.2%) showed evidence of effectiveness, 8/67 (11.9%) showed mixed findings and 24/67 (35.8%) found limited or no evidence of effectiveness. Of the 11 papers reporting peer educator outcomes, 4/11 (36.4%) showed evidence of effectiveness, 2/11 (18.2%) showed mixed findings and 5/11 (45.5%) showed limited or no evidence of effectiveness. Study quality varied greatly with many studies rated as poor quality, mainly due to unrepresentative samples and incomplete data.

School-based peer education interventions are implemented worldwide and span a wide range of health areas. A number of interventions appear to demonstrate evidence for effectiveness, suggesting peer education may be a promising strategy for health improvement in schools. Improvement in health-related knowledge was most common with less evidence for positive health behaviour change. In order to quantitatively synthesise the evidence and make more confident conclusions, there is a need for more robust, high-quality evaluations of peer-led interventions using standardised health knowledge and behaviour measures.

Peer Review reports

Ensuring good health and wellbeing amongst school-aged children is a global public health priority and the contribution schools can make to this goal is increasingly recognised [ 1 ]. Worldwide, we have seen a rise in peer education interventions over recent decades [ 2 ]. For example, a survey in England revealed that 62% of primary and secondary schools had offered a peer-led intervention in 2009 [ 3 ]. Peer-led interventions within school settings are popular for many reasons, including the important role peers play within the lives of young people, a perception that this approach involves relatively few resources, and the more even balance of authority than in teacher-led lessons [ 4 ]. The use of peer educators for health improvement has also been linked with the importance of peer influence in adolescence [ 5 ]. This is a time of increased social development and peer attachments are central to young people’s development, particularly during adolescence [ 5 , 6 ]. Further, there is evidence that young people are more likely to seek help from informal sources of support such as friends in comparison to adults [ 7 ], and of older students being perceived as role models by their younger peers [ 8 ]. Benefits are also likely to exist for peer educators themselves, including opportunities to develop confidence and leadership skills, as well as many schools rewarding peer educators with a qualification or endorsement for their participation [ 9 ].

Existing peer education interventions cover a wide range of health areas, including mental health, physical health, sexual health, and a general promotion of healthy lifestyles including eating habits and smoking prevention [ 10 , 11 , 12 , 13 ]. There is also variation in the format or delivery of peer-led interventions including 1:1 peer mentoring, peer buddy initiatives, peer counselling, and peer education [ 14 , 15 , 16 , 17 ]. This review focuses specifically on peer education, which typically involves the selection and training of ‘peer educators’ or ‘leaders’, who subsequently relay health related information or skills to younger or similar aged students in their school, known as ‘peer learners’ or ‘recipients’.

Summary of related reviews

The current literature on peer education indicates a mixed evidence base regarding its effectiveness.

Ten previous reviews were found concerning health-related peer education among young people [ 10 , 12 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Of these, six concerned sexual health/HIV prevention, two concerned health promotion/education more broadly, one focused on substance abuse and one focused on mental health.

Kim and Free’s review concerning sexual health [ 21 ] found no overall effect of peer education on condom use, mixed findings on sexually transmitted infection (STI) prevention, and positive findings regarding improvements in knowledge, attitudes and intentions. Siddiqui et al. [ 20 ] reviewed peer education programmes for promoting the sexual and reproductive health of young people in India, revealing large variations in the way peer education is implemented as well as mixed effectiveness findings and limited effects of behaviour relative to knowledge. Maticka-Tyndale and Barnet [ 22 ] compiled a review into peer-led interventions to reduce HIV risk among youth using a narrative synthesis, and found that peer interventions led to positive change in knowledge and condom use, and had some success in changing community attitudes and norms, but no significant findings for effects on other sexual behaviours and STI rates. By comparison, Tolli’s review [ 12 ] regarding the effectiveness of peer education interventions for HIV prevention found no clear evidence of peer education effectiveness for HIV prevention, adolescent pregnancy prevention or sexual health promotion in young people of member countries of the European Union.

Mellanby et al. [ 23 ] reviewed the literature comparing peer-led and adult-led school health education and identified eleven studies. Seven of these studies found peer-led to be more effective for health behaviour change than adult-led and three of these studies found peer-led to me more effective for change in knowledge and attitudes. Harden et al. [ 24 ] identified 64 peer-delivered health interventions for young people aged 11 to 24 in any setting (i.e. not restricted to school settings), with only 12 evaluations judged to be methodologically sound. Of these 12, 7 studies (58%) showed a positive effect on at least one behavioural outcome. This review concluded an unclear evidence base for peer-delivered health promotion for young people.

MacArthur et al’s [ 19 ] investigation of peer-led interventions to prevent tobacco, alcohol and/or drug use among young people aged 11–21, comprised a meta-analysis, pooling 10 studies on tobacco use, and found lower prevalence of smoking among those receiving the peer-led interventions compared with controls. The authors also found that peer-led interventions were associated with benefit in relation to alcohol use, and three studies suggested an association with lower odds of cannabis use.

A recent systematic review by King and Fazel of 11 school-based peer-led mental health interventions studies revealed mixed effectiveness [ 10 ]. Some studies showed significant improvements in peer educator self-esteem and social stress [ 25 ], but one study showed an increase in guilt in peer educators [ 26 ]. Two studies also found improvements in self-confidence [ 27 ], and quality of life in peer learners [ 28 ], but one study found an increase in learning stress and decrease in overall mental health scores [ 26 ]. The review concluded there is better evidence if benefits for peer educators compared to peer learners. The summary above of previous systematic assessments of the peer education approach reveals a limited evidence base for school-based peer education interventions. Only two reviews were included regarding school-based peer education, one of which occurred over 20 years ago [ 23 ], while the other [ 10 ] was more narrowly concerned with mental health outcomes.

Despite the widespread use of peer-led interventions, the evidence base across all health areas still remains limited and little is known regarding their overall effectiveness in terms of changing behaviours or increasing health-related knowledge and/or attitudes. Due to the limited evidence base of peer education interventions, this review is broad in scope and will cover global peer education interventions covering all health areas. Although some peer education interventions are targeted towards specific populations, this review focuses on universal interventions available to an entire cohort of students (for example whole class or whole year group). The review aims to summarise the effectiveness of existing peer-led health interventions in schools. This is a review of quantitative data; the qualitative peer education literature will be published in a separate review.

We followed the PICO (Population, Intervention, Comparator and Outcome) format to develop our research question. We completed the systematic review in accordance with the 2009 PRISMA statement [ 29 ] and registered it with PROSPERO (CRD42021229192).

Search strategy and selection criteria

Five electronic databases were searched for eligible studies: CINAHL, Embase, ERIC, MEDLINE and PsycINFO. The list of search terms (see Supplementary Materials ) were developed after scanning relevant literature for key terms. Searches took place during October 2020.

Once the search terms had been agreed amongst the study team, pilot searches were run to check that key texts were appearing. Search terms were subsequently refined and this process was repeated until all key texts appeared. Search strategies such as truncations were used to maximise results. No restrictions were placed on publication date, country or language.

Inclusion/exclusion criteria

To be included studies had to be concerned with school-based peer education interventions designed to address aspects of the health of pupils aged 11–18 years old. We are interested in this age group in particular as it is a period when peers take on a particularly important role in young people’s lives. Peer education interventions concerned with health are defined here as interventions in which school-aged children deliver the education of other pupils for the purposes of improving health outcomes or awareness/literacy relating to health, including knowledge, behaviours and attitudes. Interventions must have taken place within a school, during school hours and must be universal, i.e. not targeted towards a specific sub-group of students or students with a particular health condition.

Where comparators/controls existed, they had to include non-exposure to the interventions concerned, exposure to a differing version of the same intervention, or exposure to the intervention within a substantially differing context.

Papers were excluded from data synthesis if they satisfied any of the following criteria:

Peer education interventions only concerned academic outcomes (e.g., reading and writing achievement).

Interventions concerning anger management, behavioural problems, or social skills.

Interventions concerning traffic safety, health and safety, avoidance of injuries, or first aid.

Interventions concerning cultural, social or political awareness (e.g., media literacy).

Interventions in which health outcomes are secondary to other outcomes (e.g., interventions focused on reading that indirectly improve self-esteem).

One-to-one mentoring interventions.

Conference abstracts, research briefings, commentaries, editorials, study protocol papers and pre-prints.

Primary outcome(s)

Improvements in health, including health awareness and understanding as indicated by responses to questionnaires.

Reductions in health problems or risk-taking behaviours.

These outcomes may concern the peer educators and/or peer learners.

Data extraction, selection and coding

Two reviewers independently screened all papers according to the inclusion criteria above using the Rayyan online review platform. In cases where the reviewers were uncertain, or where the decision was disputed, the decision was discussed and agreed among the wider research team. Two reviewers (SD and EW) then divided the papers between them and independently extracted the data, discussing and queries that arose with each other and the wider team.

Data extraction included the following:

Bibliographic details – authors, year of publication, nation in which intervention was carried out

Aims of the study

Description of study design

Sample size and demographic characteristics.

Context into which the intervention is introduced (characteristics of the school involved, the area in which the school is located, characterisations of the student body, relevant policy considerations).

Description of intervention (including duration of intervention).

Outcome measures (measurement tools, time points of data collection).

Data concerning improvements in health.

Quality appraisal

We used the Mixed Methods Appraisal Tool (MMAT) to assess quality of reporting procedures. This tool consists of five specific quality rating items depending on study design (qualitative, quantitative randomized, quantitative non-randomized, quantitative descriptive and quantitative mixed methods). There are 5 quality questions specific to each study design, so all papers are rated between 0 to 5. The following ratings were used to summarise study quality; 0–1 indicating poor quality, 2–3 indicating average quality and 4–5 indicating high quality. Two reviewers (SD and EW) completed quality ratings on each paper and discussed any discrepancies between them.

Examples of randomized design quality questions included items such as: “ Is randomization appropriately performed ? And “ Are the groups comparable at baseline ?” Examples of non-randomized design quality questions included items such as: “ Are the participants representative of the target population?” and “Are there complete outcome data?”

Effectiveness summary

EW and SD completed data synthesis. Due to the volume of studies, and the large number and heterogeneity of outcome measures, in order to summarise effectiveness, we created the following scoring system to indicate effectiveness:

Significant effects are effects where there was an improvement in health-related outcomes either after the peer education intervention, or when compared to a control group, with a p value of <0.05. Due to the volume of studies and varied follow-up periods, we looked at effectiveness at first follow-up, which in the majority of papers was immediately post-intervention.

A total of 2125 articles were identified after the initial search and 73 articles were eligible for inclusion (see Fig. 1 for a flow diagram of the search). Study designs of the 73 articles were as follows: 23 were controlled trial designs (15 cluster or group randomised, 6 randomised controlled and 2 non-randomised). 15 used randomisation methods but were not controlled trials and the remaining 35 studies used uncontrolled non-randomised methods comparing intervention with a comparison group or using a pre-post survey.

Prisma flow diagram of included studies

Health and geographical areas

The 73 quantitative papers included in this review demonstrated a wide range of health areas. The majority of papers evaluated interventions aimed at sex education/HIV prevention ( n  = 23), promoting healthy lifestyles ( n  = 17) and reducing alcohol, smoking and substance use ( n  = 16). Fig. 2 illustrates number of papers per health area by peer learner or peer educator outcome focus and Table 2 illustrates a summary of proportion of health areas, overall effectiveness and quality ratings.

Number of papers by health area. NB See Supplementary Materials for full description of study designs and outcomes

Papers mainly focussed on peer learner outcomes (67/73, 91.8%), with only six papers (8.2%) focussing solely on peer educator outcomes and only five papers (6.8%) reporting on both peer learner and peer educator outcomes. The majority of papers that focussed on peer educator outcomes were those concerned with sex education (n = 4) and mental health (n = 3).

Papers typically reported knowledge, attitude and/or behavioural outcomes. Of the 73 papers, 42/73 (57.5%) reported knowledge outcomes, 43/73 (58.9%) reported attitude outcomes, 35/73 (47.9%) reported behavioural outcomes and 13/73 (17.8%) reported behavioural intentions.

As well as a broad range of health areas, the papers included in the review also spanned several different countries (Fig. 3 ).

Summary of number of papers by country

We have summarised the results first by student type and then by health area.

Results by student type

Summary of peer learner outcomes.

Of the 67 papers reporting peer learner health outcomes, 35/67 (52.2%) showed evidence of effectiveness (as per our thresholds shown in Table 1 ), 8/67 (11.9%) showed mixed findings and 24/67 (35.8%) found limited or no evidence of effectiveness.

Of the 35 papers that demonstrated effectiveness, 9/35 studies (25.7%) were rated as high quality. Therefore only 9/67 (13.4%) of the total papers showed evidence of effectiveness and were rated as high quality.

Twenty-one papers (31.3%) reported controlled trial designs (including 14 cluster or group randomised, and 5 randomised controlled and 2 non-randomised). Thirteen papers used randomisation methods but were not controlled trials and the remaining 33 papers used uncontrolled non-randomised methods comparing intervention with a comparison group or using a pre-post survey design.

Summary of peer educator outcomes

Of the 11 papers reporting on peer educator health outcomes, 4/11 (36.4%) showed evidence of effectiveness, 2/11 (18.1%) showed mixed findings and 5/11 (45.5%) showed limited or no evidence of effectiveness. Of the 4 papers showing evidence for effectiveness, 2 studies (50%) were rated as high quality.

Four papers had a randomised design comparing intervention vs. control or ‘peer educators vs. classmates’ one of which was a cluster randomised controlled trial. The remaining 7 papers used non-randomised intervention vs. control ( n  = 2) or pre-post survey designs ( n  = 5).

A full table of included studies, outcomes and effectiveness and quality ratings can be found in Supplementary Material 1 .

Results by health area

Sex education/hiv prevention.

Twenty-three studies concerned sex education/HIV prevention [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. 9/23 studies had a randomised design with the 8 studies comparing peer-led to teacher-led or ‘lessons as usual’ and one study comparing peer-led with nurse-led. 14/23 involved non-randomised designs comparing intervention vs. control or a pre-post survey design. Studies covered a wide geographical range, among which there were 7 US studies, but also studies from Canada, UK, Africa, South Africa, Turkey and Greece.

Of the twenty-three papers, 21 reported peer learner outcomes, 4 papers reported peer educator outcomes, with 2 papers reporting on both peer educator and peer learner outcomes. The mean number of participants across the studies was 2033 (range: n  = 106–9000).

8/23 (34.8%) of studies showed evidence of effectiveness, and all studies demonstrating effectiveness consisted of knowledge and attitude outcomes rather than behavioural change.

Only 4/23 studies were rated high in quality (two of which showed evidence of effectiveness), whilst the majority of studies were rated medium quality (15/23) and 4/23 rated as low quality.

Healthy lifestyles (exercise, nutrition, oral health, health information)

Seventeen studies reported interventions addressing healthy lifestyles [ 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ]. Of these papers, ten used a randomised controlled trial design primarily comparing peer-led vs. teacher-led or ‘lessons as usual’, but two oral health papers also used a dentist-led condition. Seven papers used non-randomised research designs comparing intervention vs. control or a pre-post survey design.

The most common focus was nutrition and exercise, but interventions also covered oral health, accessing health information online and interventions taking a more general approach to health improvement. Regarding geographical spread, 5/17 papers reported interventions carried out in the USA, with Australia, China, India and UK represented by two papers per country.

Sixteen of the seventeen papers reported peer learner outcomes, and only one reported peer educator outcomes. The mean number of participants per intervention was 1245 (range: n  = 76–4576).

7/17 papers in this health area were shown to be effective, 8/17 were found to be ineffective, and 2/17 showed mixed results. In other words, less than half (41.1%) showed evidence of effectiveness. Of the studies demonstrating effectiveness, the outcomes largely centred around knowledge and attitudes, but one study did demonstrate positive behaviour change [ 62 ].

Over half of the studies (9/17) were rated as high quality, 4/17 were rated medium quality and 4/17 low quality. Of the studies showing evidence for effectiveness, 4/7 (57.1%) were rated as high quality.

Alcohol, smoking, substance use

Sixteen papers were classified within the category of alcohol, smoking and substance use [ 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 ]. Ten of these papers had a randomised design (including 3 cluster randomised controlled trials) comparing peer-led (intervention) vs. teacher-led (control). Six papers were non-randomised and used either a pre-post survey design or intervention vs. control. The 16 papers varied in quality with six rated ‘high quality’, seven rated ‘medium quality’, and three rated ‘low quality’. Studies took place across more than 10 countries with one study being conducted internationally. The mean number of participants across all studies was 2165 (range: n = 105–10,730).

Fifteen papers evaluated the effect of the intervention on peer learner outcomes and only one paper evaluated the effect of the intervention on peer educator outcomes. 8/16 (50%) papers showed evidence of effectiveness. 2/16 (12.5%) papers showed mixed findings and 6/16 (37.5%) showed little to no evidence for effectiveness, including the peer educator outcome paper. Of the eight papers demonstrating evidence for effectiveness, only four (50%) were rated as high quality.

Of the studies demonstrating effectiveness, there was a combination of knowledge, attitude and behavioural outcomes, but more evidence for positive changes in knowledge and attitude.

Mental health and well-being

Six studies assessed mental health and well-being [ 27 , 86 , 87 , 88 , 89 , 90 ]. This category was inclusive of common mental health problems, self-harm and suicide prevention as well as broader topics such as self-esteem and social connectedness. Four of the six studies used non-randomised pre-post survey designs and two studies used randomised design, one of which was a cluster randomised controlled trial.

Of the six studies, 5/6 explored peer learner outcomes, 3/6 explored peer educator outcomes, 2 of which explored both peer learner and peer educator outcomes. The average sample size across the seven mental health studies was 1118 (range: n  = 50–4128).

Study quality was mixed, with two studies rated as high quality, three medium quality and one low quality. Outcome measures largely consisted of knowledge and attitude questionnaires, help-seeking behaviour and help-seeking confidence as well as condition-specific measures including body satisfaction and self-report of emotional and behavioural difficulties.

The majority of mental health studies (5/6) were rated as showing evidence for effectiveness and one study was rated ineffective. Of the studies demonstrating effectiveness, only one reported positive behaviour change (help-seeking behaviours) and this behaviour changed was observed in peer educators as opposed to peer learners [ 86 ].

Disease prevention

Four studies assessed outcomes relating to disease prevention [ 91 , 92 , 93 , 94 ] which included hepatitis, tuberculosis, cervical cancer and blood borne diseases. All four studies focused on peer learner outcomes and one study also included peer educator outcomes. Three of the four studies were non-randomised pre-post survey designs and one study was randomised. The average sample size across the four studies was 2116 (range: 1265–2930).

Three out of the four studies (75%) showed evidence for effectiveness and one study showed mixed results. No studies were rated as high quality, three were rated medium and one was rated low.

Outcomes were largely knowledge or intention based. Studies showing effectiveness mostly related to knowledge, intentions and attitudes and one study did find a positive change in behaviour [ 93 ].

Five included studies assessed asthma interventions [ 95 , 96 , 97 , 98 , 99 ]. 4/5 of these were randomised trials and one study used a non-randomised pre-post survey design. Average sample size across all studies was 427 (range: n  = 203–935). Three studies took place in Australia and two in the US. All papers evaluated the impact of the intervention on peer learner outcomes with none focussing on peer educator outcomes.

4/5 studies showed evidence for effectiveness with only one study showing no evidence for effectiveness. All studies were rated as medium quality. Measures ranged from asthma knowledge, quality of life, school absenteeism, asthma attacks at school and asthma tests. Effectiveness was largely observed for knowledge outcomes, there was less evidence for asthma attacks or symptoms.

