***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction International interest in peer-teaching and peer-assisted learning ( PAL ) during undergraduate medical programs has grown in recent years , reflected both in literature and in practice . There , remains however , a distinct lack of objective clarity and consensus on the true effectiveness of peer-teaching and its short- and long-term impacts on learning outcomes and clinical practice . Objective To summarize and critically appraise evidence presented on peer-teaching effectiveness and its impact on objective learning outcomes of medical students . Method A literature search was conducted in four electronic data bases . Titles and abstract s were screened and selection was based on strict eligibility criteria after examining full-texts . Two review ers used a st and ard review and analysis framework to independently extract data from each study . Discrepancies in opinions were resolved by discussion in consultation with other review ers . Adapted models of “ Kirkpatrick ’s Levels of Learning ” were used to grade the impact size of study outcomes . Results From 127 potential titles , 41 were obtained as full-texts , and 19 selected after close examination and group deliberation . Fifteen studies focused on  student-learner outcomes  and four on  student-teacher learning outcomes .  Ten studies utilized r and omized allocation and the majority of study participants were self-selected volunteers .  Written examinations and observed clinical evaluations were common study outcome assessment s. Eleven studies provided student-teachers with formal teacher training .  Overall , results suggest that peer-teaching , in highly selective context s , achieves short-term learner outcomes that are comparable with those produced by faculty-based teaching . Furthermore , peer-teaching has beneficial effects on student-teacher learning outcomes . Conclusions Peer-teaching in undergraduate medical programs is comparable to conventional teaching when utilized in selected context s. There is evidence to suggest that participating student-teachers benefit academically and professionally . Long-term effects of peer-teaching during medical school remain poorly understood and future research should aim to address this OBJECTIVES Interpretation of the electrocardiogram ( ECG ) is a core clinical skill that should be developed in undergraduate medical education . This study assessed whether small-group peer teaching is more effective than lectures in enhancing medical students ' ECG interpretation skills . In addition , the impact of assessment format on study outcome was analysed . METHODS Two consecutive cohorts of Year 4 medical students ( n=335 ) were r and omised to receive either traditional ECG lectures or the same amount of small-group , near-peer teaching during a 6-week cardiorespiratory course .  Before and after the course , written assessment s of ECG interpretation skills were undertaken . Whereas this final assessment yielded a considerable amount of credit points for students in the first cohort , it was merely formative in nature for the second cohort . An unannounced retention test was applied 8 weeks after the end of the cardiovascular course . RESULTS A significant advantage of near-peer teaching over lectures ( effect size 0.33 ) was noted only in the second cohort , whereas , in the setting of a summative assessment , both teaching formats appeared to be equally effective . A summative instead of a formative assessment doubled the performance increase ( Cohen 's d 4.9 versus 2.4 ) , mitigating any difference between teaching formats . Within the second cohort , the significant difference between the two teaching formats was maintained in the retention test ( p=0.017 ) . However , in both cohorts , a significant decrease in student performance was detected during the 8 weeks following the cardiovascular course . CONCLUSIONS Assessment format appeared to be more powerful than choice of instructional method in enhancing student learning . The effect observed in the second cohort was masked by an overriding incentive generated by the summative assessment in the first cohort . This masking effect should be considered in studies assessing the effectiveness of different teaching methods Context : Various research studies haveexamined the question of whether expert ornon-expert raters , faculty or students , evaluators or st and ardized patients , give morereliable and valid summative assessment s ofperformance on Objective Structured Clinical Examinations ( OSCEs ) . Less studied has beenthe question of whether or not non-facultyraters can provide formative feedback thatallows students to take advantage of theeducational opportunity that OSCEs provide . This question is becoming increasinglyimportant , however , as the strain on facultyre sources increases . Methods : A question naire was developed toassess the quality of feedback that medicalexaminers provide during OSCEs . It was pilottested for reliability using video recordingsof OSCE performances . The question naires werethen used to evaluate the feedback given duringan actual OSCE in which clinical clerks , residents , and faculty were used as examinerson two r and omly selected test stations . Results : The inter-rater reliabilityof the 19-item feedback question naire was 0.69during the pilot test . The internalconsistency was found to be 0.90 during pilottesting and 0.95 in the real OSCE . Using thisform , the feedback ratings assigned to clinical clerks were significantly greater than thoseassigned to faculty evaluators . Furthermore , performance on the same OSCE stations eightmonths later was not impaired by having beenevaluated by student examiners . Discussion : While evidence of markinflation within the clinical clerk examinersshould be addressed with examiner training , thecurrent results suggest that clerks are capableof giving adequate formative feedback to morejunior colleagues BACKGROUND Peer-marking has been suggested as a method to enhance self-directed learning and reflection , although whether this improves performance is unclear . This study evaluated the impact of peer-marking on examination performance and investigated its reliability and acceptability to  students . METHODS First-year medical students were r and omised to peer-marking using a model answer or no intervention ( control arm ) . Student scores were compared with tutor-marked scores . Two months later , students completed a summative