Peer assisted learning for point of care ultrasound in nursing education

Hong Chuen Toh, Nor Azhar, Sa’at, Sok Keng Tan, Michael Ebuna, Sanjay Patel, Acute and Emergency Care Centre Khoo Teck Puat Hospital, Singapore


Point of care ultrasound (POCUS) is increasingly utilised by the nursing community. Considerable challenges still exist with regards to training nurses in this skill, as this is typically provided by physician faculty or senior nurses. These include limited faculty time, power distance and scheduling conflicts. Peer assisted learning (PAL) has the potential to overcome these barriers. Nevertheless, despite the extensive body of literature on PAL in nursing education, there remains a paucity of data examining the role of PAL for training nurses in POCUS, and in particular the effectiveness of near peer (NP) versus same level peer (SLP) learning.


We designed a prospective quasi-experimental research to evaluate the competency of ultrasound novice nurses who learn ultrasound guided peripheral intravenous cannulation (UG-PIVC) from near peers (NP) versus same level peers (SLP). Competencies are defined as the time to complete the UG-PIVC task on a standardised mannequin. A visual aid was created to scaffold peer learning and teaching.

Two senior nurses were trained by a recognised POCUS expert physician to perform UG-PIVC on the mannequin. They were designed as NP and trained a group of 8 nurses. After training, these 8 nurses were designated as SLP and subsequently trained another group of 12 nurses. The competencies of these two group of nurses were recorded and compared using the t-test.


Nurses who were taught by the NP and SLP completed the UG-PIVC task with a mean of 104.75 seconds (SD 39.59) and 94.25 seconds (SD 34.88) respectively, p = 0.540.


There is no statistical significance in the time to task completion for both groups. The result suggests that ultrasound novice nurses could learn UG-PIVC skills from same level peers as effectively, if not more, compared to learning from near peers. PAL has the potential to alleviate faculty teaching pressure in nursing POCUS education.

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