Two studies conducted in Italy assessed bullying by evaluating the ‘NoTrap!’ anti-bullying intervention [ 100 , 101 ]. The first study rated as high quality, evaluated two independent trials and focussed on peer learner outcomes ( n  = 622; n  = 461). This study found significant reductions in victimization, bullying, cybervictimization and cyberbullying and was rated as high quality. The second study, rated as medium quality, focussed on peer educator outcomes ( n  = 524) and used a non-randomised, pre-post survey design but overall, only showed some evidence of effectiveness amongst males in terms of reduced victimization and increased prosocial behaviour and social support. No evidence was found for effectiveness among females.

Peer education interventions to improve student health cover a wide variety of topics and are used globally. This review aimed to summarise the results from peer education health interventions in secondary school students (aged 11–18-years-old), which were universal (rather than targeted interventions of sub-groups of students) and carried out at school.

Due to the heterogeneity of findings, range of health areas, types of studies and diversity of outcome measurements used, it was not possible to perform a meta-analysis or formal data synthesis to assess effectiveness. However, some broad conclusions can be made. A number of interventions appear to demonstrate evidence for effectiveness which indicates that peer education interventions can be an important school-based intervention for health improvement. Asthma interventions appeared to be particularly effective. In terms of outcome measures, the strongest evidence was for a positive change in knowledge and attitude measures, but there was less evidence overall for health behaviour outcomes which supports previous findings [ 20 , 22 ].

Although many studies did demonstrate positive results, findings overall were very mixed and several studies were of poor quality. In addition to the shortcomings picked up on by our quality appraisal, many papers lacked methodological detail and clarity regarding the intervention procedure, particularly in regard to how peer educators were selected and trained, which seems to be an important factor in those studies that found positive results and was also emphasised in a previous review [ 10 ]. Further, there were widespread problems of data reporting including noting ‘significant’ results without providing any measure of effect size or between-study variability. Other problems included selective reporting of results, such as selective emphasis on anomalous positive results, or only revealing measures of statistical significance in the case of positive effects. Interestingly, there did not appear to be a relationship between study quality and findings, given that several studies rated as effective were rated both high and low quality with a similar picture for studies showing mixed effectiveness and ineffectiveness.

In terms of frequency of health areas covered, our findings are similar to a recent ‘review of reviews’ of peer education for health and wellbeing which found that the majority of reviews focused on sexual health and HIV/AIDS interventions [ 13 ]. This previous review focused on both children and adults, however, in line with our findings, it found mixed effectiveness and considerable diversity in methods, findings and rigour of evaluation. It was particularly noted that details of peer educator training were rarely provided in HIV/AIDS interventions which supports our findings. Notably, however, the quality of studies was actually highest for peer education programs in HIV/AIDS, which differed to our review which found few studies rated as high quality. This discrepancy may be due to the different measures used to assess quality. Like our study, this review concluded that each health area showed some promising results, but also pointed to a need for higher levels of quality and rigour in future evaluations.

Despite the rising prevalence in mental health difficulties, there were relatively few studies focused on mental health outcomes, particularly more general preventative approaches to mental health and well-being, with many of the included studies focusing on suicide prevention, self-harm or specific disorders. However, many of mental health studies included in this review showed evidence for effectiveness, suggesting peer education approaches for mental health should be further studied and evaluated.

Another key finding of our review is that papers tended to focus more on peer learner outcomes and therefore impacts of peer-led interventions on peer educators themselves appear to be under-explored. This has been reported by previous reviews [ 10 ] and highlights the importance of examining and comparing both peer educators’ and learners’ outcomes within studies. In this context, we found more evidence of peer learners benefitting from the interventions, with 55.2% of studies showing a positive effect, versus only 36.4% for peer educators. This contrasted with a previous review of mental health interventions that concluded peer educators seemed to yield more benefits from participating in the interventions, possibly due to the attention they are given during training and throughout the programmes [ 10 ].

Although common measures existed across studies, including health knowledge, health intentions, and health behaviours, many studies used novel or unvalidated measurements, indicating a need for more standardised health literacy measures and a need for future validation work in this area. This supports two systematic reviews carried out in 2015, firstly a review of health literacy measures which found a lack of comprehensive instruments to measure health literacy and suggested the need for the development of new instruments [ 102 ], and secondly a review of mental health literacy measures which found a number of unvalidated measures and lack of measures that measured all components of mental health literacy concurrently [ 103 ].

Although there are a number of existing reviews summarising the extent to which peer education may improve young peoples health, the literature is still lacking on why peer education is effective within the quantitative literature. It remains unclear which mechanisms involved in peer education lead to its effectiveness (or ineffectiveness). Although many peer education studies are grounded in theory such as Diffusion of Innovation Theory [ 104 ] and Bandura’s Social Cognitive/Social Learning Theory [ 105 , 106 ], the literature is lacking a more nuanced analysis of the mechanisms through which peer education improve young people’s health. This is therefore a key area for future research.

A recent review of peer education and peer counselling for health and well-being highlights how peer education interventions are inherently difficult to quality control and evaluate [ 13 ], partly due to what makes peer education attractive; peer education defies the conventions of traditional formal education and allows young people to learn by more unstructured means, in more ‘real world’ ways, benefiting from meaningful examples and conversations with their peers. Although there are an increasing number of well-designed peer education studies [ 13 ], new evaluation methods may be needed given the complexity and multi-component nature of peer-education approaches (i.e., training, more informal teaching approaches and informal diffusion of knowledge).

Limitations

Despite our review being comprehensive, we acknowledge certain limitations. ‘Peer education’ is a complex and widely contested term and therefore how studies described their approach varied substantially. This may have meant some relevant studies were not picked up from our initial search. A previous review [ 10 ] also noted this potential limitation, with unclear and heterogeneous methods precluding meta-analysis. Therefore, a consensus on how to define ‘peer education’ and using standardised measures to assess effectiveness would facilitate more definitive synthesis of the evidence. Another potential limitation of our approach is that we only searched scientific databases, and therefore could have missed important evidence in the grey literature as we retrieved a relatively small number of initial records ( n  = 2125). Despite this, given the wide variety of study type, age range, health area and country reviewed, this suggests our search strategy was fairly robust, and yielded results that were representative of the breadth in the current literature base.

This review focussed on universal peer education interventions delivered within the secondary school setting during school hours. Further research could explore the effectiveness of varying forms of peer education including 1:1 mentoring, more targeted (not universal) interventions, as well as peer education interventions in other settings including youth clubs or community and local organisations.

Due to the breadth of this review, we did not conduct a detailed comparison between knowledge, attitude and behavioural outcomes, however the studies demonstrating effectiveness tended to show positive change on knowledge and attitude outcomes, but less evidence was seen for positive behavioural change. This is in line with previous reviews which have suggested that peer education better improves health knowledge but often does not lead to behavioural gains [ 13 , 107 ]. To this vein, it remains unclear the differential impact on behavioural intention and actual performance of behaviour, and therefore we urge future researchers to measure outcomes relating to knowledge and attitude, intentions, and actual behaviour in order to synthesise the evidence in a more standardised way. Although the literature is heterogeneous, there is available data to conduct distinct analysis on different outcome measures (knowledge, attitude and behaviour) to create a more nuanced understanding of each health area.

Given the large number of studies and variation in outcome measures (behaviour, knowledge, attitude), this review focussed on findings at first follow-up (usually immediately after intervention) and therefore the effectiveness findings are not likely to represent longer-term effects of peer education interventions, which would require further research. In addition, due to the low number of optimally designed randomised-controlled trials identified, our review could not meaningfully compare results between randomised and non-randomised studies. However, as more high quality trials continue to be published in this growing area of research, a future review could be conducted that looks into the effect of randomisation on young people’s outcomes. Our results also focused on p-values rather than effect sizes due to the large variability in how and what studies measures, future researchers should aim to agree on more standardises ways of measuring outcomes to enable better synthesis.

To conclude, school-based peer education interventions occur worldwide and span a number of health areas. A number of interventions appear to demonstrate evidence for effectiveness, suggesting peer education may be a promising strategy for health improvement in schools. However overall evidence for effectiveness and study quality are mixed. Improvement in health-related knowledge was most common with less evidence for positive health behaviour change. In order to synthesise the evidence and make more confident conclusions, it is imperative that more robust, high-quality evaluations of peer-led interventions are conducted and that studies follow reporting guidelines to describe their methods and results in sufficient detail so that meta-analyses can be conducted. In addition, further research is needed to develop understanding of the intervention mechanisms that lead to health improvement in peer education approaches as well as more focussed work on standardising and validating health literacy and behaviour measurement tools.

Pre-registration

This review was pre-registered on PROSPERO: CRD42021229192. One deviation was made from the original protocol which was the use of a different quality appraisal tool. Initially we had planned to use the Canadian Effective Public Health Project Practice (EPHPP) Quality Assessment Tool for Quantitative Studies and the Critical Appraisals Skills Programme (CASP) checklist for qualitative studies. The authors instead used a combined mixed methods tool (the Mixed Methods Appraisal Tool; MMAT) for both quantitative and qualitative studies. This was due to the large volume and variation of studies which meant there were benefits to using a single brief quality check tool across all included studies, allowing us to standardise scores across study types. The qualitative studies will be discussed in a separate realist review on key mechanisms of peer education interventions.

Availability of data and materials

All data generated or analysed during this study are included in this published article and its supplementary information files.

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This research study is funded by the National Institute for Health and Care Research (NIHR) School for Public Health Research (project number SPHR PHPES025). The views and opinions expressed in the paper are those of the authors and do not necessarily reflect those of the NIHR. The funding body played no role in the design, analysis, interpretation or writing of the manuscript.

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Steven Dodd & Mark Limmer

Population Health Sciences, University of Bristol, Bristol, UK

Emily Widnall & Judi Kidger

College of Medicine and Health, University of Exeter, Exeter, UK

Abigail Emma Russell

Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

Esther Louise Curtin

Mental Health Foundation, London, UK

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All authors contributed to the design of the systematic review. SD led on designing the search strategy with input from all co-authors. SD carried out the initial searches across four databases. SD and EW led on retrieving papers and screening abstracts and full papers. EW and SD led on data extraction with support from AR. SD and EW drafted the initial manuscript. All co-authors reviewed the manuscript and approved the final version.

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Dodd, S., Widnall, E., Russell, A.E. et al. School-based peer education interventions to improve health: a global systematic review of effectiveness. BMC Public Health 22 , 2247 (2022). https://doi.org/10.1186/s12889-022-14688-3

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Peer to Peer Learning – Examples, Benefits & Strategies

Peer-to-peer learning occurs when students engage in collaborative learning .

• Learn with each other.
• Learn from each other.
• One learn from the other.

Peers should:

• Both be students.
• Each get something educationally beneficial out of the collaboration.
• Be equals either in terms of ability level or status as ‘students’.

There is no one peer learning strategy .

Any strategy involving the collaboration of peers in a learning situation could be called ‘peer learning’.

Below are 9 peer to peer learning examples.

9 Examples & Types of Peer to Peer Learning

1. proctor model..

The proctor model involves senior students tutoring junior students.

The senior student can be: 

• An older student from a higher grade level: In this instance, the older student benefits from the peer tutoring scenario because they consolidate knowledge they already know (‘the best way to learn is to teach’). They may also undertake the task to develop mentorship and leadership skills .
• A more skilled student helping a less skilled student in the same class: In this instance, the students may be the same age level and in the same class. However, one student is significantly more advanced than the other. This student acts as the ‘ more knowledgeable other ’, helping bring the other students up to their level. The more skilled student may benefit from this scenario by refining their knowledge and being able to apply it in their explanations.

2. Discussion seminars.

Discussion seminars are common in higher education. They usually occur following a lecture or prepared study (such as a weekly reading).

The purpose of the discussion seminar is for peers to talk together in a group about the topic they have just learned about.

Discussion seminars tend to be unstructured and designed to have students jump in with thoughts or contributions when they feel they have something important to add.

A teacher may present the students with a stimulus question or object. The students use that stimulus as an entry point into a discussion of the nuances, contradictions and features of the topic at hand.

For discussion seminars to be successful, teachers need to create a safe, comfortable space where students feel free to speak up in front of their peers.

3. Peer Support Groups.

Peer support groups are also known as private study groups. These tend not to have a teacher’s presence and are often organized by peers themselves.

Common peer study groups take place during free time, after school or on weekends.

A peer study group can be beneficial for motivating students in the lead-up to exams or assignment due dates.

Students who work together can stave off distraction, boredom and frustration. Peers can push each other past difficulties and mind blocks. When studying with peers, a student has people to bounce ideas off and provide support and explanations.

4. Peer Assessment Schemes.

Peer assessment schemes involve having students look over each other’s work and give feedback to one another.

The benefits of peer assessment schemes involve:

• Being able to see how other students have gone about the task.
• Getting insight into the cognitive processes and study strategies other students used.
• Learning diplomatic skills .
• A requirement to think critically about how to address a topic or task.

However, peer assessment schemes usually cannot be used for summative or formal assessments which require stringent quality control checks.

5. Collaborative Projects

Collaborative projects are common in science lab work. They involve getting students together to work on a problem that has been presented to them by the teacher.

Collaborative projects are very popular in 21st Century approaches such as problem based learning and problem posing education .

When students work together on longer-term projects, additional benefits may arise such as:

• Negotiation skills.
• Skill sharing capabilities.
• Setting and meeting deadlines.
• Interdependence (‘we sink or swim together’)

Collaborative projects can involve groups from as small as pairs up to large group collaborations.

Read Also: Collaborate vs Cooperative Learning

6. Cascading Groups.

Cascading groups involve placing students in groups that are either successively smaller or successively larger:

• Successively smaller: The class starts out as a large group then splits in half for a follow-up activity. Then, those two groups split into halves again, and then again, until students end up in pairs or as individuals.
• Successively larger: Often called ‘think-pair-share’, this method involves starting out as an individual, then pairing up, then going into a group of 4, then 8, and so on.

A cascading group lesson has several benefits:

• In successively smaller groups, students can nominate areas of a topic they want to specialize in. They start with a general overview in the large group, then become experts on their small piece of the pie when they pair off to work alone.
• The successively smaller groups method also provides students with the chance to get support in larger groups to build up their knowledge before peeling off to work alone.
• In successively larger groups, students start off with their own thoughts which they then contribute to the larger group. As the groups get larger, students can pick up other students’ ideas and perspectives and build their knowledge more and more ‘from the ground up’.

7. Workplace mentoring.

Workplace mentoring involves having people in a workplace to pair up to support one another. 

This can involve:

• Mentor-Mentee Relationship: A more established member of the workplace team mentors a new member of the team. This method closely mirrors the situated learning approach, whereby an apprentice is slowly absorbed into the workplace by observing their peers go about their work.
• Peer Support: On a regular basis, peers will watch one another go about their work to provide and receive tips and help on how to do the tasks more effectively or efficiently.

8. Reciprocal teaching.

Reciprocal teaching involves having students develop skills in scaffolding their peers’ learning. It has four skills that students should develop:

• Questioning: ask each other questions to test knowledge.
• Predicting: ask each other to predict answers based on limited knowledge.
• Summarizing: ask each other to sum something up in shorter terms.
• Clarifying: ask for help when you’re not sure about something.

With these four skills, students can develop the metacognitive skills to support one another in learning scenarios.

9. Expert Jigsaw Method

The expert jigsaw method involves getting students into two successive groups: 

• Session 1: In the first instance, each group focuses on a different aspect of a topic.
• Session 2: Then, students peel off and re-form new groups. Each new group should have one member of each of the previous groups. This ensures that every group has one expert on a specific aspect of the topic. These new groups then go about a task, knowing there is breadth of knowledge amongst the group members.

Theoretical Foundation

Peer support in learning is underpinned by the sociocultural theory of education . The theory holds that learning and development can be progressed faster through social interactions .

This theory’s key proponents include Lev Vygotsky, Barbara Rogoff and Jerome Bruner.

Central aspects of the theory include:

• Scaffolding : Students can learn better when support is provided by a ‘more knowledgeable other’. When a student’s skills have developed sufficiently, the support is removed.
• Language Acquisition: Through social interaction, students develop the domain specific language required to discuss topics like mathematics, history, etc.
• Multiple Perspectives: By interacting with others, we see things from their perspectives which can open up new understandings about topics.

For more on the sociocultural approach, read my full post on the sociocultural theory of education .

Related Concept: Peer Mediation of Disputes

Benefits and Challenges (Pros and Cons) of Peer to Peer Learning

• Students see each other’s perspectives to help them progress their knowledge.
• Teaching others helps us to learn a topic in even more depth.
• Social interaction may help motivate students to learn.
• Studying together can become ‘fun’, which in turn may encourage students to continue to focus on the topic for longer.
• Working in groups can be distracting for students, especially if some members of the group are not as focused as others.
• Some students work better in silence or isolation where they have time to think and focus.
• Students with sensory or behavioral challenges may struggle in peer-to-peer interactions.
• Students need to be explicitly taught group work and self-regulation skills before group work is a success.
• Students may not respect the critical feedback that their peers provide .

Final Thoughts

Teaching, learning from and interacting with peers is an incredibly useful strategy.

I’ve found that no matter how hard I try, sometimes a child is far better at explaining an idea to another child than I’ll ever be. They just have the capacity to speak to each other at the same level!

Peer interactions are incredibly important for learning in classrooms and the workplace.

References and Further Reading

All citations below are in APA format :

Boud, D., Cohen, R., & Sampson, J. (2014).  Peer learning in higher education: Learning from and with each other . London: Routledge.

Keenan, C. (2014). Mapping student-led peer learning in the UK .  York: Higher Education Academy.

O’donnell, A. M., & King, A. (2014).  Cognitive perspectives on peer learning . London: Routledge.

Riese, H., Samara, A., & Lillejord, S. (2012). Peer relations in peer learning.  International Journal of Qualitative Studies in Education ,  25 (5), 601-624.

Chris Drew (PhD)

Dr. Chris Drew is the founder of the Helpful Professor. He holds a PhD in education and has published over 20 articles in scholarly journals. He is the former editor of the Journal of Learning Development in Higher Education. [Image Descriptor: Photo of Chris]

• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 5 Top Tips for Succeeding at University
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 50 Durable Goods Examples
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 100 Consumer Goods Examples
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 30 Globalization Pros and Cons

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• Table of Contents
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• Section 8. Establishing a Peer Education Program

Chapter 24 Sections

• Section 1. Overview of Developing and Improving Community Services
• Section 3. Promoting Coordination, Cooperative Agreements, and Collaborative Agreements Among Agencies
• Section 4. Developing Multisector Collaborations
• Section 7. Developing and Increasing Access to Health and Community Services
• Section 12. Planning an Adult Literacy Program
• Section 13. Establishing an Adult Literacy Program
• Main Section

In the Middle Ages or the Renaissance -- or even the 20th century in some places -- if you wanted your son to become a stonemason, you begged or bought him a place as an apprentice with a master of the trade. Although he would begin by sweeping up, carrying stone, mixing mortar, and doing other menial tasks, over time, the master mason and older apprentices would teach him the skills that would allow him to become, eventually, a journeyman, and then a master himself. During his apprenticeship, as his expertise increased, he would spend part of his time teaching younger apprentices, who would, later, teach others. This situation could be seen as an example of peer education.

The word "peer" means an equal, someone of the same condition as oneself. (British nobles are called Peers of the Realm, meaning that they are all in some sense equals under the monarch.) A peer education program involves people being tutored or taught by others from backgrounds similar to their own. That might mean kids educating kids, people educating members of their particular community, people with particular experiences educating others with those experiences, etc. A peer education relationship is one of equals, not one where the teacher has all the knowledge or authority and the learner has none.

