For some years, the faculty of many schools of nursing have been evaluated by administrators and students, and these evaluations have been used for a variety of purposes. Administrative evaluations have been used for promotion and tenure; students' evaluations have provided feedback about the adequacy of the faculty's teaching skills. Less frequently has peer review been used for either or both of these purposes. These two mechanisms existed at the Columbia University School of Nursing in the winter of 1979-80, when the faculty expressed the need for a system of review whereby peers could help each other to improve teaching skills. The development of this peeT review process is the subject of this paper. The authors hope that other nurse educators may benefit from the experiences set forth in this report.
In order to determine what constituted peer review in other programs and to provide background information, a review of the literature was conducted. This review revealed several methods of peer review in practice. Some methods were imposed on nurses/teachers by their employers, and some methods were initiated by the nurses/teachers for their own improvement.
In a midwestern university college of nursing, faculty were reviewed by the personnel department. The criteria used in that review included degrees earned; other educational achievements; research, teaching, and scholarly activities; numbers of publications and grants; dollars secured for the university; and service to the university, community, profession, and nation (Porth, 1978).
In one Family Nurse Practitioner program, faculty led students to self-directed peer review through a four-stage process: personalization, implementation, formalization, and actualization (Lamberton, Kean & Adomanis, 1977). Another employer-initiated example of peer review was in a hospital setting where a "tandem" nurse (peer) accompanied a colleague during patient care activities to observe and validate behaviors. Following that, the reviewed nurse met with the peer, head nurse, clinical coordinator, and the clinical specialist to present a nursing process study, and receive the review by the four attendees (Vengroski & Saarmann, 1978).
Self-initiated methods of peer review among nurses are described by several authors. In a diploma school, nursing faculty implemented a peer review system in three yearly stages: 1. development of interfaculty trust; 2. establishment of review criteria and tool; and 3. implementation of three review components (self-evaluation, one-to-one peer review, and group peer review) (Gorecki, 1977).
Nurses in an Iowa veteran's home began peer review by examining their own performance and comparing it to nursing standards of practice (Hauser, 1975). And in rural Tennessee, a group of family nurse practitioners set up structure, process, and outcome criteria to evaluate their practice on a monthly basis. These nurses convened yearly to evaluate their progress together (Hiserote, et. al., 1980).
Each of the above programs describes some aspects of peer review developed for and by nurses. Teachers other than nursefaculty are involved in peer review, however, and their experiences can be helpful to consider. In a colleagial evaluation system, grade school and college teachers selected a partner for peer review, developed their own evaluation criteria, and observed each other's performance in an attempt to improve teaching. In all, 30 teachers participated in a pilot test of this system of peer review, and found that the teachers could and would help each other perform more effectively. However, the authors concluded that the participation of teachers in their own performance review could not be half-hearted; in order to improve teaching, the evaluation criteria must be developed carefully, and feedback should be thoughtful and practical (Roper, Deal, & Dornbusch, 1976).
A group of faculty in the Columbia University School of Nursing piloted a peer evaluation process in 1974. The result of their experiment reinforced the idea that peer evaluation works as a means of faculty development. However, peer review at that time was not accepted by the majority of the faculty.
It was not until 1979 that the need to institute a systematic peer evaluation process was expressed by the faculty. Since there was a strong belief in the positive effects of peer review, faculty decided to develop a peer review system that would have administrative, as well as faculty support.
Therefore, the idea of developing a peer review system was presented to the Faculty and Administrative Staff Affairs Committee in October 1979. This committee then presented the concept of peer review to the Associate Dean, and requested that the matter be discussed at the Associate Dean's Advisory Committee and at a faculty meeting. The department heads were also asked to discuss peer review with their faculty. The reports from these groups indicated general faculty support for a systematic and formalized peer review process.