assessment and performance was compared between students r and omised to peer-marking and the control arm . A focus group was held with students in the intervention arm to capture their experiences and attitudes . RESULTS A total of 289 of 568 students consented to participate and 147 were r and omised to peer-marking ( 142 controls ) . Students r and omised to peer-marking achieved marginally higher examination marks ( 1.5 % difference , 95 % CI -0.8 % to 3.9 % , P = 0.19 ) than controls ( adjusting for year and in-course assessment ) , although this may have been due to chance . Students were harsher markers than the tutors . Focus group analysis suggested that students valued peer-marking , although concerns about passing judgement on a colleague 's work were expressed . CONCLUSIONS Peer-marking did not have a substantial effect on examination performance , although a modest effect can not be excluded . Students gained insight into examination technique but may not have gained deeper knowledge . Given its potential positive educational value , further work is required to underst and how peer-marking can be used more effectively to enhance the learning experience Abstract Objective . To determine the efficacy of a peer-led tuition model for training healthcare students in basic life support compared to tuition delivered by clinical tutors . Design and setting . R and omised controlled trial in the Medical School , University of Birmingham , UK . Participants . 122 first-year medical , dental , nursing and physiotherapy students . Interventions . Students were r and omised to receive basic life support tuition from either second-year student instructors or from experienced clinical staff . Measurements and results . Students ' practical skills , knowledge and satisfaction were tested at the end of the course . Instructor reliability was assessed throughout the course . Students taught by their peers were significantly more likely to be successful in the end-of-course practical CPR test than those taught by clinical staff ( 56/57 vs. 53/62 ) . The student instructors were also found to be more reliable than clinical staff at attending the training sessions ( 48/48 vs. 36/48 ) . There was no significant difference in the theoretical test results or the students ' assessment of the quality of teaching . Conclusions . This model of peer-led undergraduate training in basic life support provides a quality of education which is at least as good as that provided by clinical staff , while offering advantages in terms of reliability . The re-deployment of clinical tutors from basic to more advanced training may allow the overall enhancement of undergraduate resuscitation and critical care training BACKGROUND The surgical literature suggests that collaborative learning using peers may be a valid way to teach surgical skills and there is a growing interest in the use of computer-assisted learning for this purpose . Combining this evolving technology with this type of teaching would theoretically offer a number of advantages including a reduction in the amount of faculty time devoted to this task . In this study , we evaluate the efficacy of a type of collaborative learning in a computer-assisted learning environment . MATERIAL S AND METHODS We design ed a prospect i ve , r and omized study comparing novice learners who were allowed to work in pairs with those who worked independently in a specially equipped computer-assisted learning classroom .  Both pretest and posttest assessment s were performed by videotaping this skill . Three experts then evaluated the videotapes , in a blinded fashion . Three different outcomes were assessed . RESULTS Seventy-seven subjects were enrolled in and completed the study . Comparison of the outcome measures demonstrated no between group difference in the average performance scores or posttest times . The proportion of subjects who correctly tied a square knot was significantly lower in the computer-assisted peer teaching group when compared with the computer-assisted learning alone group ( P = 0.04 ) . CONCLUSIONS Collaborative learning in a computer-assisted learning environment is not an effective combination for teaching surgical skills to novices OBJECTIVES This study ( a post-intervention assessment ) was design ed to assess the effectiveness of peer-assisted learning ( PAL ) using student-teachers ( STs ) with limited training to teach complicated technical skills for interpreting ultrasound images of the shoulder . METHODS Students in Years 3 and 4 of medical school were r and omly assigned to two groups . In the PAL group ( PG ) , teaching was delivered by a group of nine STs from Years 3 and 4 , who undertook a 30-minute general training and 1 week of self-teaching . In the staff-led group ( SG ) , students were taught by a group of three ultrasound-experienced doctors . Exposure took place in two separate lessons ( each of 120 minutes ) and introduced eight st and ard sectional planes ( EULAR ) using a 10-MHz Nemio XG system ( Toshiba Medical Systems GmbH ) . The theoretical and practical learning outcomes were tested using a multiple-choice question ( MCQ ) test and an objective structured clinical examination ( OSCE ) . Qualitative differences were evaluated using Likert scale-based items . RESULTS Evaluation of differences between the PG ( n = 75 ) and SG ( n = 76 ) in the theoretical ( MCQ score ; P = 0.644 ) and practical ( total OSCE score ; P = 0.133 ) outcomes showed no difference between the two groups . However , the STs themselves showed significantly better results overall ( P < 0.05 ) . Staff members were rated more highly than STs , especially on items relating to competence ( P < 0.05 ) . CONCLUSIONS Complicated technical skills can be adequately taught to students using the PAL system by STs with limited training . Self-teaching learning strategies are successful in context s of limited teacher training . However , despite positive objective results , STs still face prejudice from students with regard to competency 
    Output:
    
Variability was found in the reporting of tutor recruitment and training processes , tutor outcomes , and tutor competencies .
Conclusion Results from this review suggest that there are many perceived learning benefits for student tutors .
However , there were mixed results regarding the accuracy of peer assessment and feedback , and no substantial evidence to conclude that participation as a peer tutor improves one ’s own examination performance .