Peer education can cover any area: health issues, literacy, community development, schoolwork... whatever is needed. Peer educators are usually volunteers -- partially to keep that relationship of equals -- and learners may become educators themselves. Teachers and learners may switch roles from time to time as part of the program: imagine, for instance, a situation where young Native Americans teach elders to read, and the elders teach them the traditions or the language of their ancestors. Such programs exist, and they serve to connect old and young in a community, and to preserve a culture in danger of being lost.

A peer education program is a way of improving services by spreading needed information throughout a community. Through such programs, people can gain the knowledge and skills to strengthen their communities, advocate for themselves and their needs, and assert more control over their lives. Just as our apprentice stonemason could go on to become a master of his trade, and to teach apprentices and journeymen, learners in peer education programs may go on to become leaders in their communities, and to teach others what they have learned.

In some ways, peer education can be similar to mentoring or support groups , or even to skill-swapping programs. But, unlike mentoring, peer education needs to be a relationship of equals; unlike a support group, it has a particular practical goal; and unlike barter or skills exchange, the materials it concerns are information and education. Yet peer educators do act as mentors a lot of the time, they definitely provide support -- often mutual for teacher and learner -- and peer educators and learners often trade skills and knowledge. In other words, peer education may be a lot more than a simple teaching relationship, and a good peer education program can have a profound effect on the lives of individuals and their communities.

"Peer education" is used here to cover the broadest possible range of activities and services. We include everything from relatively formal peer tutoring situations to programs that are essentially street outreach by peers. Some topics discussed in this section - recruitment of learners, for instance - only apply to certain kinds of situations, while others address peer education in general. Keep in mind what your own purposes are in deciding what is relevant to your program.

What is peer education?

As explained above, peer education is a teaching or co-teaching relationship between people who are in some way equals. That equality can be defined by age, gender, geography (people from the same neighborhood, or the same village), income, racial or ethnic group, culture, background, disability... anything that people might have in common. The essential idea is that peer educators and learners share some degree of common experience and desire to help and learn from one another.

Peer education is based on the assumption that learners are often likely to relate to and trust others in their own circumstances more than professionals whose experience might be entirely different from theirs. The education relationship thus needs to be one of equals, not one in which the teacher holds the authority and gives out bits of knowledge or approval as she sees fit. The possibility -- and perhaps even the expectation -- of an exchange of knowledge, or of the learner becoming an educator is often an important part of peer education.

Much of the early research in peer tutoring, for example, was conducted at a time when the concept was one of a more competent person teaching a less competent one (an older student teaching a much younger one in a school, for example). It seemed to show that it was in fact the tutor, rather than the tutee, who experienced the most benefit from the relationship. The act of teaching helped the tutor to solidify her understanding of the material, and also served to boost her self-esteem and self -confidence, enabling her to improve her learning in general. Current thinking takes this finding into account, reasoning that if it is the act of teaching that is so powerful, then everyone should be a teacher. Thus, peer tutoring is now conceived as a situation where everyone involved is both teacher and learner. As described in Peer Tutoring: Toward a New Model , this conception uses the tutoring process as a "central instructional strategy," in which tutoring itself is designed to facilitate learning, and in which everyone involved in a peer tutoring program is both tutor and learner.

In a true peer education situation, the peer educator acts less as teacher than as facilitator. The burden of learning is on the learner. In this situation, both peer educator and learner understand that whatever progress the learner makes belongs to him, not to the peer educator. At the same time, the educator doesn't bear the pressure of needing to know all the answers all the time, so that her authority won't be compromised. Sometimes, a peer educator can create a much more powerful learning experience by not knowing the answer: by learning alongside the learner and helping him to find the answer, she has taught him how to negotiate new learning.

Many educators believe that, in the words of an old proverb, "There are no teachers, there are only learners." It is impossible to cram knowledge or thinking skill into someone's head. She has to learn it, to understand and place it in context. Given that assumption, the educator functions best as a facilitator , someone who makes learning easier. By working problems through with the learner, by demonstrating to the learner how he goes about finding information or solving a problem to which he doesn't know the answer, the educator can often be more effective than if he simply told the learner something.

Peer education doesn't have to be a one-on-one relationship. In fact, the formal tutor-learner arrangement doesn't exist at all in some programs. Peer education can be done in groups, either with one or more peer educators and several learners, or with a group of co-learners. Who is a teacher and who is a learner may change in the course of a session, depending upon what's being discussed or taught. The whole relationship may be created as a reciprocal arrangement, with each participant teaching the other in return for being taught something else (remember those Native American teens and elders). Another possibility is that once the learner has mastered whatever is being taught, he will then become a peer educator in turn, as will those he then teaches.

It needs to be mentioned here that none of this is necessarily intuitive for volunteer -- or even paid -- peer educators. Knowing something doesn't necessarily mean that you can teach it well; and being a peer doesn't necessarily mean that you won't take on the mantle of authority when you're placed in a position where you could. Peer educators need training before they start, and support and supervision while they're working. Training, support, and supervision will be discussed in more detail later in this section.

Different types of peer education programs

Peer education programs can take different shapes for different communities, different issues, and different needs. While a homework help program in a school may work for teens, the school setting may not work at all for older dropouts who want to improve their reading and writing, but still have bad memories of formal education. A parent -to-parent program meant to reach mothers with young children needs to take into account their child care needs, and the needs of the kids themselves. A program in which seniors help to inform seniors about wills and negotiating the probate system should respect the physical limitations of all who might be involved.

Many of the possibilities for peer education may not include any formal education at all, although they do involve an educational process. Some forms that peer education may take include

Formal education programs

In formal education programs, such as Literacy Volunteers of America, community volunteers (or, occasionally, paid tutors from the community) help others learn particular skills or information. These programs are often one-on-one, but may also involve other arrangements: one tutor working with a group of learners, several tutors and learners all working together, groups of learners working together as well as with tutors, etc.

Formal education is often limited to a specific subject, but carries the possibility of ranging broadly, depending upon the interests of tutors and learners. Programs may meet in a formal space -- a library, a hospital conference room, a school -- or in tutors' or learners' homes. Meeting spaces are usually secluded enough to protect learners' privacy.

This sort of education carries the danger of turning into -- or of being from the outset -- an unequal relationship, rather than an actual peer education situation. Although volunteers and tutors may be from the same community, they may come from very different circumstances and experiences, and tutors may see themselves as "stooping" to help an "unfortunate" learner. Here is where careful training and support for the tutor -- as well as a serious screening process before training begins -- are extremely important. Many of the benefits of peer education can be lost if the tutor -learner relationship is not one of equal partnership.

Outreach programs

In outreach programs, the peer educator seeks out learners in the environment where they're most comfortable and most likely to be found. This type of program is often especially effective with teens at risk, who may be reluctant to come to any formal sessions, and who often distrust adults.

An effective AIDS education program in Boston trained teen volunteers in understanding the disease and in safe sex methods. The volunteers then hit the streets and schoolyards, equipped with supplies of condoms and printed information, to talk to other kids wherever they could find them. Once the trained teens were known, they were able to get peers to come to presentations to learn more about AIDS and its prevention, and to both practice and preach the gospel of safe sex.

As in the above example, peer educators in an outreach program may not be seen as "teaching" in anything resembling the standard way, but their message may be the more powerful for that reason. They may work with individuals or groups, and some of those they reach -- as in fact happened in the AIDS prevention program -- may then become peer educators themselves.

In a workshop, a trained volunteer conducts scheduled presentations on particular topics in the community. A workshop may be sponsored by an established organization, or may be part of a free-standing program aimed at an issue of community interest or importance. It may be a one-time presentation, or part of a series that learners are encouraged to attend over a period of time. By the same token, it might focus on a specific topic (teen violence prevention in the community), or on a broader area (building a healthy community).

Workshops are often conducted in public places, and in the same place every time, but they may also travel to sites where learners are available. The workshop model is often the one by which peer educators are trained.

For example, a group of women in an adult basic education program were recruited as volunteer peer health educators. They attended workshops in areas of health (understanding breast cancer and the importance and technique of breast self-examination, smoking, nutrition, effects of legal and illegal drugs, etc.), and then in turn conducted workshops on those topics in their program. Eventually, they branched out into their own and other communities, presenting workshops to various groups. As a result of their training and the presentations they made, they were able to change many of their own and their families' practices, and to both raise awareness and help to effect healthier lifestyles among other community members as well.

On-demand or by-request peer education

On-demand education is where peer tutors staff a "center" to provide on-the-spot help to those who need it. Such education can cover a broad range of issues, but usually a particular center has a particular focus, depending on who runs it and how -- or whether -- it's funded.

Some examples of this type of peer education might be:

• Actual academic education: in adult literacy, for instance, or in English for recent immigrants (An especially effective peer education program for Chinese immigrants on the waiting list for a formal English as a Second Language program used tutors who were graduates of the program). Similarly, high school students might offer homework help to other high school students in an after-school program.
• Making available information to give learners more control over a particular area of their lives: health, tenants' rights, etc.
• Help in understanding and negotiating a bureaucratic or other system: housing, unemployment, or Social Security, for instance.

A group of welfare recipients, frustrated by their own misadventures in trying to deal with public assistance, approached a Legal Assistance office. Ultimately, they received training in the regulations governing various agencies, and, with a small grant from a foundation, became community legal advocates. They helped others in the community learn to find their way through the alphabet soup of state agencies, and to gain some power over a system they had previously been unable to penetrate. One of the most important aspects of the community legal advocate program was that the advocates didn't do things for those they advised. Rather, they helped people find out what to do and supported them in doing it. Thus, those who consulted the advocates actually learned the procedures and had the experience of making the phone calls, negotiating with agencies, etc. so they could do it again, without help, if they needed to.

Situation-specific peer education

In situation-specific peer education, the goal is to master a specific skill or understand a specific situation. A Teamsters' union local, for example, may set up a program where already-certified truck drivers help others learn what they need to pass the new and more complex Class 1 licensing test.

For example, after her 14-year-old son was beaten up on the way home from school, a woman decided that teen violence was a problem in her small town. She organized a meeting to discuss the issue which attracted 35 parents and teens. This core group then created an organization which ultimately ran, among other things, workshops and informal peer-education sessions in which teens and parents talked with others in the community about how to prevent teen violence.

Other examples of this type of situation-specific education, like that above, often don't look like education at all. A peer conflict resolution program -- which, if it's done well, not only deals with an immediate conflict, but teaches participants how to deal with other conflicts in the future -- is a good illustration of a peer education situation that doesn't appear to be education. An AIDS teach-in conducted by HIV sufferers and support workers is another.

Positives and negatives of a peer education program

Advantages of peer education.

Peer education programs work well in some circumstances, but may not be the right choice in others. Some particular advantages of peer education programs are:

• Low resource costs . Since they often use volunteers and have almost no overhead, peer education programs can be run very cheaply.
• The potential of a high degree of contact . Volunteers who are themselves part of the community can spread information about programs easily and quickly, and their word will be trusted.
• Growth for both educator and learner . Because of the equal relationship and the assumption that both peer educator and learner have valuable knowledge and skills, both can gain in knowledge and self-esteem from the education situation.

Circumstances where peer education programs can be useful

So when might you want to use a peer education program... and when might you not want to? There are a number of situations where a peer education program could be especially useful:

Where other programs are not possible

There are several reasons why a professional or formal program may not be an option in a particular circumstance.

• Where there is very limited or no funding available
• In a closed community, where outsiders are not welcome or trusted, or where language is a barrier
• Where there are simply no professionals trained in the area in which people need to be educated (think of those Native American teens and elders)
• Where people have difficulty getting to a program because of physical, geographical, or other constraints (in the huge and sparsely-populated rural counties of some western states, e.g., people may have to travel more than 100 miles each way to reach a logical program site)

Where peers are more likely to be listened to than professionals or others not part of the learners' peer group

Some examples:

• Teens, especially teens at risk or gang members, who often have adversarial relationships with adults in general, and with adults in perceived positions of authority in particular.
• Minority communities, where community members may be suspicious of those who represent past or present mistreatment, and where past or present discrimination may not be easily ignored.
• Women who may either distrust men because of past or present mistreatment, or because of age-old patterns of discrimination. The need for peers may be especially acute among those women who are unaware that they are intimidated by the presence of men, particularly those in positions of apparent authority. In some cases, men, even with the best will in the world, may find it all but impossible to help women change those patterns and find their voices.
• Ethnic groups where language, shared experiences, and cultural norms and style may create barriers for non-members. The Hmong people of Laos, many of whom were forced to exchange an ancient culture for refugee camps and the streets of American cities after the Vietnam War, come immediately to mind.
• Groups of people who share a unique experience or trauma -- MS sufferers, families of murder victims, Vietnam veterans, refugees from genocide attempts, etc.

Where you need to reach a large number of people in the community in a relatively short time

An emergency community health initiative, for instance. Especially in non-literate communities, a group of trained peer tutors can reach and inform large numbers of people, particularly if they know the community well.

Where you are starting a process that is meant to be self-maintaining

Peer educators not only teach, but train learners as peer educators, who then repeat the process. This is often a way to institutionalize programs that are funded only for a limited period of time.

Where the "peer" is the most important part of the program, because of what it demonstrates

Peer mediation programs in schools, for instance, serve not only to resolve conflicts and teach conflict resolution, but to show kids that kids can be conflict resolvers.

Circumstances where peer education programs might not be useful or necessary

• Where more expertise is needed than can be instilled in a tutor training . A program aimed at children with special needs, for instance, might employ volunteers in some capacity, but would probably need professionally trained staff.
• Where peers are not available or not appropriate as educators . A program aimed at a population of immigrants from a group few of which had previously immigrated, for instance, might not be appropriate for peer education.
• Where a fair amount of money is available for a professional program . Unless there are particular reasons for starting a peer education program, it may be better to have paid and well-trained staff and the other resources that a professional program can bring. Such a program may be able to incorporate peer education (learners working together, for example), and thus reap the benefits of that method while still partaking of the advantages a professional program can bring.
• Where you can educate a broad range of people through the media . This may mean distance learning, TV courses for the general public, education over the internet, etc.

Planning a peer education program

There is a good deal of thinking and preparation to be done before you actually start recruiting volunteers and tutees and setting up a program.

General rules

To begin with, there are some general rules that should apply to any process that can truly be called peer education.

The relationship of equals is the absolute core of a peer education program.

There needs to be an assumption on everyone's part - peer educators, learners, trainers, program coordinator -- that the educator-learner roles are fluid, and that every learner -- either now or later -- is an actual or potential peer educator.

It is essential to plan the program with your focus on the community, rather than on what you want to do.

This means that

• Potential peer educators and learners need to be part of the planning process
• The program has to be one that fits the needs of the community, and shouldn't start before you've conducted a formal or informal needs and assets assessment of the community
• The program has to be one that will work in the community. If there is some history of past program success or failure, it's important to find it out -- here's where involving potential tutors and learners in the planning process proves its worth -- so you can avoid either reinventing the wheel or repeating past mistakes.

Initial questions

As we've seen, there are many possible designs for peer education programs, and each can be customized for a particular community and particular circumstances. Before you decide what's right for your situation, you should answer some basic questions:

What is the actual purpose of the program?

Academics? Spreading a particular body of information (e.g. infant nutrition)? Changing the thinking of the community in a particular area (domestic violence prevention, for example)? Each of these may imply a different design:

• An academic program may work best in a one-on-one or group setting in a quiet place
• Spreading a body of information might best be accomplished in a support-group format, or through a community outreach program that can touch a large number of people
• Changing community thinking might combine several approaches: outreach, modeling, learners becoming peer educators and training other peer educators, etc.

Who is the target population?

Parents of young children? The community at large? The homeless? The unemployed?

How will you define "peers" for that population?

If you're trying to reach the homeless, do peer educators have to be currently or formerly homeless, for instance? Or can they simply be people from the same community? How you answer this question may have a lot to do with the structure and, perhaps, even the eventual success of your program.

Where can the target population be reached?

If it's the homeless you're aiming at, the library may be a great place to have a program base, since that's where many homeless people spend their days, especially in bad weather.

What is the target population likely to respond to?

A group of alienated teens may not want to sit in a class, for instance, but might be totally comfortable talking informally in a park.

Are there successful examples of this type of program in similar circumstances elsewhere?

There's no need to reinvent the wheel if there's a good model out there.

Program structure

Whether it's run or staffed by professionals or volunteers, a peer education program needs a structure if it's going to operate effectively. There should be an individual or group that coordinates and administers the program, and either oversees or actually carries out a number of functions:

• Recruiting peer educators and learners
• Developing, continually refining, and conducting tutor training
• Matching learners with appropriate peer educators or programs
• Supervising peer educators
• Handling problems among peer educators, learners, supervisors, and the program itself
• Recordkeeping
• Program evaluation and ongoing improvement

The program also needs a communication structure, so that peer educators and learners can easily be contacted about special events, cancellations, scheduling, etc. It needs a spokesperson who is trusted to speak for the program, sometimes -- in a crisis, for instance -- without having the opportunity to consult with others. And, if it's funded by any formal sources -- public money, foundations, etc. -- it needs someone to communicate with and report to funders. The coordinating structure, or lack of it, can have a great deal to do with whether a peer education program is successful or not. Coordinators are often paid staff , and need, at the very least, some experience in education, in tutor training and supervision, or in working in a program similar to yours.

Setting up a peer education program

Recruitment of peer educators and learners.

It's obvious that, whatever your program looks like, it won't exist without peer educators and learners. Although in some cases, learners may be recruited by the peer educators themselves (as in the case of the AIDS education program described earlier), in many instances, you'll have to find both peer educators and learners. Depending on the type of program, it may make sense to recruit and train peer educators before you seek out learners, or it may be more effective to try to attract both at once. In either case, you'll probably want to use some or all of these methods to let people know that they can become involved:

Using the media

There are several ways you can recruit through newspapers, radio, and TV.

• Formal, often paid, advertising . Using newspapers, radio, and/or TV ads to get your message out.
• Public Service Announcements (PSAs) and other unpaid advertising . You may be able to run radio or TV ads as PSAs, which are free, or to convince a station or newspaper to run a free ad for you out of the goodness of its heart.
• Press releases or letters to the editor . Another way of inserting your message in the media without cost is to either issue a press release or write a letter to the editor about your program. There is no guarantee that either of these will be published in a large, urban newspaper, but in smaller markets, they almost always are.
• Holding a press conference or preparing a guest column or op-ed (opinion and editorial) piece

Community advertising, using fliers and posters placed in conspicuous places

Supermarkets, laundromats, fast food restaurants, schools, sports facilities, the Y, churches, and social clubs are all places where your information is likely to be seen by a large number of people.

Announcements in appropriate places

This can range from an announcement from the pulpit by a clergyman to a recorded message on a video loop in the local shopping mall.

Outreach through agencies, organizations, religious centers, and other community hubs

Often staff people, clergy, or others who work directly with individuals, may know someone who is looking for a volunteer opportunity or who needs the service the program will offer.

Direct mailings to a list , or to all households in a particular area

You may have accumulated a list of potential tutors or learners in the course of developing your program, or an agency (such as welfare or unemployment), church, or service club may be willing to insert notices to all its participants in one of its own mailings.

Personal outreach in the community and word-of-mouth

For most people, perhaps the most effective recruiting method is hearing it from friends, relatives, or others whom they know and trust.

In using any of these recruitment methods, you'll want to remember to consider the community in framing your message . Some important points:

• Use language that the people you're aiming at can understand, whether that means choosing your vocabulary carefully in English, or composing your message in Vietnamese.
• Try to be as brief and as clear as possible about what you're offering or asking people to do.