TIMETABLE OF EVENTS
In January 1980, a workshop was conducted for the entire faculty to develop a format for peer review. A summary of the timetable of events is presented in Table 1. In this all-day workshop, faculty were divided into small groups of about ten people with a group leader. The following topics were discussed:
1. How often should faculty be evaluated?
2. How should provision for observation be made?
3. Who will do peer review? Does the faculty member have a choice about who will evaluate her?
4. What is peer review to be used for?
5. What method should be used to share the information with the faculty member? Who else will have access to this information?
The small groups then came together to share their ideas. Faculty decided that for classroom teaching, a yearly peer evaluation was appropriate. It was recommended that the faculty member being evaluated have the freedom to choose the evaluator from among her peers.
Faculty members were most vocal about the purpose of peer review and the confidentiality of the review. Some faculty members expressed grave concern that the peer review, which was envisioned as a mechanism to enhance professional growth, would be used additionally as a criterion for retention and/or promotion. The prevailing belief was that the information contained in the review should be shared only with those persons selected by the reviewee.
The decision was made at this first workshop to form two ad hoc committees of faculty to continue to work with the ideas generated by the discussion groups. The Peer Review Tool Development Committee established the objective of creating a peer review tool. The goal of the Committee on Implementation of Peer Review was to determine a mechanism for implementation of peer review. Both committees were to complete their work and present it to the faculty by the end of spring semester, 1980.
The Peer Review Tool Development Committee met monthly to work on the criteria for review. Prior to selecting criteria, philosophical viewpoints were solicited from faculty and reaffirmed the belief that the tool would be used to review the teacher's behaviors in the classroom or clinical area, nor to evaluate the performer. The philosophy was established as one of faculty development and instructional improvement based on the motivational theories of internal locus of control (Manuck, Hinrichson, & Ross, 1975) and behavior modification, which state that when people wish to pursue self-improvement, they will be assisted by having a concise tool and constructive feedback from one who is considered an equal (Ketefian, 1977). Basic theories of teaching/learning were used to formulate the items for review, and each item was stated in behavorial terms; that is, observable, measurable items were stated clearly and concisely. Items were grouped into four categories: 1. content presentation, 2. strategies and methods, 3. clarity of presentation, and 4. evaluation. The committee's intent was to prepare items which would be general enough to be used in the classroom as well as in the clinical area. Therefore, only one peer review tool was developed (Table 2).
COLUMBIA UNIVERSITY SCHOOL OF NURSING TEACHER PEER REVIEW TOOL
In May 1980, the Peer Review Tool Development Committee presented a first draft of the Peer Review Tool and a form entitled Evaluation of Peer Review to the faculty (Table 3). The latter form provided reviewees and reviewers with the opportunity to evaluate the process of peer review. The faculty recommended a few minor changes in the wording of the tool, unanimously accepted it for use in the fall, and recommended that the Tool Development Committee be responsible for evaluating the tool and the process of peer review. The Peer Review Tool Development Committee accepted its new task and the Committee on Implementation of Peer Review was dissolved.
Upon returning from summer vacation, each faculty member received a Peer Review Tool, directions for its use, and an Evaluation of Peer Review form. Faculty were asked to try the process and return the evaluation forms to the Committee by December 1980.
In January 1981, another Peer Review Workshop was held. The Peer Review Tool Development Committee presented the results of the first pilot test of the tool, and encouraged faculty input. Most of the discussion was focused on three issues: 1. clarity of items, 2. additional suggestions for altering the peer review process, and 3. proposals for the next step in the peer review process. The faculty decided that more time was needed to use the tool and to evaluate the peer review process. Therefore, additional peer review forms were distributed to the faculty in February 1981. All faculty members were encouraged to try peer review and return the completed evaluation forms to the Committee by the end of April 1981.
