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Year : 2020  |  Volume : 33  |  Issue : 3  |  Page : 108-113

Is peer assessment an effective learning tool in an internationally and educationally heterogeneous cohort of students?

Department of Peripheral Nerve Injuries, Stanmore Royal National Orthopaedic Hospital, Stanmore, England, UK

Date of Submission23-May-2018
Date of Decision08-Sep-2020
Date of Acceptance12-Sep-2020
Date of Web Publication16-Mar-2021

Correspondence Address:
Chang Park
Department of Peripheral Nerve Injuries, Stanmore Royal National Orthopaedic Hospital, Stanmore HA7 4LP, England
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/efh.EfH_230_18

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Background: Peer assessment is a well-established tool in peer-assisted learning, however there is little work in its use across a multidisciplinary cohort. Twenty-two students of a variety of undergraduate backgrounds from different nationalities attended a 3-week university summer school on the topic of peripheral nerve injuries. Methods: Peer assessment of an oral presentation made up an aspect of the formative assessment of the course. Students were surveyed using a Likert score on their impression of peer assessment as a learning and assessment tool. Results: Fourteen (64%) students agreed that the peer assessment process improved the learning process and 5 (23%) strongly agreed. Thirteen (59%) students agreed and nine (41%) strongly agreed that it improved the engagement with their peers' presentation. Seventeen (77%) students either agreed or strongly agreed that it was appropriate to use as a method of formative assessment. Discussion: Students agreed that peer assessment improved learning and engagement and is an appropriate assessment tool. Whereas peer assessment has been proven to be an effective method for assessment and reflective learning within a homogenous group, this study demonstrates that this remains true in a heterogeneous cohort of international undergraduates where expertise, underlying knowledge base, and learning approaches may vary.

Keywords: Assessment, peer-assisted learning, peer evaluation, student assessment

How to cite this article:
Park C, Quick T. Is peer assessment an effective learning tool in an internationally and educationally heterogeneous cohort of students?. Educ Health 2020;33:108-13

How to cite this URL:
Park C, Quick T. Is peer assessment an effective learning tool in an internationally and educationally heterogeneous cohort of students?. Educ Health [serial online] 2020 [cited 2023 Mar 30];33:108-13. Available from:

  Background Top

The concept of peer-assisted learning (PAL) has been well established in the medical profession both at an undergraduate and postgraduate level and widely adopted by medical schools.[1],[2] PAL is defined as “people from similar social grouping who are not professional teachers helping each other to learn and learning themselves from teaching and encompasses the process of peer assessment (PA).”[3] PAL has been recognized to aid the development of teaching and assessment skills and as such has been widely embraced.[4]

The activity of PAL has been divided into three categories: peer assessment, peer teaching, and teacher training programs.[2] Peer assessment is the process wherein “groups of individuals rate their peers.”[5] Peer assessment has been advocated as a method of learning that not only facilitates the students' reflection of their own work, as well as providing the general benefits of patient assisted learning, but also increases student satisfaction.[6] By reviewing their peers, students develop objective evaluation skills and greater awareness of the performance guidelines set by a reflective process of their own and other's learning.[7],[8] Despite the theoretical support of peer assessment and its benefits,[2] the reluctance to engage with peer assessment tools by both the participants and also facilitators is acknowledged, and the process for an effective peer assessment is described as more complex than that of simply introducing the appropriate assessment tool.[9],[10],[11],[12]

Despite these reservations, the use of PAL and peer assessment is now well established and although the literature describes in detail its use in both medical and nursing students,[13] especially when assessing the qualities of professional behavior, there has been little work in its use across a true multidisciplinary cohort.[14],[15] This may be in part due to the limited opportunities in its implementation in such a cohort. This study evaluates the opinions of peer assessment as both a learning and assessment tool in a heterogeneous undergraduate cohort, including medical, engineering, and science students, across 11 nationalities enrolled in a 3-week summer school on the topic of “The Science, Medicine, and Engineering of Nerve Injury Treatment.”