An adult literacy program found that its best learner recruitment tool was a poster that said only "Need Help with Reading, Writing, Math, GED? Call (phone number)", and that included tear-off versions of the phone number at the bottom of the sheet. Even those with very low reading levels could read it, it was clear about what services were available, and people could carry the phone number with them -- in some cases for months -- until they decided they were ready to make the call.

• Be aware of customs or word meanings that could make your message vague or, worse, offensive to the community.
• Concentrate your efforts in the places where the target community is most likely to be exposed to it. That may mean Spanish-language radio, soccer clubs, churches, or particular community gathering places.
• In general, messages describing the problem will help to recruit volunteers. Messages describing learners overcoming adversity or making their lives better will help to recruit learners.

Something you'll need to decide about recruiting tutors is whether you're going to screen people, or simply train everyone who applies. There will be some self-screening -- people will come to an orientation or go through the training, and realize that they aren't cut out to be peer educators, or disagree with the philosophy of the program. But there are always a few folks who are eager and enthusiastic... and just don't get it, in one way or another. It's better for the program -- and kinder to them -- if you can spot them before they make a commitment, and steer them to some other volunteer opportunity more suited to their talents.

One way to deal with this issue is to address it at an initial orientation, explaining that peer education, like anything else, is not for everyone, and that there will be a screening process. You may want to ask people to apply formally for peer educator positions, or your screening may be informal. Screening after training is another option, and will be discussed later in this section.

Another screening issue you might want to deal with is whether you'll set any specific criteria of eligibility or ineligibility. You may decide that all peer educators need high school diplomas, for instance. Substance use might be grounds for not accepting someone in a particular program, and may not matter in another. A record of child sexual assault would be an issue in an after-school homework help situation, but might not matter in a senior-to-senior program... or that program might decide it can't tolerate the issue philosophically. It's always best to try to anticipate matters like these, and make some decisions about them before you're actually faced with them.

Peer educator orientation and training

Although a peer education program might be both staffed and administered by volunteers, it is nonetheless absolutely necessary that peer educators be trained and supported. A lot -- perhaps most -- of a tutor's or other peer educator's expertise in working with learners may be gained on the job, but she still needs a grounding in the methods, philosophy, and assumptions of the program and some tools to start with. How, and to what extent, you provide this base is crucial to the success of your peer education program.

It may seem that training is unnecessary in situations where all learners are peer educators and vice-versa, as is the case in some adult literacy programs. In fact, training is especially important in those situations. It may differ from the relatively formal, structured process implied below, but learners need to have some idea of the expectations, the difficulties, and the rewards of sitting on both sides of the educational table. Training in education or teaching methods can give learners new insight into their own learning process, and change their approach to learning entirely. By the same token, being asked to think about the barriers that learners experience in approaching new ideas or material may enable them to understand and remove some of their own.

Orientation - helping people understand what the program and its issues are actually about -- can be viewed as the beginning of the training, but it can also be used as an introduction to help potential peer educators decide whether they want to enter training. An orientation could be held at the very beginning of training, or even before a training is scheduled, to help people decide whether they really want to become tutors or not. Some areas you might want to cover in orientation include:

• What the program is about . What you're trying to accomplish, what areas the peer educator will be expected to cover, etc.
• The basic assumptions of the program . This would include an introduction to the philosophy of the program, commitment to the partnership of peer educator and learner, any particular program biases about teaching or presentation methods or subject matter, relationship to the community... whatever may be unique or central to your program that tutors are expected to buy into.
• Learners and their concerns . Depending on the type of program, potential volunteers may be drawn from the same pool as learners -- or might be learners themselves -- and therefore need less of an orientation in this area. In any case, it's best if learners could be included in this part of the orientation, to speak for themselves and answer questions.

In all orientation and training, it's ideal if you can include both learners and experienced current or former peer educators, in order to give trainees a real picture of what they're taking on. Knowing what to expect will filter out some of those who really aren't appropriate for the job, and will help to make others better. In addition, the inclusion of learners and peer educators together in a training process underscores the idea that peer education is truly a partnership, and that learners have much to offer as well as to gain.   Peer education training itself is meant to prepare peer educators to work with learners successfully. It should be long enough -- both in total hours of training and in the length of time over which the whole training takes place -- to not only give educators the background and knowledge they need, but to give them time to digest and absorb the material and ideas presented. The numbers in a training group should be small enough so that everyone can get some individual attention, but large enough so that there can be good discussion and role play opportunities. Eight to ten is usually ideal, with 15 probably being about as big as a group should be.

Perhaps most important, the training should reflect the philosophy and methods of the program. If you're asking peer educators to respect what learners already know, then their training should respect what they already know. If you're asking them to use specific methods in working with learners, then those same methods should be used, to the extent possible, in the training, both so peer educators can experience them firsthand (and thus have some idea what learners are experiencing), and because using those methods is the best evidence that you really believe in them.

Some important aspects of training:

• A grounding in methods of instruction (in the particular style the program expects, if there is one)
• Whatever content peer educators will be expected to know and/or help learners master
• A copy and discussion of the written curriculum, if there is one
• More on the program's philosophical framework, and how it meshes with the actual way the program is run and education is conducted
• Real tools that peer educators can use, especially in initial sessions - specific curriculum, exercises, games, props, particular books, videos, etc.
• Lots of opportunities for peer educators to try out and get feedback - in a safe situation - on what they've learned (i.e. role playing or some other method that gives them the chance to practice before they face learners)
• If appropriate or possible, the chance for peer educators to observe veterans at work, and to talk with them about what they're doing and how they view it
• Opportunities to meet with learners, if learners aren't already part of the training process

At the end of the training period, you might consider providing closure in one or more ways.

• A training exit interview for each potential peer educator, discussing with him what he's learned, and whether he feels ready to continue, or feels that peer education may not be for him. Such an interview can provide an informal screening, eliminating many people who simply wouldn't fit into the program. (This interview could also be used as a formal screening tool, as long as potential tutors understood that.)
• A graduation ceremony, in the course of which each peer educator who decides to go on signs a contract, committing herself to the minimum time and work requirements of the program, and receives a certificate as a trained peer educator.
• An individual meeting, where appropriate, of each peer educator with the learner or group he'll be working with.

Peer educator supervision and support

Like training, ongoing supervision is an absolute necessity for an effective peer education program. Each peer educator should have a designated supervisor -- whether the coordinator, a paid or volunteer staff member, a more experienced peer educator, or even, in a reciprocal arrangement, another peer educator of similar experience -- with whom she has regularly scheduled meetings to discuss her work, and who is available at other times for help and support when needed.

In most cases, the supervisor would deal with problems between peer educators and learners, or between peer educators.

There are at least two ways of looking at supervision. One consists essentially of the supervisor as watchdog, making sure that the staff member or volunteer does her job right, and follows the rules of the organization. Too often, this has been the model followed in education, the one that generates horror stories of teachers being fired because their skirts were too short, or because they were critical of an assigned text. The other view of supervision sees it as a mentoring relationship, aimed at improving performance through constructive feedback, suggestions, and discussion of real situations and problems. This is the model generally used in counseling and psychology, and more frequently now in education and medicine. It is, in the writer's opinion, far more effective and useful than the other, and more apt to lead to improvement in performance.

In addition to supervision, peer educators need ongoing support. Some of this can be provided by the supervisor, in the form of advice, encouragement, help dealing with problems, etc. Ideally, peer educators should also have regularly scheduled opportunities to meet together --with or without a supervisor -- to discuss common issues and concerns. The feeling of shared experience and peer support -- as well as the understanding that others share the same difficulties with the work -- can be a tremendous resource for all concerned.

Regularly scheduled in-service training and workshops can provide another form of peer educator support. The opportunity for peer educators to continue to learn techniques, background information, and content will make them more effective, provide them with a benefit, and remind them that they are valued by the program. The nature of in-service offerings could be determined by educators' own expressed needs, the program coordinator's understanding of what is needed to do a good job, or -- most likely -- a combination of the two.

Personnel policies for peer educators and learners

Even in a program run entirely by volunteers, there need to be personnel policies that cover as many as possible of the situations that might arise with and among peer educators, learners, and the program. It would be ideal if everyone - educators and learners, as well as program staff -- is familiar with these policies from the beginning, so that there are no misunderstandings about the intent of the program. There are a number of areas that these policies might cover.

Peer educator time commitment

How many hours a week for how long a time period will you ask peer educators to commit to? Do the hours include particular days or combinations of days? Do they allow for holidays or vacations, and if so, how long?

One way to deal with this issue is by having peer educators sign a contract, with the terms spelled out. Not every program will find this sort of thing necessary or desirable, but many use it, and peer educators find it a reasonable and appropriate way to express their commitment. In fact, if you're dealing with volunteers, a contract like this is hardly enforceable: it's simply a way of making sure that everyone knows and agrees to the expectations of the program.

Peer educator rights and obligations

Policy here might deal with such issues as:

• Notifying learners and the program when the peer educator is unable to attend a scheduled session
• Notifying the peer educator if the learner or program must cancel a scheduled meeting
• Who's responsible for providing substitutes, if that's applicable
• Expectations for peer educators' behavior and philosophical stance (the partnership of educator and learner issue, for instance)

A peer educator job description

In order to run the most effective program, it is important for peer educators to know exactly what is expected of them.

A mechanism for peer educators to discuss problems

Although you hope that everything will go smoothly, it is important to build in ways to deal with problems before the problems occur. Problems that might arise include peer educators experiencing dissatisfaction with the program, learners, or other educators.

A mechanism for learners to discuss problems

Again, it is important to ensure that if problems do arise, there are already methods in place for dealing with them.

A mechanism for dealing with learners who create problems

Especially in programs that serve adolescents, there need to be clear policies about the rights and obligations of learners as well as those of peer educators. In the best of circumstances, learners should have input into developing those policies , and should know about them -- and be given a copy of them -- at the time they enter the program.

Personal safety and security

Depending on your resources, you might want to prepare a program handbook to give to peer educators, learners, and staff. The handbook could include not only training -related material (program philosophy and mission statement, for instance), but information on personnel policies, volunteer time commitment, security, necessary phone numbers, etc. If it's done in a loose-leaf format, you could put together different versions for peer educators and learners, if that were appropriate.

Program evaluation and refinement

A peer education program, like any other, needs to be able to look at what it's doing, figure out how well it works, continually refine those parts of the program that already work well, improve or rework those things that don't work well, and change to meet the changing needs of the target population.

In order to examine itself, a program needs to decide what to look at - what information it will gather, how it will interpret it once it has it - and how to look at it - the way it will gather that information.

In choosing what to look at, there are several - not necessarily mutually exclusive - possibilities.

• Numbers. The number of peer educators, number of learners, number of education hours, number of education sessions, duration of education relationships (how long a tutor-learner pair continues to work together), changes in learners' levels (where they're engaged in some measurable learning activity) -- all of these can give you information about the effectiveness of some aspects of your program.
• Peer educator and learner satisfaction with the program. Do people feel they're making progress? What kind of learning do they see happening? Is it what they hoped or expected? Are they getting what they need? Are they getting enough support? What would they change?
• What really goes on in the program. Monitoring actual education sessions to determine what is happening in them, and whether the program's philosophy and goals are actually being carried out in the work that's being done.
• Outcomes for learners. Outcomes come in many shapes and sizes. There may be some specific learning that the program is aiming at (facts about AIDS, ways that violence affects others besides the victim), but that learning may be evidenced by behavior (practicing safe sex more often, no longer using spanking to discipline children). In addition, behavior that seems totally unrelated to the apparent learning may in fact reflect it powerfully.

Adult literacy and employment training programs often see a huge leap in learners' self-esteem and, consequently, in their willingness to take risks and their ability to persevere and succeed at difficult tasks. Staff in such programs frequently note that learners begin to dress differently, to hold themselves straighter, to look others in the eye more often, to speak more loudly and decisively. These changes may seem unconnected to the subject matter, but are directly connected to the experience of learning, and can be markers of learners' success.

• Changes in the community related to the desired program results. If your peer education program has been teaching mothers about immunization, and the percentage of immunized infants in the community has jumped from 40 to 70 in the year you've been in operation, there's a good chance your program can take some of the credit.
• Community perceptions of the program. Does the community see changes? Does it ascribe any of those changes to the work of your program?

How you look at your information will depend to some extent on what you're looking at. The more different aspects of the program you're examining, the more varied your information-gathering might be.

Some of the possible ways to gather information are:

• Personal interviews
• Phone calls
• Gathering statistics from program records
• Personal observation
• Evaluation forms (usually check-off or multiple choice)
• Tutor and learner self-reports
• Community input forums

If you're going to gather information, you have to have a mechanism for collecting that information. Keeping some sort of records is absolutely necessary if you're going to conduct any kind of meaningful evaluation. You may want to keep attendance, a log of hours spent and what happened during that time, peer educator and/or learner journals about results and change, regular testing results... whatever will give you the information you need to evaluate the program accurately and make adjustments to it that actually make a difference for the better.

If your evaluation is going to be really useful, the combination of the information you choose to consider and the way you find it should reflect your goals for the program, your philosophy, and your mission.

In general, a good evaluation of a peer education program should:

• Include feedback from peer educators, learners, and anyone else involved in the program
• Take place at regular intervals
• Focus on improved practice
• Include a mechanism for incorporating suggestions for improvement and working out solutions to problems
• Well-thought-out and carefully conducted regular evaluations are a giant step toward keeping your program dynamic and effective

A peer education program can be an effective way to reach a large number of people, especially in situations where the population is suspicious of outsiders or there is very little money available for services. Successful programs are based on the assumption that the peer educator-learner relationship is a partnership, and that peer educators may become learners and vice-versa. Other elements of a well-designed program include:

• Community involvement in both the design and operation of the program
• A clear sense of purpose and an understanding of the target population
• A coordinating structure that assures the smooth running of the program
• Recruitment of peer educators and learners that takes their cultures, needs, and issues into account
• A well-thought-out peer education training process that reflects the philosophy, methods, and goals of the program
• Ongoing supervision, support, and in-service training opportunities for peer educators
• Personnel policies for volunteers and learners that are clear about expectations, rights, and obligations
• A format and regular schedule for program evaluation and improvement

If you can put together a peer education program that includes these components, you have a great chance of success.

Online Resources

Counseling department, College of the Holy Cross  is a peer education program with help for eating disorders/nutrition, relationships (tolerance, sexual abuse, etc.), responsible choices (substance use), and HIV/AIDS/STDs.

Interactive Sciences is an organization that uses peer education to teach technology.

Peer-Education: Toward a New Model  by Audrey Gartner and Frank Riessman, from ERIC Digest. ERIC Clearinghouse on Teaching and Teacher Education.

Peer Education in Adult Basic and Literacy Education  by Susan Imel, from ERIC Digest No. 146. ERIC Clearinghouse on Adult, Career, and Vocational Education. Columbus, OH: 1994.

Peer Resources Bookstore  provides publications on peer education and peer counseling.

Print Resource

Correctional Service of Canada. Final Report: Inmate AIDS Peer Education Project. A report on a successful peer education project at the Dorchester Penitentiary (New Brunswick). For copies of the report and/or the Facilitation Manual that goes with it, contact the Health Care Services Branch, The Correctional Service of Canada, 340 Laurier Avenue West, Ottawa K1P 0P9 Canada. Tel. (613) 995-5058. Fax (613) 995-6277.

• Original article
• Open access
• Published: 09 April 2020

Why does peer instruction benefit student learning?

• Jonathan G. Tullis 1 &
• Robert L. Goldstone 2  

Cognitive Research: Principles and Implications volume  5 , Article number:  15 ( 2020 ) Cite this article

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In peer instruction, instructors pose a challenging question to students, students answer the question individually, students work with a partner in the class to discuss their answers, and finally students answer the question again. A large body of evidence shows that peer instruction benefits student learning. To determine the mechanism for these benefits, we collected semester-long data from six classes, involving a total of 208 undergraduate students being asked a total of 86 different questions related to their course content. For each question, students chose their answer individually, reported their confidence, discussed their answers with their partner, and then indicated their possibly revised answer and confidence again. Overall, students were more accurate and confident after discussion than before. Initially correct students were more likely to keep their answers than initially incorrect students, and this tendency was partially but not completely attributable to differences in confidence. We discuss the benefits of peer instruction in terms of differences in the coherence of explanations, social learning, and the contextual factors that influence confidence and accuracy.

Significance

Peer instruction is widely used in physics instruction across many universities. Here, we examine how peer instruction, or discussing one’s answer with a peer, affects students’ decisions about a class assignment. Across six different university classes, students answered a question, discussed their answer with a peer, and finally answered the question again. Students’ accuracy consistently improved through discussion with a peer. Our peer instruction data show that students were hesitant to switch away from their initial answer and that students did consider both their own confidence and their partner’s confidence when making their final decision, in accord with basic research about confidence in decision making. More broadly, the data reveal that peer discussion helped students select the correct answer by prompting them to create new knowledge. The benefit to student accuracy that arises when students discuss their answers with a partner is a “process gain”, in which working in a group yields better performance than can be predicted from individuals’ performance alone.

Peer instruction is specific evidence-based instructional strategy that is well-known and widely used, particularly in physics (Henderson & Dancy, 2009 ). In fact, peer instruction has been advocated as a part of best methods in science classrooms (Beatty, Gerace, Leonard, & Dufresne, 2006 ; Caldwell, 2007 ; Crouch & Mazur, 2001 ; Newbury & Heiner, 2012 ; Wieman et al., 2009 ) and over a quarter of university physics professors report using peer instruction (Henderson & Dancy, 2009 ). In peer instruction, instructors pose a challenging question to students, students answer the question individually, students discuss their answers with a peer in the class, and finally students answer the question again. There are variations of peer instruction in which instructors show the class’s distribution of answers before discussion (Nielsen, Hansen-Nygård, & Stav, 2012 ; Perez et al., 2010 ), in which students’ answers are graded for participation or for correctness (James, 2006 ), and in which instructors’ norms affect whether peer instruction offers opportunities for answer-seeking or for sense-making (Turpen & Finkelstein, 2007 ).

Despite wide variations in its implementation, peer instruction consistently benefits student learning. Switching classroom structure from didactic lectures to one centered around peer instruction improves learners’ conceptual understanding (Duncan, 2005 ; Mazur, 1997 ), reduces student attrition in difficult courses (Lasry, Mazur, & Watkins, 2008 ), decreases failure rates (Porter, Bailey-Lee, & Simon, 2013 ), improves student attendance (Deslauriers, Schelew, & Wieman, 2011 ), and bolsters student engagement (Lucas, 2009 ) and attitudes to their course (Beekes, 2006 ). Benefits of peer instruction have been found across many fields, including physics (Mazur, 1997 ; Pollock, Chasteen, Dubson, & Perkins, 2010 ), biology (Knight, Wise, & Southard, 2013 ; Smith, Wood, Krauter, & Knight, 2011 ), chemistry (Brooks & Koretsky, 2011 ), physiology (Cortright, Collins, & DiCarlo, 2005 ; Rao & DiCarlo, 2000 ), calculus (Lucas, 2009 ; Miller, Santana-Vega, & Terrell, 2007 ), computer science (Porter et al., 2013 ), entomology (Jones, Antonenko, & Greenwood, 2012 ), and even philosophy (Butchart, Handfield, & Restall, 2009 ). Additionally, benefits of peer instruction have been found at prestigious private universities, two-year community colleges (Lasry et al., 2008 ), and even high schools (Cummings & Roberts, 2008 ). Peer instruction benefits not just the specific questions posed during discussion, but also improves accuracy on later similar problems (e.g., Smith et al., 2009 ).