As a result of these two attempts to use this format for peer review, several findings emerged. Of 59 faculty to whom peer review forms were distributed, 34 participated voluntarily in peer review at least once. One individual arranged to have her own performance reviewed three times! The majority (99^f) of persons who attempted peer review felt that the review did achieve its intended purpose, that of assisting in improvement of teaching skills. The presence of the reviewer was not thought to be a negative influence on the teaching-learning process, and both reviewees and reviewers were unanimous in agreeing that the items on the tool were clear. Faculty did offer three main suggestions for changing the process: 1. develop separate tools for clinical, lecture, and seminar reviews; 2. provide space for the reviewee to identify specific behaviors or skills she is attempting to improve; and 3. expand the process of review, so that it becomes a part of an overall system of faculty evaluation.
On the form entitled Evaluation of Peer Review, faculty were asked to list the criteria used to select a peer to review their teaching behaviors. In responding to this item, most faculty indicated that the peer was selected because of their knowledge and expertise with the subject matter or because they belonged to the same clinical specialty area. The second most common reason for selection of the reviewer was her availability to come to the classroom or clinical area. Other considerations involved in selecting a peer were her ability to be fair and constructive, her interest in teaching methods and improvement of teaching, and the reviewee's perception of comfort while in the presence of the reviewer.
These two pilot projects provided the Committee with several insights into the phenomenon of peer review and its place within the broader program of faculty evaluation and development. The first insight gained is that some schools may desire a means to measure the overall quality of teaching behaviors within the school before and after implementing a system of peer review. Without such an evaluation, it is impossible to document that any improvement in teaching ability is actually occurring, except in the case of individual faculty members. The method of peer review described in this paper does not provide for such an overall evaluation of teaching behaviors.
EVALUATION OF PEER REVIEW PROCEDURE AND PROCESS
A second insight is that this type of voluntary, colleagial peer review did not provide direction for selecting topics for faculty inservice education programs, except for the workshops on peer review itself. While individual faculty members have received one-to-one assistance in improving teaching skills, this process did not lend itself to a determination of learning needs of the faculty as a whole.
Third, this method of peer review did not result in participation by the entire faculty. It seems likely that for the total faculty to grow and develop, and for the level of school-wide teaching to improve, peer review needs to be subsumed into the school evaluation/development program. The next step is to incorporate the peer evaluation criteria into the evaluation system of the school.
Finally, valuable personal insights have been gained from participation in this voluntary, colleagial form of peer review. Improvement in teaching skills has immeasurably added to the professional growth of many faculty members.
The authors wish to thank Joann S. Jamann, Dean, School of Nursing, Columbia University, for her assistance in the preparation of this manuscript.
- Gorecki, Y. Faculty peer review. Nursing Outlook, July 1977, 25, 439-442.
- Hauser, M. Initiation into peer review. American Journal of Nursing, December 1975, 75, 2204-2208.
- Hiserote, J., et al. Peer review among rural clinics. Nurse Practitioner, January/February 1980, 5. 30-32.
- Ketefian, S. A paradigm for faculty evaluation. Nursing Outlook, November 1977, 25, 718-720.
- Lamberton, M., Keen, M., and Adomanis, A. Peer review in a family nurse clinician program. Nursing Outlook, January 1977, 25, 47-53.
- Manuck, S.B., Hinrichsen, J.J., and Ross, E. O. Life stress, locus of control, and treatment seeking. Psychological Reports, 1975, 37, 589-590.
- Porth, C. Peer review for nursing faculty. Journal of the New York State Nurses Association, December 1978, 9, 48-53.
- Roper, S.S., Deal, T.E., and Dornbusch, S. Collégial evaluation of classroom teaching. Evaluation Review Quarterly, Spring 1976, pp. 55-66.
- Vengroski, S. and Saarmann, L. Peer review in quality assurance. American Journal of Nursing, December 1978, 78, 2094-2096.
TIMETABLE OF EVENTS
COLUMBIA UNIVERSITY SCHOOL OF NURSING TEACHER PEER REVIEW TOOL
EVALUATION OF PEER REVIEW PROCEDURE AND PROCESS