  Methods Top

Twenty-two students attended a 3-week summer school at the University College London on the topic of “The Science, Medicine, and Engineering of Nerve Injury Treatment.” The course was conducted in English and covered not only the basic science of nerve injuries and the multidisciplinary approach in managing nerve injuries to include both medical and surgical management but also the role of bioengineering and physical and psychological rehabilitation. The students underwent an online application process to enroll to the summer school and came from a variety of undergraduate backgrounds from different nationalities.

The summer school summative assessment consisted of a multiple-choice question examination along with a 2500-word discursive systematic review on a topic of the students' choosing. Furthermore on the penultimate day of the course, a 10-min presentation on a topic of the students' choice formed 20% of the assessment marks. Formative peer assessment of this presentation composed of a further 5% of the marks available in the overall assessment of the course. A peer assessment tool was provided by the course facilitators and at the end of each presentation, the students marked their colleagues on the topics of content, delivery, and overall impression of the presentation using a three-tiered marking scheme, ranging from 1 star to 3 [Appendix 1]. As such, each student would receive peer assessment from the 21 peers, and the facilitators collated this assessment and the scores and feedback provided to the students at the completion of the course along with the scores of all summative assessments. Throughout the process of assessment, the scores remained anonymous to all students.

To assess the students' opinion of the peer assessment process, a 7-point questionnaire consisting of a Likert score of 0–5 (from 0 strongly disagree to 5 strongly agree) on their impression of peer assessment as a learning and assessment tool was completed by the students at the end of the oral presentation assessment [Appendix 2]. The first three questions explored the students' opinions toward peer assessment in aiding their personal learning and the next three explored their opinions regarding peer assessment as an assessment tool on the course. A final question asked the students' overall opinion of the peer assessment and students were offered to provide any further comments regarding the process. The peer-to-peer evaluation was part of the existing course and therefore further formal ethical approval was not required. Informed consent was taken from the students before their inclusion in the study. The results were collated by the authors and recorded via Microsoft Excel.

  Results Top

Twenty-two students were enrolled in the summer school. Eleven nationalities were represented, and the students were enrolled in 15 different institutions across four continents [Table 1]. Four students were male (18%) and the remaining 18 were female (82%). Nine (41%) students were current undergraduates in medicine. Two students were studying biomedicine, three biology, and two psychology.Two students were enrolled in biomedical engineering and a one student from life sciences, technology management, neuroscience and physiology and oral medicine respectively.
Table 1: Demographics of students enrolled in the summer school program

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Of the 22 students, 14 (64%) agreed that the peer assessment process improved the learning process and a further 5 (23%) strongly agreed. Three (14%) students felt neutral that the peer assessment neither improved nor detracted from the learning process. Thirteen (59%) agreed and nine (41%) strongly agreed that it improved the engagement with their peers' presentation. Asked if the students felt that the results of the peer assessment would aid in their reflection of the learning process and their own learning, 12 (55%) agreed it would and 9 (41%) strongly agreed. Only one student remained neutral to this idea [Figure 1].
Figure 1: Results of the students' opinions toward peer assessment in aiding their personal learning

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With regard to the use of peer assessment as an assessment tool on the course, 12 (55%) students agreed that they were happy for peer assessment to be used on the course and a further 5 (23%) strongly agreed. Five (23%) remained neutral and none disagreed or strongly disagreed. Asked about the weighting of the marks at 5% of total available, 14 (64%) agreed that it was weighted correctly and a further 5 (23%) strongly agreed it was weighted appropriately. Only three students (14%) were neutral to the weighting of marks. Eight students (36%) agreed and five (23%) strongly agreed that anonymity allowed them to be nonbiased in their assessment. Six (27%) students remained neutral to the idea and two students (9%) disagreed that remaining anonymous in their assessment affected their bias and one (5%) student strongly disagreed with the idea [Figure 2].
Figure 2: Results of the students' opinions regarding peer assessment as an assessment tool on the course

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Finally, 12 students (55%) agreed that peer assessment was overall helpful in the learning process and the remaining ten (45%) strongly agreed so.