One of the consistent empirical hallmarks of peer instruction is that students’ answers are more frequently correct following discussion than preceding it. For example, in introductory computer science courses, post-discussion performance was higher on 70 out of 71 questions throughout the semester (Simon, Kohanfars, Lee, Tamayo, & Cutts, 2010 ). Further, gains in performance from discussion are found on many different types of questions, including recall, application, and synthesis questions (Rao & DiCarlo, 2000 ). Performance improvements are found because students are more likely to switch from an incorrect answer to the correct answer than from the correct answer to an incorrect answer. In physics, 59% of incorrect answers switched to correct following discussion, but only 13% of correct answers switched to incorrect (Crouch & Mazur, 2001 ). Other research on peer instruction shows the same patterns: 41% of incorrect answers are switched to correct ones, while only 18% of correct answers are switched to incorrect (Morgan & Wakefield, 2012 ). On qualitative problem-solving questions in physiology, 57% of incorrect answers switched to correct after discussion, and only 7% of correct answers to incorrect (Giuliodori, Lujan, & DiCarlo, 2006 ).

There are two explanations for improvements in pre-discussion to post-discussion accuracy. First, switches from incorrect to correct answers may be driven by selecting the answer from the peer who is more confident. When students discuss answers that disagree, they may choose whichever answer belongs to the more confident peer. Evidence about decision-making and advice-taking substantiates this account. First, confidence is correlated with correctness across many settings and procedures (Finley, Tullis, & Benjamin, 2010 ). Students who are more confident in their answers are typically more likely to be correct. Second, research examining decision-making and advice-taking indicates that (1) the less confident you are, the more you value others’ opinions (Granovskiy, Gold, Sumpter, & Goldstone, 2015 ; Harvey & Fischer, 1997 ; Yaniv, 2004a , 2004b ; Yaniv & Choshen-Hillel, 2012 ) and (2) the more confident the advisor is, the more strongly they influence your decision (Kuhn & Sniezek, 1996 ; Price & Stone, 2004 ; Sah, Moore, & MacCoun, 2013 ; Sniezek & Buckley, 1995 ; Van Swol & Sniezek, 2005 ; Yaniv, 2004b ). Consequently, if students simply choose their final answer based upon whoever is more confident, accuracy should increase from pre-discussion to post-discussion. This explanation suggests that switches in answers should be driven entirely by a combination of one’s own initial confidence and one’s partner’s confidence. In accord with this confidence view, Koriat ( 2015 ) shows that an individual’s confidence typically reflects the group’s most typically given answer. When the answer most often given by group members is incorrect, peer interactions amplify the selection of and confidence in incorrect answers. Correct answers have no special draw. Rather, peer instruction merely amplifies the dominant view through differences in the individual’s confidence.

In a second explanation, working with others may prompt students to verbalize explanations and verbalizations may generate new knowledge. More specifically, as students discuss the questions, they need to create a common representation of the problem and answer. Generating a common representation may compel students to identify gaps in their existing knowledge and construct new knowledge (Schwartz, 1995 ). Further, peer discussion may promote students’ metacognitive processes of detecting and correcting errors in their mental models. Students create more new knowledge and better diagnostic tests of answers together than alone. Ultimately, then, the new knowledge and improved metacognition may make the correct answer appear more compelling or coherent than incorrect options. Peer discussion would draw attention to coherent or compelling answers, more so than students’ initial confidence alone and the coherence of the correct answer would prompt students to switch away from incorrect answers. Similarly, Trouche, Sander, and Mercier ( 2014 ) argue that interactions in a group prompt argumentation and discussion of reasoning. Good arguments and reasoning should be more compelling to change individuals’ answers than confidence alone. Indeed, in a reasoning task known to benefit from careful deliberation, good arguments and the correctness of the answers change partners’ minds more than confidence in one’s answer (Trouche et al., 2014 ). This explanation predicts several distinct patterns of data. First, as seen in prior research, more students should switch from incorrect answers to correct than vice versa. Second, the intrinsic coherence of the correct answer should attract students, so the likelihood of switching answers would be predicted by the correctness of an answer above and beyond differences in initial confidence. Third, initial confidence in an answer should not be as tightly related to initial accuracy as final confidence is to final accuracy because peer discussion should provide a strong test of the coherence of students’ answers. Fourth, because the coherence of an answer is revealed through peer discussion, student confidence should increase more from pre-discussion to post-discussion when they agree on the correct answers compared to agreeing on incorrect answers.

Here, we examined the predictions of these two explanations of peer instruction across six different classes. We specifically examined whether changes in answers are driven exclusively through the confidence of the peers during discussion or whether the coherence of an answer is better constructed and revealed through peer instruction than on one’s own. We are interested in analyzing cognitive processes at work in a specific, but common, implementation of classroom-based peer instruction; we do not intend to make general claims about all kinds of peer instruction or to evaluate the long-term effectiveness of peer instruction. This research is the first to analyze how confidence in one’s answer relates to answer-switching during peer instruction and tests the impact of peer instruction in new domains (i.e., psychology and educational psychology classes).

Participants

Students in six different classes participated as part of their normal class procedures. More details about these classes are presented in Table  1 . The authors served as instructors for these classes. Across the six classes, 208 students contributed a total of 1657 full responses to 86 different questions.

The instructors of the courses developed multiple-choice questions related to the ongoing course content. Questions were aimed at testing students’ conceptual understanding, rather than factual knowledge. Consequently, questions often tested whether students could apply ideas to new settings or contexts. An example of a cognitive psychology question used is: Which is a fixed action pattern (not a reflex)?

Knee jerks up when patella is hit

Male bowerbirds building elaborate nests [correct]

Eye blinks when air is blown on it

Can play well learned song on guitar even when in conversation

The procedures for peer instruction across the six different classes followed similar patterns. Students were presented with a multiple-choice question. First, students read the question on their own, chose their answer, and reported their confidence in their answer on a scale of 1 “Not at all confident” to 10 “Highly confident”. Students then paired up with a neighbor in their class and discussed the question with their peer. After discussion, students answered the question and reported the confidence for a second time. The course instructor indicated the correct answer and discussed the reasoning for the answer after all final answers had been submitted. Instruction was paced based upon how quickly students read and answered questions. Most student responses counted towards their participation grade, regardless of the correctness of their answer (the last question in each of the cognitive psychology classes was graded for correctness).

There were small differences in procedures between classes. Students in the cognitive psychology classes input their responses using classroom clickers, but those in other classes wrote their responses on paper. Further, students in the cognitive psychology classes explicitly reported their partner’s answer and confidence, while students in other classes only reported the name of their partner (the partners’ data were aligned during data recording). The cognitive psychology students then were required to mention their own answer and their confidence to their partner during peer instruction; students in other classes were not required to tell their answer or their confidence to their peer. Finally, the questions appeared at any point during the class period for the cognitive psychology classes, while the questions typically happened at the beginning of each class for the other classes.

Analytic strategy

Data are available on the OpenScienceFramework: https://mfr.osf.io/render?url=https://osf.io/5qc46/?action=download%26mode=render .

For most of our analyses we used linear mixed-effects models (Baayen, Davidson, & Bates, 2008 ; Murayama, Sakaki, Yan, & Smith, 2014 ). The unit of analysis in a mixed-effect model is the outcome of a single trial (e.g., whether or not a particular question was answered correctly by a particular participant). We modeled these individual trial-level outcomes as a function of multiple fixed effects - those of theoretical interest - and multiple random effects - effects for which the observed levels are sampled out of a larger population (e.g., questions, students, and classes sampled out of a population of potential questions, students, and classes).

Linear mixed-effects models solve four statistical problems involved with the data of peer instruction. First, there is large variability in students’ performance and the difficulty of questions across students and classes. Mixed-effect models simultaneously account for random variation both across participants and across items (Baayen et al., 2008 ; Murayama et al., 2014 ). Second, students may miss individual classes and therefore may not provide data across every item. Similarly, classes varied in how many peer instruction questions were posed throughout the semester and the number of students enrolled. Mixed-effects models weight each response equally when drawing conclusions (rather than weighting each student or question equally) and can easily accommodate missing data. Third, we were interested in how several different characteristics influenced students’ performance. Mixed effects models can include multiple predictors simultaneously, which allows us to test the effect of one predictor while controlling for others. Finally, mixed effects models can predict the log odds (or logit) of a correct answer, which is needed when examining binary outcomes (i.e., correct or incorrect; Jaeger, 2008 ).

We fit all models in R using the lmer() function of the lme4 package (Bates, Maechler, Bolker, & Walker, 2015 ). For each mixed-effect model, we included random intercepts that capture baseline differences in difficulty of questions, in classes, and in students, in addition to multiple fixed effects of theoretical interest. In mixed-effect models with hundreds of observations, the t distribution effectively converges to the normal, so we compared the t statistic to the normal distribution for analyses involving continuous outcomes (i.e., confidence; Baayen, 2008 ). P values can be directly obtained from Wald z statistics for models with binary outcomes (i.e., correctness).

Does accuracy change through discussion?

First, we examined how correctness changed across peer discussion. A logit model predicting correctness from time point (pre-discussion to post-discussion) revealed that the odds of correctness increased by 1.57 times (95% confidence interval (conf) 1.31–1.87) from pre-discussion to post-discussion, as shown in Table  2 . In fact, 88% of students showed an increase or no change in accuracy from pre-discussion to post-discussion. Pre-discussion to post-discussion performance for each class is shown in Table  3 . We further examined how accuracy changed from pre-discussion to post-discussion for each question and the results are plotted in Fig.  1 . The data show a consistent improvement in accuracy from pre-discussion to post-discussion across all levels of initial difficulty.

The relationship between pre-discussion accuracy (x axis) and post-discussion accuracy (y axis). Each point represents a single question. The solid diagonal line represents equal pre-discussion and post-discussion accuracy; points above the line indicate improvements in accuracy and points below represent decrements in accuracy. The dashed line indicates the line of best fit for the observed data

We examined how performance increased from pre-discussion to post-discussion by tracing the correctness of answers through the discussion. Figure  2 tracks the percent (and number of items) correct from pre-discussion to post-discussion. The top row shows whether students were initially correct or incorrect in their answer; the middle row shows whether students agreed or disagreed with their partner; the last row show whether students were correct or incorrect after discussion. Additionally, Fig. 2 shows the confidence associated with each pathway. The bottow line of each entry shows the students’ average confidence; in the middle white row, the confidence reported is the average of the peer’s confidence.

The pathways of answers from pre-discussion (top row) to post-discussion (bottom row). Percentages indicate the portion of items from the category immediately above in that category, the numbers in brackets indicate the raw numbers of items, and the numbers at the bottom of each entry indicate the confidence associated with those items. In the middle, white row, confidence values show the peer’s confidence. Turquoise indicates incorrect answers and yellow indicates correct answers

Broadly, only 5% of correct answers were switched to incorrect, while 28% of incorrect answers were switched to correct following discussion. Even for the items in which students were initially correct but disagreed with their partner, only 21% of answers were changed to incorrect answers after discussion. However, out of the items where students were initially incorrect and disagreed with their partner, 42% were changed to the correct answer.

Does confidence predict switching?

Differences in the amount of switching to correct or incorrect answers could be driven solely by differences in confidence, as described in our first theory mentioned earlier. For this theory to hold, answers with greater confidence must have a greater likelihood of being correct. To examine whether initial confidence is associated with initial correctness, we calculated the gamma correlation between correctness and confidence in the answer before discussion, as shown in the first column of Table  4 . The average gamma correlation between initial confidence and initial correctness (mean (M) = 0.40) was greater than zero, t (160) = 8.59, p  < 0.001, d  = 0.68, indicating that greater confidence was associated with being correct.

Changing from an incorrect to a correct answer, then, may be driven entirely by selecting the answer from the peer with the greater confidence during discussion, even though most of the students in our sample were not required to explicitly disclose their confidence to their partner during discussion. We examined how frequently students choose the more confident answer when peers disagree. When peers disagreed, students’ final answers aligned with the more confident peer only 58% of the time. Similarly, we tested what the performance would be if peers always picked the answer of the more confident peer. If peers always chose the more confident answer during discussion, the final accuracy would be 69%, which is significantly lower than actual final accuracy (M = 72%, t (207) = 2.59, p  = 0.01, d  = 0.18). While initial confidence is related to accuracy, these results show that confidence is not the only predictor of switching answers.

Does correctness predict switching beyond confidence?

Discussion may reveal information about the correctness of answers by generating new knowledge and testing the coherence of each possible answer. To test whether the correctness of an answer added predictive power beyond the confidence of the peers involved in discussion, we analyzed situations in which students disagreed with their partner. Out of the instances when partners initially disagreed, we predicted the likelihood of keeping one’s answer based upon one’s own confidence, the partner’s confidence, and whether one’s answer was initially correct. The results of a model predicting whether students keep their answers is shown in Table  5 . For each increase in a point of one’s own confidence, the odds of keeping one’s answer increases 1.25 times (95% conf 1.13–1.38). For each decrease in a point of the partner’s confidence, the odds of keeping one’s answer increased 1.19 times (1.08–1.32). The beta weight for one’s confidence did not differ from the beta weight of the partner’s confidence, χ 2  = 0.49, p  = 0.48. Finally, if one’s own answer was correct, the odds of keeping one’s answer increased 4.48 times (2.92–6.89). In other words, the more confident students were, the more likely they were to keep their answer; the more confident their peer was, the more likely they were to change their answer; and finally, if a student was correct, they were more likely to keep their answer.

To illustrate this relationship, we plotted the probability of keeping one’s own answer as a function of the difference between one’s own and their partner’s confidence for initially correct and incorrect answers. As shown in Fig.  3 , at every confidence level, being correct led to equal or more frequently keeping one’s answer than being incorrect.

The probability of keeping one’s answer in situations where one’s partner initially disagreed as a function of the difference between partners’ levels of confidence. Error bars indicate the standard error of the proportion and are not shown when the data are based upon a single data point

As another measure of whether discussion allows learners to test the coherence of the correct answer, we analyzed how discussion impacted confidence when partners’ answers agreed. We predicted confidence in answers by the interaction of time point (i.e., pre-discussion versus post-discussion) and being initially correct for situations in which peers initially agreed on their answer. The results, displayed in Table  6 , show that confidence increased from pre-discussion to post-discussion by 1.08 points and that confidence was greater for initially correct answers (than incorrect answers) by 0.78 points. As the interaction between time point and initial correctness shows, confidence increased more from pre-discussion to post-discussion when students were initially correct (as compared to initially incorrect). To illustrate this relationship, we plotted pre-confidence against post-confidence for initially correct and initially incorrect answers when peers agreed (Fig.  4 ). Each plotted point represents a student; the diagonal blue line indicates no change between pre-confidence and post-confidence. The graph reflects that confidence increases more from pre-discussion to post-discussion for correct answers than for incorrect answers, even when we only consider cases where peers agreed.

The relationship between pre-discussion and post-discussion confidence as a function of the accuracy of an answer when partners agreed. Each dot represents a student

If students engage in more comprehensive answer testing during discussion than before, the relationship between confidence in their answer and the accuracy of their answer should be stronger following discussion than it is before. We examined whether confidence accurately reflected correctness before and after discussion. To do so, we calculated the gamma correlation between confidence and accuracy, as is typically reported in the literature on metacognitive monitoring (e.g., Son & Metcalfe, 2000 ; Tullis & Fraundorf, 2017 ). Across all students, the resolution of metacognitive monitoring increases from pre-discussion to post-discussion ( t (139) = 2.98, p  = 0.003, d  = 0.24; for a breakdown of gamma calculations for each class, see Table 4 ). Confidence was more accurately aligned with accuracy following discussion than preceding it. The resolution between student confidence and correctness increases through discussion, suggesting that discussion offers better coherence testing than answering alone.

To examine why peer instruction benefits student learning, we analyzed student answers and confidence before and after discussion across six psychology classes. Discussing a question with a partner improved accuracy across classes and grade levels with small to medium-sized effects. Questions of all difficulty levels benefited from peer discussion; even questions where less than half of students originally answered correctly saw improvements from discussion. Benefits across the spectrum of question difficulty align with prior research showing improvements when even very few students initially know the correct answer (Smith et al., 2009 ). More students switched from incorrect answers to correct answers than vice versa, leading to an improvement in accuracy following discussion. Answer switching was driven by a student’s own confidence in their answer and their partner’s confidence. Greater confidence in one’s answer indicated a greater likelihood of keeping the answer; a partner’s greater confidence increased the likelihood of changing to their answer.

Switching answers depended on more than just confidence: even when accounting for students’ confidence levels, the correctness of the answer impacted switching behavior. Across several measures, our data showed that the correctness of an answer carried weight beyond confidence. For example, the correctness of the answer predicted whether students switched their initial answer during peer disagreements, even after taking the confidence of both partners into account. Further, students’ confidence increased more when partners agreed on the correct answer compared to when they agreed on an incorrect answer. Finally, although confidence increased from pre-discussion to post-discussion when students changed their answers from incorrect to the correct ones, confidence decreased when students changed their answer away from the correct one. A plausible interpretation of this difference is that when students switch from a correct answer to an incorrect one, their decrease in confidence reflects the poor coherence of their final incorrect selection.

Whether peer instruction resulted in optimal switching behaviors is debatable. While accuracy improved through discussion, final accuracy was worse than if students had optimally switched their answers during discussion. If students had chosen the correct answer whenever one of the partners initially chose it, the final accuracy would have been significantly higher (M = 0.80 (SD = 0.19)) than in our data (M = 0.72 (SD = 0.24), t (207) = 6.49, p  < 0.001, d  = 0.45). While this might be interpreted as “process loss” (Steiner, 1972 ; Weldon & Bellinger, 1997 ), that would assume that there is sufficient information contained within the dyad to ascertain the correct answer. One individual selecting the correct answer is inadequate for this claim because they may not have a compelling justification for their answer. When we account for differences in initial confidence, students’ final accuracy was better than expected. Students’ final accuracy was better than that predicted from a model in which students always choose the answer of the more confident peer. This over-performance, often called “process gain”, can sometimes emerge when individuals collaborate to create or generate new knowledge (Laughlin, Bonner, & Miner, 2002 ; Michaelsen, Watson, & Black, 1989 ; Sniezek & Henry, 1989 ; Tindale & Sheffey, 2002 ). Final accuracy reveals that students did not simply choose the answer of the more confident student during discussion; instead, students more thoroughly probed the coherence of answers and mental models during discussion than they could do alone.

Students’ final accuracy emerges from the interaction between the pairs of students, rather than solely from individuals’ sequestered knowledge prior to discussion (e.g. Wegner, Giuliano, & Hertel, 1985 ). Schwartz ( 1995 ) details four specific cognitive products that can emerge through working in dyads. Specifically, dyads force verbalization of ideas through discussion, and this verbalization facilitates generating new knowledge. Students may not create a coherent explanation of their answer until they engage in discussion with a peer. When students create a verbal explanation of their answer to discuss with a peer, they can identify knowledge gaps and construct new knowledge to fill those gaps. Prior research examining the content of peer interactions during argumentation in upper-level biology classes has shown that these kinds of co-construction happen frequently; over three quarters of statements during discussion involve an exchange of claims and reasoning to support those claims (Knight et al., 2013 ). Second, dyads have more information processing resources than individuals, so they can solve more complex problems. Third, dyads may foster greater motivation than individuals. Finally, dyads may stimulate the creation of new, abstract representations of knowledge, above and beyond what one would expect from the level of abstraction created by individuals. Students need to communicate with their partner; to create common ground and facilitate discourse, dyads negotiate common representations to coordinate different perspectives. The common representations bridge multiple perspectives, so they lose idiosyncratic surface features of individuals’ representation. Working in pairs generates new knowledge and tests of answers that could not be predicted from individuals’ performance alone.

More broadly, teachers often put students in groups so that they can learn from each other by giving and receiving help, recognizing contradictions between their own and others’ perspectives, and constructing new understandings from divergent ideas (Bearison, Magzamen, & Filardo, 1986 ; Bossert, 1988-1989 ; Brown & Palincsar, 1989 ; Webb & Palincsar, 1996 ). Giving explanations to a peer may encourage explainers to clarify or reorganize information, recognize and rectify gaps in understandings, and build more elaborate interpretations of knowledge than they would have alone (Bargh & Schul, 1980 ; Benware & Deci, 1984 ; King, 1992 ; Yackel, Cobb, & Wood, 1991 ). Prompting students to explain why and how problems are solved facilitates conceptual learning more than reading the problem solutions twice without self-explanations (Chi, de Leeuw, Chiu, & LaVancher, 1994 ; Rittle-Johnson, 2006 ; Wong, Lawson, & Keeves, 2002 ). Self-explanations can prompt students to retrieve, integrate, and modify their knowledge with new knowledge; self-explanations can also help students identify gaps in their knowledge (Bielaczyc, Pirolli, & Brown, 1995 ; Chi & Bassock, 1989 ; Chi, Bassock, Lewis, Reimann, & Glaser, 1989 ; Renkl, Stark, Gruber, & Mandl, 1998 ; VanLehn, Jones, & Chi, 1992 ; Wong et al., 2002 ), detect and correct errors, and facilitate deeper understanding of conceptual knowledge (Aleven & Koedinger, 2002 ; Atkinson, Renkl, & Merrill, 2003 ; Chi & VanLehn, 2010 ; Graesser, McNamara, & VanLehn, 2005 ). Peer instruction, while leveraging these benefits of self-explanation, also goes beyond them by involving what might be called “other-explanation” processes - processes recruited not just when explaining a situation to oneself but to others. Mercier and Sperber ( 2019 ) argue that much of human reason is the result of generating explanations that will be convincing to other members of one’s community, thereby compelling others to act in the way that one wants.

Conversely, students receiving explanations can fill in gaps in their own understanding, correct misconceptions, and construct new, lasting knowledge. Fellow students may be particularly effective explainers because they can better take the perspective of their peer than the teacher (Priniski & Horne, 2019 ; Ryskin, Benjamin, Tullis, & Brown-Schmidt, 2015 ; Tullis, 2018 ). Peers may be better able than expert teachers to explain concepts in familiar terms and direct peers’ attention to the relevant features of questions that they do not understand (Brown & Palincsar, 1989 ; Noddings, 1985 ; Vedder, 1985 ; Vygotsky, 1981 ).

Peer instruction may benefit from the generation of explanations, but social influences may compound those benefits. Social interactions may help students monitor and regulate their cognition better than self-explanations alone (e.g., Jarvela et al., 2015 ; Kirschner, Kreijns, Phielix, & Fransen, 2015 ; Kreijns, Kirschner, & Vermeulen, 2013 ; Phielix, Prins, & Kirschner, 2010 ; Phielix, Prins, Kirschner, Erkens, & Jaspers, 2011 ). Peers may be able to judge the quality of the explanation better than the explainer. In fact, recent research suggests that peer instruction facilitates learning even more than self-explanations (Versteeg, van Blankenstein, Putter, & Steendijk, 2019 ).

Not only does peer instruction generate new knowledge, but it may also improve students’ metacognition. Our data show that peer discussion prompted more thorough testing of the coherence of the answers. Specifically, students’ confidences were better aligned with accuracy following discussion than before. Improvements in metacognitive resolution indicate that discussion provides more thorough testing of answers and ideas than does answering questions on one’s own. Discussion facilitates the metacognitive processes of detecting errors and assessing the coherence of an answer.

Agreement among peers has important consequences for final behavior. For example, when peers agreed, students very rarely changed their answer (less than 3% of the time). Further, large increases in confidence occurred when students agreed (as compared to when they disagreed). Alternatively, disagreements likely engaged different discussion processes and prompted students to combine different answers. Whether students weighed their initial answer more than their partner’s initial answer remains debatable. When students disagreed with their partner, they were more likely to stick with their own answer than switch; they kept their own answer 66% of the time. Even when their partner was more confident, students only switched to their partner’s answer 50% of the time. The low rate of switching during disagreements suggests that students weighed their own answer more heavily than their partner’s answer. In fact, across prior research, deciders typically weigh their own thoughts more than the thoughts of an advisor (Harvey, Harries, & Fischer, 2000 ; Yaniv & Kleinberger, 2000 ).

Interestingly, peers agreed more frequently than expected by chance. When students were initially correct (64% of the time), 78% of peers agreed. When students were initially incorrect (36% of the time), peers agreed 43% of the time. Pairs of students, then, agree more than expected by a random distribution of answers throughout the classroom. These data suggest that students group themselves into pairs based upon likelihood of sharing the same answer. Further, these data suggest that student understanding is not randomly distributed throughout the physical space of the classroom. Across all classes, students were instructed to work with a neighbor to discuss their answer. Given that neighbors agreed more than predicted by chance, students seem to tend to sit near and pair with peers that share their same levels of understanding. Our results from peer instruction reveal that students physically locate themselves near students of similar abilities. Peer instruction could potentially benefit from randomly pairing students together (i.e. not with a physically close neighbor) to generate the most disagreements and generative activity during discussion.

Learning through peer instruction may involve deep processing as peers actively challenge each other, and this deep processing may effectively support long-term retention. Future research can examine the persistence of gains in accuracy from peer instruction. For example, whether errors that are corrected during peer instruction stay corrected on later retests of the material remains an open question. High and low-confidence errors that are corrected during peer instruction may result in different long-term retention of the correct answer; more specifically, the hypercorrection effect suggests that errors committed with high confidence are more likely to be corrected on subsequent tests than errors with low confidence (e.g., Butler, Fazio, & Marsh, 2011 ; Butterfield & Metcalfe, 2001 ; Metcalfe, 2017 ). Whether hypercorrection holds for corrections from classmates during peer instruction (rather than from an absolute authority) could be examined in the future.

The influence of partner interaction on accuracy may depend upon the domain and kind of question posed to learners. For simple factual or perceptual questions, partner interaction may not consistently benefit learning. More specifically, partner interaction may amplify and bolster wrong answers when factual or perceptual questions lead most students to answer incorrectly (Koriat, 2015 ). However, for more “intellective tasks,” interactions and arguments between partners can produce gains in knowledge (Trouche et al., 2014 ). For example, groups typically outperform individuals for reasoning tasks (Laughlin, 2011 ; Moshman & Geil, 1998 ), math problems (Laughlin & Ellis, 1986 ), and logic problems (Doise & Mugny, 1984; Perret-Clermont, 1980 ). Peer instruction questions that allow for student argumentation and reasoning, therefore, may have the best benefits in student learning.

The underlying benefits of peer instruction extend beyond the improvements in accuracy seen from pre-discussion to post-discussion. Peer instruction prompts students to retrieve information from long-term memory, and these practice tests improve long-term retention of information (Roediger III & Karpicke, 2006 ; Tullis, Fiechter, & Benjamin, 2018 ). Further, feedback provided by instructors following peer instruction may guide students to improve their performance and correct misconceptions, which should benefit student learning (Bangert-Drowns, Kulik, & Kulik, 1991 ; Thurlings, Vermeulen, Bastiaens, & Stijnen, 2013 ). Learners who engage in peer discussion can use their new knowledge to solve new, but similar problems on their own (Smith et al., 2009 ). Generating new knowledge and revealing gaps in knowledge through peer instruction, then, effectively supports students’ ability to solve novel problems. Peer instruction can be an effective tool to generate new knowledge through discussion between peers and improve student understanding and metacognition.

Availability of data and materials

As described below, data and materials are available on the OpenScienceFramework: https://mfr.osf.io/render?url=https://osf.io/5qc46/?action=download%26mode=render .

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• Group decisions
• Peer instruction
• Metacognition
• Decision making

Peer Learning: Boost Engagement and Performance

Dive into the transformative power of peer learning, its benefits, and how to effectively foster it in your organization.

Peer learning is a collaborative approach to employee learning and development in which individuals with similar knowledge or experience work together to learn and achieve a common goal. It can be an effective way to improve retention of information and increase motivation and engagement, particularly in education and workplace settings. Peer learning can enhance the learning experience and develop skills such as teamwork, communication, and problem-solving.

Let's find out what it is, why its important, and its benefits.

What is peer learning in the workplace?

Peer learning involves individuals learning together without a traditional instructor, sharing knowledge and experiences to enhance mutual understanding. This collaborative method boosts engagement, encourages active participation, and develops key skills like communication and teamwork, making it effective for both academic and professional growth.

By incorporating peer learning into the workplace , organizations can support the professional development of their employees and improve overall productivity and performance.

Explaining the peer learning theory

The peer learning theory is supported by research in the fields of education and psychology, which suggests that collaborative learning can be an effective way to facilitate the learning process and enhance the learning experience for learners.

It's thought that the interactive and collaborative nature of peer learning helps to engage learners and facilitate the understanding of complex concepts.

Overall, the peer learning theory suggests that individuals can learn from and with their peers in a collaborative and interactive way.

Why is peer learning important?

Peer learning is important because it is a powerful and effective way to facilitate the learning process and enhance the learning experience for employees, and can also foster a sense of collaboration and support in the workplace, leading to higher engagement rates among employees.

Benefits of peer learning

Peer learning has many benefits, including increased and the development of valuable skills. It can also provide an opportunity for learners to share diverse perspectives .

Let’s break down how peer learning can help businesses and employees.

Improved retention of information

Research has shown that peer learning can lead to better learner retention rates compared to traditional lecturing methods. This is thought to be due to the interactive and collaborative nature of peer learning, which helps to engage students and facilitate the understanding of complex concepts.

Increased motivation and engagement

Peer learning can foster a sense of collaboration and support among learners, which can boost motivation and engagement in the learning process.

When employees feel that they are working towards a common goal with their peers, they may be more motivated to participate and contribute during learning.

Opportunity for diverse perspectives and collaboration

Peer learning can provide an opportunity for learners to share and discuss diverse perspectives, leading to a more well-rounded understanding of the subject matter. It can also facilitate collaboration and teamwork, which can be valuable skills in both education and the workplace.

Development of social skills and communication skills

Peer learning can also help to develop social skills and communication skills, as learners must work together and communicate effectively in order to achieve their goals.

Training Objectives

Disadvantages of peer learning environments.

While peer learning has many advantages, there are also some potential disadvantages to consider:

• Dependent on the quality of the peer group: The effectiveness of peer learning can depend on the quality and knowledge level of the peer group. If the peer group is not knowledgeable or skilled in the subject matter, it may be difficult for the learners to gain valuable insights and understanding.
• May not be suitable for all learners: Peer learning may not be suitable for all learners, particularly those who may struggle with social interactions or may not feel comfortable working in a group setting.
• Potential for unequal contributions: In peer learning groups, there may be some learners who contribute more than others, which can lead to an uneven distribution of workload and may not be an effective use of time for all learners.

Despite these potential disadvantages, peer learning can still be a valuable approach to the professional development of employees when implemented effectively.

Examples of peer learning in practice

Peer learning activities are educational or professional development activities that involve learners working together to learn and achieve a common goal. 

There are many different types of peer learning activities that can be incorporated into work settings, depending on the goals and needs of the learners. 

Some examples of peer learning include:

• Group study sessions in education: Group study sessions are a common example of peer learning in education settings. These sessions can involve students working together to review and discuss course material, and may be facilitated by a teacher or peer tutor.
• Collaborative projects in the workplace: Collaborative projects can be a form of peer learning in the workplace, as employees work together to complete a task or project. This can involve sharing knowledge and skills, as well as problem-solving and decision-making as a team.
• Online communities and forums: Online communities and forums can also be a form of peer learning, as individuals with similar interests or expertise can share information and collaborate virtually.
• Peer tutoring programs: Peer tutoring programs, in which students work with their peers to provide tutoring or academic support, can also be a form of peer learning.

Tips for implementing peer learning in your organization

Implementing peer-to-peer learning can be a relatively straightforward process, but it's important to plan and prepare in order to ensure success. 

Here are a few best practices for implementing peer learning:

• Encourage collaboration and open communication: To facilitate peer learning, it's important to create an environment that encourages collaboration and open communication. This may involve setting up dedicated collaborative spaces or promoting the use of communication tools such as discussion forums or chat.
• Facilitate opportunities for peer feedback and reflection: Providing opportunities for peer feedback and reflection can help to enhance the learning process. This could involve having learners share their work with their peers for feedback, or facilitating group discussions or reflection activities.
• Set clear goals and expectations for peer learning activities: Setting clear goals and expectations for peer learning activities can help to ensure that the learning process is productive and effective. This may involve establishing guidelines for group work or outlining the objectives of a collaborative project.
• Foster a culture of continuous learning and support: Creating a culture of continuous learning and support can help to encourage and facilitate peer learning within an organization. This may involve providing resources and support for professional development, as well as promoting a culture of open communication and collaboration.

The power of peer-to-peer learning for employee development

Peer learning is a powerful and effective way to facilitate the learning process and improve retention of information , particularly in workplace settings.

It can also foster a sense of collaboration and support in the workplace, leading to increased motivation and engagement among employees.

By incorporating peer learning into your organization, you can enhance the learning experience and facilitate the development of valuable skills such as teamwork, communication, and problem-solving.

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Peer education training manual. For the training of peer educators and peer education advisers in secondary schools

Peer education is a powerful strategy to promote positive behaviour change and improve the life skills of young people. This peer education program builds upon the concepts and life skills first introduced in the Upper Primary Personal Development syllabus. It reinforces and deepens the learning outcomes in Lower Secondary Personal Development. This peer education program aims to: reduce students’ risk-taking behaviour and improve positive behaviour; provide students with facts about sexual and reproductive health, STIs and HIV/AIDS, drugs and alcohol, and gender issues; equip students with the values and life skills to make well-informed and healthy choices about their behaviour; to improve the decision–making and negotiating skills of students so that they may be able to deal with issues such as negative peer pressure and early sexual debut, and; improve the communication skills of students so that they may be able to interact positively in different situations.

Sustainable Campus

Peer to peer education, peer education for students.

Students leaders help educate each other to strengthen our sustainable campus culture. Many student organizations practice peer-to-peer education. The campus also has several formal sustainability peer-engagement programs. 

Residential Sustainability Leaders (RSL) Program

Registration & meetings occur at the start of each semester Apply or learn more

The Residential Student Leaders (RSL) program serve as the primary student peer-to-peer leadership network at Cornell.  RSLs form an action-oriented, problem-solving group who work to identify sustainability-related issues in residential facilities and across campus.

RSLs work closely with the Campus Sustainability Office, Residential Life, and West Campus House System to implement real solutions on campus to pressing sustainability problems.  Open to students at every level.

Compost Managers Program

Registration & training occur at the start of each semester

Apply or learn more

Composting is available in all on-campus residential communities.  Students can apply to become Compost Managers , to support the campus-wide Residential Composting Program by becoming leaders on-campus overseeing kitchen compost bins within their residential communities and who provide peer-to-peer education on composting practices.

Compost Managers empty compost bins weekly, work to reduce food waste contamination, and communicate with residential staff and the Campus Sustainability Office.  

Campus Sustainability Office Internships

Applications accepted as positions become available

The Campus Sustainability Office offers 5+ paid internships each semester in roles such as "Student Engagement Coordinator," "Sustainability Coordinator," and more. 

Looking for staff peer-to-peer education programs? Check out the Sustainability Teams page.

Peer to Peer Education

• Inclusionary

As a peer educator, you have a unique role in facilitating learning activities. Non-formal education, led by young people, can be a lot more engaging and effective in learning about new ideas. It is a brilliant way to open up people’s minds up to new ways of thinking about the world, and a lot of fun for both the facilitators and the participants.

You should look for activities from the OBESSU toolkit, or the resources listed for social inclusion, to organise according to the needs of your organisation. Also, there are general tips for facilitators which are important to think about when you are preparing to organise an event. Some of these include

Being prepared and organised

Make a plan and stick to it - Start with the goals of the session, then the content and at last the methods

Ask for help if you need it - brief a team to help you in facilitating or with the logistics - or, contact the OBESSU PoT!

Power dynamics

Peer educators don’t have to be experts or have degrees in particular fields -

But, they need to be good at facilitating dialogue between people and leading the group through a learning activity

Language and tone

Be friendly and approachable

Speak clearly and don’t use difficult words or terminology

Offer for anyone to ask questions or to interrupt if they don’t understand

PowerPoint presentation, and other materials

Make sure that you don’t have too many crazy colour combinations on your powerpoints!

Use accessible language and don’t write every single thing down in slides - only the most important points (if detailed information is needed, print some handouts!)

Try using Kahoot or Prezi, if you will have a good internet connection in the room, as a way to have fun and accessible technological tools

Lupus Peer-to-Peer Early Education Program Expands

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March 28, 2024

Lupus Therapeutics , the clinical research affiliate of the Lupus Research Alliance, has announced an innovative expansion of the highly successful Patient Advocates for Lupus Studies (PALS) program with the introduction of a first-in-lupus “Trial Buddy” component made possible by a partnership with Bristol Myers Squibb. The Trial Buddy addition provides extra support to people with lupus while they are involved in the Phase 3 POETYK SLE trials to evaluate how personal interaction can impact study retention and participation.

PALS, a peer-to-peer clinical trial early education program, was co-designed with lupus patients to improve clinical trial awareness, knowledge, and enrollment, with a focus on ensuring diverse representation in lupus clinical trials. As part of the program, individuals living with lupus who have participated in clinical research are trained to serve as peer educators to those who have never been in a trial.  Many trials struggle to recruit enough participants and often do not represent the diverse groups most affected by lupus. 1,2 Insufficient enrollment and under-representation by people of color in clinical trials can lead to results that do not accurately reflect the effect of potential therapies among all patients.1,3  The pilot PALS program successfully met its objectives to increase knowledge, attitudes, and intentions among people with lupus to participate in clinical trials.

PALS, a peer-to-peer clinical trial early education program, was co-designed with lupus patients to improve clinical trial awareness, knowledge, and enrollment, with a focus on ensuring diverse representation in lupus clinical trials. As part of the program, individuals living with lupus who have participated in clinical research are trained to serve as peer educators to those who have never been in a trial.  Many trials struggle to recruit enough participants and often do not represent the diverse groups most affected by lupus. 1,2 Insufficient enrollment and under-representation by people of color in clinical trials can lead to results that do not accurately reflect the effect of potential therapies among all patients.1,3 The pilot PALS program successfully met its objectives to increase knowledge, attitudes, and intentions among people with lupus to participate in clinical trials.

PALS Expansion Increases People Reached Now that it has been proven effective, the PALS program will expand and provide similar peer education at Yale University, University of Texas Southwestern Medical Center, and Oklahoma Medical Research Foundation in addition to Emory University, one of the original sites. Increasing the number of sites aims to extend the demonstrated benefit of the program to foster greater and more diverse participation in lupus trials.

The new Trial Buddy program will also be implemented at these four sites, as well as Columbia University, to enable PALS to assist adults living with lupus who are enrolled in the POETYK SLE clinical trials. These Phase 3 trials are evaluating deucravacitinib as a potential treatment for active systemic lupus erythematosus. To prepare for meaningful interactions with the trial participants, the PALS have received additional training in clinical trials and the POETYK SLE trials specifically. Independent of the formal clinical protocols for POETYK SLE, the PALS will be equipped to provide their assigned Trial Buddy with resources and answer any questions related to participation in the study. Each PAL will have regularly scheduled check-ins with their Trial Buddy to provide consistent support throughout the course of the trial.