  Discussion Top

PAL and peer assessment has been widely adopted across medical student curriculums globally, and there has been extensive work on its perceived benefits.[2] The previous studies have explored the benefits and limitations of peer assessment, but often only within a homogenous cohort of students and peers within the same university degree or profession and very rarely across professional and academic boundaries, let alone nationalities and educational systems.[2],[5],[9],[14]

The students enrolled in the summer school came from various undergraduate courses from numerous nations of study and engaged in an interpersonal 3-week program. Although this may in ways reflect a cohort within a medical school, the fact that the students are currently enrolled in their respective undergraduate courses with differing curricula, educational backgrounds, and cultural diversity makes this cohort, and thus study, novel and heterogeneous. Despite this heterogeneity, the results of the study show that overwhelmingly, all students either agreed or strongly agreed that the process of peer assessment aided the learning process, supporting the existing work that peer assessment is well received by those involved.[2],[6],[7]

Poirier et al. described the assessment of an online global health course in a heterogeneous cohort of 32 pharmacy, nursing, and health education students.[15] This study, however, was an online-based course with no physical interaction between students. The assessment of PAL was limited to the students' view on the appropriateness of peer assessment as a method of evaluating team participation on projects as part of the course. Poirier et al. found that although the multidisciplinary course enhanced their desire to work with other disciplines, the use of peer assessment in the group projects was less favorably viewed. However, unlike our course where peer assessment was used to critically appraise their peer's presentation, Poirier et al.'s peer assessment was limited to an online evaluation of their peers' engagement in online interactions only.

In our study, 87% of the students assessed in this study have agreed or strongly agreed that the peer assessment process improved the learning process and all the students agreed or strongly agreed that it improved their engagement with their peers' presentation. This has demonstrated that in this heterogeneous cohort of students, the benefits of peer assessment described by Dochy et al. still remain true and the mixture of educational and language backgrounds has not affected the proposed benefits of peer assessment.[6] Both Yu and Dochy et al. have further described that the benefits of peer assessment enable the student to reflect on both their own and peer's work, and and all but one student agreed or strongly agreed to this, further supporting this claim.[1],[6]

Anonymity has been frequently mentioned as a factor in any peer assessment tool to encourage participation and fair allocation of marks.[9],[16] However, Arnold et al. also found in their qualitative study of PAL that fully anonymous feedback would discourage student from taking the peer feedback seriously and would limit the feedback potential offered from the learning process for both positive and negative evaluation.[9],[16] As such, Arnold et al. support a confidential system as a potential compromise in peer assessment. In this study, the nature of multiple peer assessors would mean that a confidential system was not possible. Our study mirrored the mixed findings by Arnold et al., with 59% agreeing or strongly agreeing that anonymity was beneficial, while the remaining 41% were either disagreed with the concept. This mixed opinion may be in part due to the nature of the summer school program; students coming together for a short period of time in a very condensed educational program and then returning to their respective courses. As such, this may affect some of the concerns Arnold et al. raised of the uncomfortable prospect having to continue to work in close relationship with those you assess and disrupting teamwork and interpersonal relationship that would be less evident in this more temporary cohort.

Students, when asked about their opinion of the use of peer assessment as part of the formative marking process, were overall very positive with the concept, and 78% agreed or strongly agreed that it should be part of the formative assessment and furthermore 87% of the students felt that the weighting of 5% of all marks available was appropriate. The remaining students were all neutral to the concept and none disagreed with the idea. Dochy et al. and Tornwall support the use of peer assessment as a formative assessment tool as students find it to be a supportive learning tool, as evidenced by our own study.[6],[17] It provides multiple sources of feedback, encourages critical thinking of the curriculum content, and engages the students in interacting with their peers. The disadvantages of peer assessment have been described as “friendship marking,” resulting in over marking. Therefore, in our study, model peer assessment is often used in conjunction with more traditional assessment methods and in our study the students found the weighting of such marks to be acceptable.

This study was conducted in the inaugural summer school. The numbers included in study are small at 22 students and as such further work needs to be performed on subsequent summer schools to further support the use of peer assessment in this heterogeneous cohort. The limited numbers in the study has meant that any statistical analysis is limited to descriptive statistics. Furthermore, as there were no previous cohorts to compare to in terms of performance within the course and with a small sample size it is difficult to draw, for the time being, any correlation between attitudes toward peer assessment as a learning and assessment tool and the student's individual performance and measurable improvements in learning processes or engagement.