Alyssa Johnsen, MD, PhD, vice president and head of late clinical development, Immunology at Bristol Myers Squibb noted, “We are proud to partner with the Lupus Research Alliance to bring forth innovative initiatives like the Patient Advocates for Lupus Studies program and look forward to piloting its use in the POETYK SLE Phase 3 trials.”

Lupus Therapeutics Executive Vice President Stacie Bell, PhD commented, “The aim of the Trial Buddy program is to encourage and support continued participation throughout clinical studies. This approach will be evaluated in association with the POETYK Phase 3 trials and may be expanded for use to increase diverse participation in other lupus trials.”

References:

• The Society for Women’s Health Research. (2011). Dialogues on Diversifying Clinical Trials:Successful Strategies for Engaging Women and Minorities in Clinical Trials.September 22-23, 2011.
• Mitka, M. (2011). Treatment for lupus, first in 50 years, offers modest benefits, hope to patients. JAMA, 305(17), 1754-1755.
• Dirks N. L., et al. Pharmacokinetics of immunosuppressants: a perspective on ethnic differences. Int J Clin Pharacol Ther. 2004 Dec; 42(12):701‐18

Related Posts

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LRA Mourns Loss of Co-Founder and Board Co-Chair Richard K. DeScherer – NYT Obituary READ MORE

Congress Passes Budget With $10M for Lupus Research Program READ MORE

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School-based peer education interventions to improve health: a global systematic review of effectiveness

Steven dodd.

1 Faculty of Health and Medicine, Lancaster University, Lancaster, UK

Emily Widnall

2 Population Health Sciences, University of Bristol, Bristol, UK

Abigail Emma Russell

3 College of Medicine and Health, University of Exeter, Exeter, UK

Esther Louise Curtin

4 Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

Ruth Simmonds

5 Mental Health Foundation, London, UK

Mark Limmer

Judi kidger, associated data.

All data generated or analysed during this study are included in this published article and its supplementary information files.

Introduction

Peer education, whereby peers (‘peer educators’) teach their other peers (‘peer learners’) about aspects of health is an approach growing in popularity across school contexts, possibly due to adolescents preferring to seek help for health-related concerns from their peers rather than adults or professionals. Peer education interventions cover a wide range of health areas but their overall effectiveness remains unclear. This review aims to summarise the effectiveness of existing peer-led health interventions implemented in schools worldwide.

Five electronic databases were searched for eligible studies in October 2020. To be included, studies must have evaluated a school-based peer education intervention designed to address the health of students aged 11–18-years-old and include quantitative outcome data to examine effectiveness. The number of interventions were summarised and the impact on improved health knowledge and reductions in health problems or risk-taking behaviours were investigated for each health area separately, the Mixed Methods Appraisal Tool was used to assess quality.

A total of 2125 studies were identified after the initial search and 73 articles were included in the review. The majority of papers evaluated interventions focused on sex education/HIV prevention ( n  = 23), promoting healthy lifestyles ( n  = 17) and alcohol, smoking and substance use ( n  = 16). Papers mainly reported peer learner outcomes (67/73, 91.8%), with only six papers (8.2%) focussing solely on peer educator outcomes and five papers (6.8%) examining both peer learner and peer educator outcomes. Of the 67 papers reporting peer learner outcomes, 35/67 (52.2%) showed evidence of effectiveness, 8/67 (11.9%) showed mixed findings and 24/67 (35.8%) found limited or no evidence of effectiveness. Of the 11 papers reporting peer educator outcomes, 4/11 (36.4%) showed evidence of effectiveness, 2/11 (18.2%) showed mixed findings and 5/11 (45.5%) showed limited or no evidence of effectiveness. Study quality varied greatly with many studies rated as poor quality, mainly due to unrepresentative samples and incomplete data.

School-based peer education interventions are implemented worldwide and span a wide range of health areas. A number of interventions appear to demonstrate evidence for effectiveness, suggesting peer education may be a promising strategy for health improvement in schools. Improvement in health-related knowledge was most common with less evidence for positive health behaviour change. In order to quantitatively synthesise the evidence and make more confident conclusions, there is a need for more robust, high-quality evaluations of peer-led interventions using standardised health knowledge and behaviour measures.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14688-3.

Ensuring good health and wellbeing amongst school-aged children is a global public health priority and the contribution schools can make to this goal is increasingly recognised [ 1 ]. Worldwide, we have seen a rise in peer education interventions over recent decades [ 2 ]. For example, a survey in England revealed that 62% of primary and secondary schools had offered a peer-led intervention in 2009 [ 3 ]. Peer-led interventions within school settings are popular for many reasons, including the important role peers play within the lives of young people, a perception that this approach involves relatively few resources, and the more even balance of authority than in teacher-led lessons [ 4 ]. The use of peer educators for health improvement has also been linked with the importance of peer influence in adolescence [ 5 ]. This is a time of increased social development and peer attachments are central to young people’s development, particularly during adolescence [ 5 , 6 ]. Further, there is evidence that young people are more likely to seek help from informal sources of support such as friends in comparison to adults [ 7 ], and of older students being perceived as role models by their younger peers [ 8 ]. Benefits are also likely to exist for peer educators themselves, including opportunities to develop confidence and leadership skills, as well as many schools rewarding peer educators with a qualification or endorsement for their participation [ 9 ].

Existing peer education interventions cover a wide range of health areas, including mental health, physical health, sexual health, and a general promotion of healthy lifestyles including eating habits and smoking prevention [ 10 – 13 ]. There is also variation in the format or delivery of peer-led interventions including 1:1 peer mentoring, peer buddy initiatives, peer counselling, and peer education [ 14 – 17 ]. This review focuses specifically on peer education, which typically involves the selection and training of ‘peer educators’ or ‘leaders’, who subsequently relay health related information or skills to younger or similar aged students in their school, known as ‘peer learners’ or ‘recipients’.

Summary of related reviews

The current literature on peer education indicates a mixed evidence base regarding its effectiveness.

Ten previous reviews were found concerning health-related peer education among young people [ 10 , 12 , 18 – 24 ]. Of these, six concerned sexual health/HIV prevention, two concerned health promotion/education more broadly, one focused on substance abuse and one focused on mental health.

Kim and Free’s review concerning sexual health [ 21 ] found no overall effect of peer education on condom use, mixed findings on sexually transmitted infection (STI) prevention, and positive findings regarding improvements in knowledge, attitudes and intentions. Siddiqui et al. [ 20 ] reviewed peer education programmes for promoting the sexual and reproductive health of young people in India, revealing large variations in the way peer education is implemented as well as mixed effectiveness findings and limited effects of behaviour relative to knowledge. Maticka-Tyndale and Barnet [ 22 ] compiled a review into peer-led interventions to reduce HIV risk among youth using a narrative synthesis, and found that peer interventions led to positive change in knowledge and condom use, and had some success in changing community attitudes and norms, but no significant findings for effects on other sexual behaviours and STI rates. By comparison, Tolli’s review [ 12 ] regarding the effectiveness of peer education interventions for HIV prevention found no clear evidence of peer education effectiveness for HIV prevention, adolescent pregnancy prevention or sexual health promotion in young people of member countries of the European Union.

Mellanby et al. [ 23 ] reviewed the literature comparing peer-led and adult-led school health education and identified eleven studies. Seven of these studies found peer-led to be more effective for health behaviour change than adult-led and three of these studies found peer-led to me more effective for change in knowledge and attitudes. Harden et al. [ 24 ] identified 64 peer-delivered health interventions for young people aged 11 to 24 in any setting (i.e. not restricted to school settings), with only 12 evaluations judged to be methodologically sound. Of these 12, 7 studies (58%) showed a positive effect on at least one behavioural outcome. This review concluded an unclear evidence base for peer-delivered health promotion for young people.

MacArthur et al’s [ 19 ] investigation of peer-led interventions to prevent tobacco, alcohol and/or drug use among young people aged 11–21, comprised a meta-analysis, pooling 10 studies on tobacco use, and found lower prevalence of smoking among those receiving the peer-led interventions compared with controls. The authors also found that peer-led interventions were associated with benefit in relation to alcohol use, and three studies suggested an association with lower odds of cannabis use.

A recent systematic review by King and Fazel of 11 school-based peer-led mental health interventions studies revealed mixed effectiveness [ 10 ]. Some studies showed significant improvements in peer educator self-esteem and social stress [ 25 ], but one study showed an increase in guilt in peer educators [ 26 ]. Two studies also found improvements in self-confidence [ 27 ], and quality of life in peer learners [ 28 ], but one study found an increase in learning stress and decrease in overall mental health scores [ 26 ]. The review concluded there is better evidence if benefits for peer educators compared to peer learners. The summary above of previous systematic assessments of the peer education approach reveals a limited evidence base for school-based peer education interventions. Only two reviews were included regarding school-based peer education, one of which occurred over 20 years ago [ 23 ], while the other [ 10 ] was more narrowly concerned with mental health outcomes.

Despite the widespread use of peer-led interventions, the evidence base across all health areas still remains limited and little is known regarding their overall effectiveness in terms of changing behaviours or increasing health-related knowledge and/or attitudes. Due to the limited evidence base of peer education interventions, this review is broad in scope and will cover global peer education interventions covering all health areas. Although some peer education interventions are targeted towards specific populations, this review focuses on universal interventions available to an entire cohort of students (for example whole class or whole year group). The review aims to summarise the effectiveness of existing peer-led health interventions in schools. This is a review of quantitative data; the qualitative peer education literature will be published in a separate review.

We followed the PICO (Population, Intervention, Comparator and Outcome) format to develop our research question. We completed the systematic review in accordance with the 2009 PRISMA statement [ 29 ] and registered it with PROSPERO (CRD42021229192).

Search strategy and selection criteria

Five electronic databases were searched for eligible studies: CINAHL, Embase, ERIC, MEDLINE and PsycINFO. The list of search terms (see Supplementary Materials ) were developed after scanning relevant literature for key terms. Searches took place during October 2020.

Once the search terms had been agreed amongst the study team, pilot searches were run to check that key texts were appearing. Search terms were subsequently refined and this process was repeated until all key texts appeared. Search strategies such as truncations were used to maximise results. No restrictions were placed on publication date, country or language.

Inclusion/exclusion criteria

To be included studies had to be concerned with school-based peer education interventions designed to address aspects of the health of pupils aged 11–18 years old. We are interested in this age group in particular as it is a period when peers take on a particularly important role in young people’s lives. Peer education interventions concerned with health are defined here as interventions in which school-aged children deliver the education of other pupils for the purposes of improving health outcomes or awareness/literacy relating to health, including knowledge, behaviours and attitudes. Interventions must have taken place within a school, during school hours and must be universal, i.e. not targeted towards a specific sub-group of students or students with a particular health condition.

Where comparators/controls existed, they had to include non-exposure to the interventions concerned, exposure to a differing version of the same intervention, or exposure to the intervention within a substantially differing context.

Papers were excluded from data synthesis if they satisfied any of the following criteria:

• Peer education interventions only concerned academic outcomes (e.g., reading and writing achievement).
• Interventions concerning anger management, behavioural problems, or social skills.
• Interventions concerning traffic safety, health and safety, avoidance of injuries, or first aid.
• Interventions concerning cultural, social or political awareness (e.g., media literacy).
• Interventions in which health outcomes are secondary to other outcomes (e.g., interventions focused on reading that indirectly improve self-esteem).
• One-to-one mentoring interventions.
• Conference abstracts, research briefings, commentaries, editorials, study protocol papers and pre-prints.

Primary outcome(s)

• Improvements in health, including health awareness and understanding as indicated by responses to questionnaires.
• Reductions in health problems or risk-taking behaviours.

These outcomes may concern the peer educators and/or peer learners.

Data extraction, selection and coding

Two reviewers independently screened all papers according to the inclusion criteria above using the Rayyan online review platform. In cases where the reviewers were uncertain, or where the decision was disputed, the decision was discussed and agreed among the wider research team. Two reviewers (SD and EW) then divided the papers between them and independently extracted the data, discussing and queries that arose with each other and the wider team.

Data extraction included the following:

• Bibliographic details – authors, year of publication, nation in which intervention was carried out
• Aims of the study
• Description of study design
• Sample size and demographic characteristics.
• Context into which the intervention is introduced (characteristics of the school involved, the area in which the school is located, characterisations of the student body, relevant policy considerations).
• Description of intervention (including duration of intervention).
• Outcome measures (measurement tools, time points of data collection).
• Data concerning improvements in health.

Quality appraisal

We used the Mixed Methods Appraisal Tool (MMAT) to assess quality of reporting procedures. This tool consists of five specific quality rating items depending on study design (qualitative, quantitative randomized, quantitative non-randomized, quantitative descriptive and quantitative mixed methods). There are 5 quality questions specific to each study design, so all papers are rated between 0 to 5. The following ratings were used to summarise study quality; 0–1 indicating poor quality, 2–3 indicating average quality and 4–5 indicating high quality. Two reviewers (SD and EW) completed quality ratings on each paper and discussed any discrepancies between them.

Examples of randomized design quality questions included items such as: “ Is randomization appropriately performed ? And “ Are the groups comparable at baseline ?” Examples of non-randomized design quality questions included items such as: “ Are the participants representative of the target population?” and “Are there complete outcome data?”

Effectiveness summary

EW and SD completed data synthesis. Due to the volume of studies, and the large number and heterogeneity of outcome measures, in order to summarise effectiveness, we created the following scoring system to indicate effectiveness:

Significant effects are effects where there was an improvement in health-related outcomes either after the peer education intervention, or when compared to a control group, with a p value of <0.05. Due to the volume of studies and varied follow-up periods, we looked at effectiveness at first follow-up, which in the majority of papers was immediately post-intervention.

A total of 2125 articles were identified after the initial search and 73 articles were eligible for inclusion (see Fig. ​ Fig.1 1 for a flow diagram of the search). Study designs of the 73 articles were as follows: 23 were controlled trial designs (15 cluster or group randomised, 6 randomised controlled and 2 non-randomised). 15 used randomisation methods but were not controlled trials and the remaining 35 studies used uncontrolled non-randomised methods comparing intervention with a comparison group or using a pre-post survey.

Prisma flow diagram of included studies

Health and geographical areas

The 73 quantitative papers included in this review demonstrated a wide range of health areas. The majority of papers evaluated interventions aimed at sex education/HIV prevention ( n  = 23), promoting healthy lifestyles ( n  = 17) and reducing alcohol, smoking and substance use ( n  = 16). Fig. ​ Fig.2 2 illustrates number of papers per health area by peer learner or peer educator outcome focus and Table ​ Table2 2 illustrates a summary of proportion of health areas, overall effectiveness and quality ratings.

Number of papers by health area. NB See Supplementary Materials for full description of study designs and outcomes

Number of included papers by health area

a The proportion of ‘effective’ studies was calculated for each health area and then assigned an overall effectiveness rating based on our scoring thresholds in Table ​ Table1 1 (e.g. if ≥ 60% studies in a health area demonstrated effectiveness this health area was given an overall rating of effective)

b The average quality rating was calculated across all papers in health area, 0–1 indicating poor quality, 2–3 indicating average quality and 4–5 indicating high quality

Papers mainly focussed on peer learner outcomes (67/73, 91.8%), with only six papers (8.2%) focussing solely on peer educator outcomes and only five papers (6.8%) reporting on both peer learner and peer educator outcomes. The majority of papers that focussed on peer educator outcomes were those concerned with sex education (n = 4) and mental health (n = 3).

Papers typically reported knowledge, attitude and/or behavioural outcomes. Of the 73 papers, 42/73 (57.5%) reported knowledge outcomes, 43/73 (58.9%) reported attitude outcomes, 35/73 (47.9%) reported behavioural outcomes and 13/73 (17.8%) reported behavioural intentions.

As well as a broad range of health areas, the papers included in the review also spanned several different countries (Fig. ​ (Fig.3 3 ).

Summary of number of papers by country

We have summarised the results first by student type and then by health area.

Results by student type

Summary of peer learner outcomes.

Of the 67 papers reporting peer learner health outcomes, 35/67 (52.2%) showed evidence of effectiveness (as per our thresholds shown in Table ​ Table1), 1 ), 8/67 (11.9%) showed mixed findings and 24/67 (35.8%) found limited or no evidence of effectiveness.

Scoring thresholds for effectiveness

Of the 35 papers that demonstrated effectiveness, 9/35 studies (25.7%) were rated as high quality. Therefore only 9/67 (13.4%) of the total papers showed evidence of effectiveness and were rated as high quality.

Twenty-one papers (31.3%) reported controlled trial designs (including 14 cluster or group randomised, and 5 randomised controlled and 2 non-randomised). Thirteen papers used randomisation methods but were not controlled trials and the remaining 33 papers used uncontrolled non-randomised methods comparing intervention with a comparison group or using a pre-post survey design.

Summary of peer educator outcomes

Of the 11 papers reporting on peer educator health outcomes, 4/11 (36.4%) showed evidence of effectiveness, 2/11 (18.1%) showed mixed findings and 5/11 (45.5%) showed limited or no evidence of effectiveness. Of the 4 papers showing evidence for effectiveness, 2 studies (50%) were rated as high quality.

Four papers had a randomised design comparing intervention vs. control or ‘peer educators vs. classmates’ one of which was a cluster randomised controlled trial. The remaining 7 papers used non-randomised intervention vs. control ( n  = 2) or pre-post survey designs ( n  = 5).

A full table of included studies, outcomes and effectiveness and quality ratings can be found in Supplementary Material 1 .

Results by health area

Sex education/hiv prevention.

Twenty-three studies concerned sex education/HIV prevention [ 30 – 52 ]. 9/23 studies had a randomised design with the 8 studies comparing peer-led to teacher-led or ‘lessons as usual’ and one study comparing peer-led with nurse-led. 14/23 involved non-randomised designs comparing intervention vs. control or a pre-post survey design. Studies covered a wide geographical range, among which there were 7 US studies, but also studies from Canada, UK, Africa, South Africa, Turkey and Greece.

Of the twenty-three papers, 21 reported peer learner outcomes, 4 papers reported peer educator outcomes, with 2 papers reporting on both peer educator and peer learner outcomes. The mean number of participants across the studies was 2033 (range: n  = 106–9000).

8/23 (34.8%) of studies showed evidence of effectiveness, and all studies demonstrating effectiveness consisted of knowledge and attitude outcomes rather than behavioural change.

Only 4/23 studies were rated high in quality (two of which showed evidence of effectiveness), whilst the majority of studies were rated medium quality (15/23) and 4/23 rated as low quality.

Healthy lifestyles (exercise, nutrition, oral health, health information)

Seventeen studies reported interventions addressing healthy lifestyles [ 53 – 69 ]. Of these papers, ten used a randomised controlled trial design primarily comparing peer-led vs. teacher-led or ‘lessons as usual’, but two oral health papers also used a dentist-led condition. Seven papers used non-randomised research designs comparing intervention vs. control or a pre-post survey design.

The most common focus was nutrition and exercise, but interventions also covered oral health, accessing health information online and interventions taking a more general approach to health improvement. Regarding geographical spread, 5/17 papers reported interventions carried out in the USA, with Australia, China, India and UK represented by two papers per country.

Sixteen of the seventeen papers reported peer learner outcomes, and only one reported peer educator outcomes. The mean number of participants per intervention was 1245 (range: n  = 76–4576).

7/17 papers in this health area were shown to be effective, 8/17 were found to be ineffective, and 2/17 showed mixed results. In other words, less than half (41.1%) showed evidence of effectiveness. Of the studies demonstrating effectiveness, the outcomes largely centred around knowledge and attitudes, but one study did demonstrate positive behaviour change [ 62 ].