  Conclusion Top

Peer assessment has become increasingly popular as an assessment and learning tool in medical education.[1],[2] Its use however has been focused on the assessment of professional skills and the student cohort has been a homogenous group, usually of students within the same year group at medical school or senior graduates assessing their junior colleagues.[2],[8],[9],[10],[14],[16],[18] Furthermore, the nature of peer assessment has meant that no single assessment tool has been validated as a “gold standard,” and we agree that further research is required in validating PAL and peer assessment in medical education.[14] This study, however, has shown that our heterogeneous cohort of undergraduates, from various nationalities and multidisciplinary backgrounds, felt that peer assessment aided their learning process. As this was the first cohort of students to be enrolled in the course, further work may be required in subsequent courses, however we advocate that peer assessment and PAL in general should continue to be utilized and developed in such a cohort.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Yu TC, Wilson NC, Singh PP, Lemanu DP, Hawken SJ, Hill AG. Medical students-as-teachers: A systematic review of peer-assisted teaching during medical school. Adv Med Educ Pract 2011;2:157-72.  Back to cited text no. 1
Burgess A, McGregor D, Mellis C. Medical students as peer tutors: A systematic review. BMC Med Educ 2014;14:115.  Back to cited text no. 2
Topping KJ. The effectiveness of peer tutoring in further and higher education: A typology and review of the literature. High Educ 1996;32:321-45.  Back to cited text no. 3
Nestel D, Kidd J. Peer assisted learning in patient-centred interviewing: The impact on student tutors. Med Teach 2005;27:439-44.  Back to cited text no. 4
Falchikov N. Peer feedback marking; Developing peer assessment. Innov Educ Train Int 1995;32:175-87.  Back to cited text no. 5
Dochy FJ, Segers M, Sluijsmans D. The use of self-, peer and co-assessment in higher education: A review. Stud High Educ 1999;24:331-50.  Back to cited text no. 6
Driessen E, van Tartwijk J, Dornan T. The self critical doctor: Helping students become more reflective. BMJ 2008;336:827-30.  Back to cited text no. 7
Tsingos C, Bosnic-Anticevich S, Smith L. Reflective practice and its implications for pharmacy education. Am J Pharm Educ 2014;78:18.  Back to cited text no. 8
Arnold L, Shue CK, Kritt B, Ginsburg S, Stern DT. Medical students' views on peer assessment of professionalism. J Gen Intern Med 2005;20:819-24.  Back to cited text no. 9
Bucknall V, Sobic EM, Wood HL, Howlett SC, Taylor R, Perkins GD. Peer assessment of resuscitation skills. Resuscitation 2008;77:211-5.  Back to cited text no. 10
Kritikos VS, Woulfe J, Sukkar MB, Saini B. Intergroup peer assessment in problem-based learning tutorials for undergraduate pharmacy students. Am J Pharm Educ 2011;75:73.  Back to cited text no. 11
Van Rosendaal GM, Jennett PA. Resistance to peer evaluation in an internal medicine residency. Acad Med 1992;67:63.  Back to cited text no. 12
Duers LE. The learner as co-creator: A new peer review and self-assessment feedback form created by student nurses. Nurse Educ Today 2017;58:47-52.  Back to cited text no. 13
Speyer R, Pilz W, Van Der Kruis J, Brunings JW. Reliability and validity of student peer assessment in medical education: A systematic review. Med Teach 2011;33:e572-85.  Back to cited text no. 14
Poirier TI, Devraj R, Blankson F, Xin H. Interprofessional Online Global Health Course. Am J Pharm Educ 2016;80:155.  Back to cited text no. 15
Arnold L, Shue CK, Kalishman S, Prislin M, Pohl C, Pohl H, et al. Can there be a single system for peer assessment of professionalism among medical students? A multi-institutional study. Acad Med 2007;82:578-86.  Back to cited text no. 16
Tornwall J. Peer assessment practices in nurse education: An integrative review. Nurse Educ Today 2018;71:266-75.  Back to cited text no. 17
Hulsman RL, van der Vloodt J. Self-evaluation and peer-feedback of medical students' communication skills using a web-based video annotation system. Exploring content and specificity. Patient Educ Couns 2015;98:356-63.  Back to cited text no. 18


  [Figure 1], [Figure 2]

  [Table 1]


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