Over half of the studies (9/17) were rated as high quality, 4/17 were rated medium quality and 4/17 low quality. Of the studies showing evidence for effectiveness, 4/7 (57.1%) were rated as high quality.

Alcohol, smoking, substance use

Sixteen papers were classified within the category of alcohol, smoking and substance use [ 70 – 85 ]. Ten of these papers had a randomised design (including 3 cluster randomised controlled trials) comparing peer-led (intervention) vs. teacher-led (control). Six papers were non-randomised and used either a pre-post survey design or intervention vs. control. The 16 papers varied in quality with six rated ‘high quality’, seven rated ‘medium quality’, and three rated ‘low quality’. Studies took place across more than 10 countries with one study being conducted internationally. The mean number of participants across all studies was 2165 (range: n = 105–10,730).

Fifteen papers evaluated the effect of the intervention on peer learner outcomes and only one paper evaluated the effect of the intervention on peer educator outcomes. 8/16 (50%) papers showed evidence of effectiveness. 2/16 (12.5%) papers showed mixed findings and 6/16 (37.5%) showed little to no evidence for effectiveness, including the peer educator outcome paper. Of the eight papers demonstrating evidence for effectiveness, only four (50%) were rated as high quality.

Of the studies demonstrating effectiveness, there was a combination of knowledge, attitude and behavioural outcomes, but more evidence for positive changes in knowledge and attitude.

Mental health and well-being

Six studies assessed mental health and well-being [ 27 , 86 – 90 ]. This category was inclusive of common mental health problems, self-harm and suicide prevention as well as broader topics such as self-esteem and social connectedness. Four of the six studies used non-randomised pre-post survey designs and two studies used randomised design, one of which was a cluster randomised controlled trial.

Of the six studies, 5/6 explored peer learner outcomes, 3/6 explored peer educator outcomes, 2 of which explored both peer learner and peer educator outcomes. The average sample size across the seven mental health studies was 1118 (range: n  = 50–4128).

Study quality was mixed, with two studies rated as high quality, three medium quality and one low quality. Outcome measures largely consisted of knowledge and attitude questionnaires, help-seeking behaviour and help-seeking confidence as well as condition-specific measures including body satisfaction and self-report of emotional and behavioural difficulties.

The majority of mental health studies (5/6) were rated as showing evidence for effectiveness and one study was rated ineffective. Of the studies demonstrating effectiveness, only one reported positive behaviour change (help-seeking behaviours) and this behaviour changed was observed in peer educators as opposed to peer learners [ 86 ].

Disease prevention

Four studies assessed outcomes relating to disease prevention [ 91 – 94 ] which included hepatitis, tuberculosis, cervical cancer and blood borne diseases. All four studies focused on peer learner outcomes and one study also included peer educator outcomes. Three of the four studies were non-randomised pre-post survey designs and one study was randomised. The average sample size across the four studies was 2116 (range: 1265–2930).

Three out of the four studies (75%) showed evidence for effectiveness and one study showed mixed results. No studies were rated as high quality, three were rated medium and one was rated low.

Outcomes were largely knowledge or intention based. Studies showing effectiveness mostly related to knowledge, intentions and attitudes and one study did find a positive change in behaviour [ 93 ].

Five included studies assessed asthma interventions [ 95 – 99 ]. 4/5 of these were randomised trials and one study used a non-randomised pre-post survey design. Average sample size across all studies was 427 (range: n  = 203–935). Three studies took place in Australia and two in the US. All papers evaluated the impact of the intervention on peer learner outcomes with none focussing on peer educator outcomes.

4/5 studies showed evidence for effectiveness with only one study showing no evidence for effectiveness. All studies were rated as medium quality. Measures ranged from asthma knowledge, quality of life, school absenteeism, asthma attacks at school and asthma tests. Effectiveness was largely observed for knowledge outcomes, there was less evidence for asthma attacks or symptoms.

Two studies conducted in Italy assessed bullying by evaluating the ‘NoTrap!’ anti-bullying intervention [ 100 , 101 ]. The first study rated as high quality, evaluated two independent trials and focussed on peer learner outcomes ( n  = 622; n  = 461). This study found significant reductions in victimization, bullying, cybervictimization and cyberbullying and was rated as high quality. The second study, rated as medium quality, focussed on peer educator outcomes ( n  = 524) and used a non-randomised, pre-post survey design but overall, only showed some evidence of effectiveness amongst males in terms of reduced victimization and increased prosocial behaviour and social support. No evidence was found for effectiveness among females.

Peer education interventions to improve student health cover a wide variety of topics and are used globally. This review aimed to summarise the results from peer education health interventions in secondary school students (aged 11–18-years-old), which were universal (rather than targeted interventions of sub-groups of students) and carried out at school.

Due to the heterogeneity of findings, range of health areas, types of studies and diversity of outcome measurements used, it was not possible to perform a meta-analysis or formal data synthesis to assess effectiveness. However, some broad conclusions can be made. A number of interventions appear to demonstrate evidence for effectiveness which indicates that peer education interventions can be an important school-based intervention for health improvement. Asthma interventions appeared to be particularly effective. In terms of outcome measures, the strongest evidence was for a positive change in knowledge and attitude measures, but there was less evidence overall for health behaviour outcomes which supports previous findings [ 20 , 22 ].

Although many studies did demonstrate positive results, findings overall were very mixed and several studies were of poor quality. In addition to the shortcomings picked up on by our quality appraisal, many papers lacked methodological detail and clarity regarding the intervention procedure, particularly in regard to how peer educators were selected and trained, which seems to be an important factor in those studies that found positive results and was also emphasised in a previous review [ 10 ]. Further, there were widespread problems of data reporting including noting ‘significant’ results without providing any measure of effect size or between-study variability. Other problems included selective reporting of results, such as selective emphasis on anomalous positive results, or only revealing measures of statistical significance in the case of positive effects. Interestingly, there did not appear to be a relationship between study quality and findings, given that several studies rated as effective were rated both high and low quality with a similar picture for studies showing mixed effectiveness and ineffectiveness.

In terms of frequency of health areas covered, our findings are similar to a recent ‘review of reviews’ of peer education for health and wellbeing which found that the majority of reviews focused on sexual health and HIV/AIDS interventions [ 13 ]. This previous review focused on both children and adults, however, in line with our findings, it found mixed effectiveness and considerable diversity in methods, findings and rigour of evaluation. It was particularly noted that details of peer educator training were rarely provided in HIV/AIDS interventions which supports our findings. Notably, however, the quality of studies was actually highest for peer education programs in HIV/AIDS, which differed to our review which found few studies rated as high quality. This discrepancy may be due to the different measures used to assess quality. Like our study, this review concluded that each health area showed some promising results, but also pointed to a need for higher levels of quality and rigour in future evaluations.

Despite the rising prevalence in mental health difficulties, there were relatively few studies focused on mental health outcomes, particularly more general preventative approaches to mental health and well-being, with many of the included studies focusing on suicide prevention, self-harm or specific disorders. However, many of mental health studies included in this review showed evidence for effectiveness, suggesting peer education approaches for mental health should be further studied and evaluated.

Another key finding of our review is that papers tended to focus more on peer learner outcomes and therefore impacts of peer-led interventions on peer educators themselves appear to be under-explored. This has been reported by previous reviews [ 10 ] and highlights the importance of examining and comparing both peer educators’ and learners’ outcomes within studies. In this context, we found more evidence of peer learners benefitting from the interventions, with 55.2% of studies showing a positive effect, versus only 36.4% for peer educators. This contrasted with a previous review of mental health interventions that concluded peer educators seemed to yield more benefits from participating in the interventions, possibly due to the attention they are given during training and throughout the programmes [ 10 ].

Although common measures existed across studies, including health knowledge, health intentions, and health behaviours, many studies used novel or unvalidated measurements, indicating a need for more standardised health literacy measures and a need for future validation work in this area. This supports two systematic reviews carried out in 2015, firstly a review of health literacy measures which found a lack of comprehensive instruments to measure health literacy and suggested the need for the development of new instruments [ 102 ], and secondly a review of mental health literacy measures which found a number of unvalidated measures and lack of measures that measured all components of mental health literacy concurrently [ 103 ].

Although there are a number of existing reviews summarising the extent to which peer education may improve young peoples health, the literature is still lacking on why peer education is effective within the quantitative literature. It remains unclear which mechanisms involved in peer education lead to its effectiveness (or ineffectiveness). Although many peer education studies are grounded in theory such as Diffusion of Innovation Theory [ 104 ] and Bandura’s Social Cognitive/Social Learning Theory [ 105 , 106 ], the literature is lacking a more nuanced analysis of the mechanisms through which peer education improve young people’s health. This is therefore a key area for future research.

A recent review of peer education and peer counselling for health and well-being highlights how peer education interventions are inherently difficult to quality control and evaluate [ 13 ], partly due to what makes peer education attractive; peer education defies the conventions of traditional formal education and allows young people to learn by more unstructured means, in more ‘real world’ ways, benefiting from meaningful examples and conversations with their peers. Although there are an increasing number of well-designed peer education studies [ 13 ], new evaluation methods may be needed given the complexity and multi-component nature of peer-education approaches (i.e., training, more informal teaching approaches and informal diffusion of knowledge).

Limitations

Despite our review being comprehensive, we acknowledge certain limitations. ‘Peer education’ is a complex and widely contested term and therefore how studies described their approach varied substantially. This may have meant some relevant studies were not picked up from our initial search. A previous review [ 10 ] also noted this potential limitation, with unclear and heterogeneous methods precluding meta-analysis. Therefore, a consensus on how to define ‘peer education’ and using standardised measures to assess effectiveness would facilitate more definitive synthesis of the evidence. Another potential limitation of our approach is that we only searched scientific databases, and therefore could have missed important evidence in the grey literature as we retrieved a relatively small number of initial records ( n  = 2125). Despite this, given the wide variety of study type, age range, health area and country reviewed, this suggests our search strategy was fairly robust, and yielded results that were representative of the breadth in the current literature base.

This review focussed on universal peer education interventions delivered within the secondary school setting during school hours. Further research could explore the effectiveness of varying forms of peer education including 1:1 mentoring, more targeted (not universal) interventions, as well as peer education interventions in other settings including youth clubs or community and local organisations.

Due to the breadth of this review, we did not conduct a detailed comparison between knowledge, attitude and behavioural outcomes, however the studies demonstrating effectiveness tended to show positive change on knowledge and attitude outcomes, but less evidence was seen for positive behavioural change. This is in line with previous reviews which have suggested that peer education better improves health knowledge but often does not lead to behavioural gains [ 13 , 107 ]. To this vein, it remains unclear the differential impact on behavioural intention and actual performance of behaviour, and therefore we urge future researchers to measure outcomes relating to knowledge and attitude, intentions, and actual behaviour in order to synthesise the evidence in a more standardised way. Although the literature is heterogeneous, there is available data to conduct distinct analysis on different outcome measures (knowledge, attitude and behaviour) to create a more nuanced understanding of each health area.

Given the large number of studies and variation in outcome measures (behaviour, knowledge, attitude), this review focussed on findings at first follow-up (usually immediately after intervention) and therefore the effectiveness findings are not likely to represent longer-term effects of peer education interventions, which would require further research. In addition, due to the low number of optimally designed randomised-controlled trials identified, our review could not meaningfully compare results between randomised and non-randomised studies. However, as more high quality trials continue to be published in this growing area of research, a future review could be conducted that looks into the effect of randomisation on young people’s outcomes. Our results also focused on p-values rather than effect sizes due to the large variability in how and what studies measures, future researchers should aim to agree on more standardises ways of measuring outcomes to enable better synthesis.

To conclude, school-based peer education interventions occur worldwide and span a number of health areas. A number of interventions appear to demonstrate evidence for effectiveness, suggesting peer education may be a promising strategy for health improvement in schools. However overall evidence for effectiveness and study quality are mixed. Improvement in health-related knowledge was most common with less evidence for positive health behaviour change. In order to synthesise the evidence and make more confident conclusions, it is imperative that more robust, high-quality evaluations of peer-led interventions are conducted and that studies follow reporting guidelines to describe their methods and results in sufficient detail so that meta-analyses can be conducted. In addition, further research is needed to develop understanding of the intervention mechanisms that lead to health improvement in peer education approaches as well as more focussed work on standardising and validating health literacy and behaviour measurement tools.

Pre-registration

This review was pre-registered on PROSPERO: CRD42021229192. One deviation was made from the original protocol which was the use of a different quality appraisal tool. Initially we had planned to use the Canadian Effective Public Health Project Practice (EPHPP) Quality Assessment Tool for Quantitative Studies and the Critical Appraisals Skills Programme (CASP) checklist for qualitative studies. The authors instead used a combined mixed methods tool (the Mixed Methods Appraisal Tool; MMAT) for both quantitative and qualitative studies. This was due to the large volume and variation of studies which meant there were benefits to using a single brief quality check tool across all included studies, allowing us to standardise scores across study types. The qualitative studies will be discussed in a separate realist review on key mechanisms of peer education interventions.

Acknowledgements

Not applicable.

Authors’ contributions

All authors contributed to the design of the systematic review. SD led on designing the search strategy with input from all co-authors. SD carried out the initial searches across four databases. SD and EW led on retrieving papers and screening abstracts and full papers. EW and SD led on data extraction with support from AR. SD and EW drafted the initial manuscript. All co-authors reviewed the manuscript and approved the final version.

This research study is funded by the National Institute for Health and Care Research (NIHR) School for Public Health Research (project number SPHR PHPES025). The views and opinions expressed in the paper are those of the authors and do not necessarily reflect those of the NIHR. The funding body played no role in the design, analysis, interpretation or writing of the manuscript.

Availability of data and materials

Declarations.

None to declare.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Steven Dodd and Emily Widnall are joint first authors.

Teaching Connections

Advancing discussions about teaching, students’ peer review procedure on an english proficiency course: reflecting to move forward.

Timothy Luke GROOMBRIDGE and Deborah Ann CHOO Centre for English Language Communication (CELC)

Timothy and Deborah reflect on the benefits and limitations of applying student peer review (PR) in their English for Academic Purposes efficiency course. In particular, they discuss how PR is applied in the course and examine the extent it adheres to principles offered in the literature.

Image by pch.vector on Freepik .

While the overall efficacy of student peer review (PR), both from the perspective of the reviewer and the reviewee is not in doubt (Liu & Hansen Edwards, 2018; Papadopoulos et al., 2016), limitations on the procedure currently employed on an English for Academic Purposes proficiency course at NUS are worth exploring. In this context, peer review refers to students evaluating each other’s assignments and suggesting modifications. The aim of this brief reflection is to outline the procedure, to analyse to what extent it adheres to principles offered in the literature, and to provide the rationale for further study of this key learning component.

Time, or the lack of it, is perhaps the main obstacle to improving the PR process. Recently, course time has been reduced and this resulted in the axing of the in-person meetings that students often seemed to favour, and which Liu and Hansen Edwards (2018) stress the importance of, as it crucially allows clarification of written comments to take place. However, this was somewhat compensated for by the fact that students, working in groups of three, had more time to read their allotted scripts—the first half of a 1000-word Problem Solution essay —and to make suggestions following a set of “Yes”/“No” questions that followed the grading rubric’s categories of “Content”, “Organisation”, and “Language”. Communication was delivered asynchronously via e-mail. However, some students reported that they had also shared their texts with each other via WhatsApp. Although all students followed the procedure and reported that it had been a positive experience, a rigorous analysis is required to establish what sort of edits are being recommended and to what extent quality uptake is occurring, i.e. to what extent is student feedback literacy being developed (Carless & Boud, 2018).

Several key issues are of note. Firstly, there is limited time for PR training for both students and of teachers. Such training is regarded as essential by the research (Chang, 2016; Hyland, 2019). Currently, teachers can give brief instructions in the class before the PR tasks are undertaken, and students are independently meant to access instructional notes and videos. However, it is unlikely that everyone does this, and anecdotal comments from students suggest this is the case. Secondly, the checklist questions: the current list comprises 30 “Yes”/“No” questions. Both global and local foci are encouraged. It might be more effective, however, to reduce the number of questions (Chang, 2016), and make them predominantly open-ended and also to emphasise textual organisation over surface features (Liu & Hansen Edwards, 2018). Baker (2016) suggests it is often the local errors that less experienced students seem to focus on, and such feedback is perhaps more relevant in terms of fine-tuning writing just prior to final submission, which is not the case in the current context. Carless and Boud (2018) also recommend that teachers can model effective PR, thus providing learners with much-needed examples of how organisational changes can be suggested and under what circumstances. (For an example of PR modelling, see Appendix.)

The overall impression of the PR process, from both the teachers’ and students’ perspectives, would appear to be mixed. Although students reported enjoying the procedure, and provisionally it would appear that some of the comments and suggestions made have had a beneficial effect on re-drafts, there seems little doubt that a more in-depth study is warranted to assess:

• the type of comments that are given and whether uptake is taking place.
• the quality and type of the uptake.
• the efficacy, or otherwise, of the check questions.
• the type and quantity of training that both learners and teachers receive/require.
• whether the grading rubric should be adjusted to reflect the process more accurately.

The main aim of any further study would be to improve the PR literacy of students and to move towards a more optimal model of PR (Crossman & Kite, 2012; Van Den Berg et al., 2006). It could also go some way to determine whether the PR that occurs on an initial proficiency course has any beneficial washback on the other courses the learners undertake at NUS. Also, the concept of grading PR as a separate course component might be considered (Baker, 2016). Several students reported that they would have spent considerably more time on the process had their efforts been more fully rewarded.

The preliminary findings outlined in this reflection warrant further examination and we are currently seeking Institutional Review Board (IRB) approval to conduct a study. Such approval would allow for a thorough analysis of the comments and scripts to gain a far clearer understanding of the strengths and weaknesses of PR, and would also make it possible to formally survey the learners to gain insights into their perceptions of the process.

Appendix. An Example of Effective Modelling of Peer Review .

Baker, K. M. (2016). Peer review as a strategy for improving students’ writing process. Active Learning in Higher Education , 17 (3), 179-92. https://doi.org/10.1177/1469787416654794

Carless, D. & Boud, D. (2018). The development of student feedback literacy. Enabling uptake of feedback. Assessment and Evaluation in Higher Education, 43 (8), 1315-25 https://doi.org/10.1080/02602938.2018.1463354

Chang, C. Y. H. (2016). Two decades of research in L2 peer review. Journal of Writing Research , 8 (1), 81-117. https://doi.org/10.17239/jowr-2016.08.01.03

Crossman, J. M., & Kite, S. L. (2012). Facilitating improved writing among students through directed peer review. Active Learning in Higher Education , 13 (3), 219-29. https://journals.sagepub.com/doi/10.1177/1469787412452980

Hyland, K., & Hyland, F. (2019). Contexts and issues in feedback on L2 writing. Feedback in Second Language Writing: Contexts and Issues , 1-22. https://doi.org/10.1017/9781108635547.003

Liu, J., & Hansen Edwards, J. G. (2018). Peer response in second language writing classrooms . University of Michigan Press.

Papadopoulos, P. M., Lagkas, T. D., & Demetriadis, S. N. (2017). Technology-enhanced peer review: Benefits and implications of providing multiple reviews.  Journal of Educational Technology & Society , 20 (3), 69-81. http://www.jstor.org/stable/26196120

Van Den Berg I, Admiraal W and Pilot A (2006) Peer assessment in university teaching: Evaluating seven course designs. Assessment & Evaluation in Higher Education 31 (1), 19–36. https://doi.org/10.1080/02602930500262346