Peer review is a practical way to examine nursing performance and quality of care. It is a systematic process of evaluation of a peer's work, compared with standards, which facilitates quality improvement (American Nurses Association, 2015). In the academic setting, peer review is a tool for active learning as students interact with content and receive feedback from each other. Effective peer review requires knowledge, skills, and attitudes that are learned and cultivated; however, there are no clearly defined best practices for teaching it (Sethares & Morris, 2016). In both the online and in-class environments, students express concerns about peer review related to fairness, quality, accuracy of peer feedback, and retribution (Ohaja, Dunlea, & Muldoon, 2013). These concerns are often a basis for negative attitudes that undermine peer review in nursing practice.
The primary goals for this experiential learning assignment were to develop evaluative communication skills for professional peer review and increase knowledge of SMART (Specific, Measurable, Attainable, Relevant, and Timely) goal development. In a required online course, graduate nursing students were assigned to develop a SMART goal to direct a quality improvement project. Students were then assigned to review the work of two classmates using an open source, online peer review application called iPeer (version 3.1.5).
Preparation for the assignment included completing an online didactic module describing key characteristics and techniques for effective feedback. Key characteristics of effective peer feedback include (a) a focused review referring to specific performance standards, (b) descriptive comments reflecting unbiased observations, (c) constructive language intended to inspire growth, (d) blended feedback with a mix of reinforcement and helpful suggestions for improvement, and (e) achievable recommendations to close performance gaps (Tornwall, 2018).
A grading rubric was used by student reviewers to provide non-anonymous evaluations of the SMART goal. Brief narrative comments explaining ratings for each criterion were required. Faculty assigned grade points to reviewers based on (a) completion of the peer review and (b) use of key characteristics of effective peer feedback.
Faculty conducted a postassignment survey to examine students' perceived abilities and comfort levels related to conducting their online peer reviews. Institutional review board approval was obtained for this project. Fifty-seven students completed the survey. Two primary themes emerged from the content analysis of students' anecdotal comments: (a) Comfort with Providing and Receiving Feedback, and (b) Impact on Peer Review Performance. Subthemes of honesty and safety were linked to the online process involving remote communication. Student comments included:
- Hesitant to critique my peer; more stressful to evaluate classmates than direct colleagues in professional setting.
- As women we have a hard time speaking frankly.
- I do not enjoy giving feedback unless it's positive.
In terms of impact, student comments included:
- [Online peer review is] more focused and faster.
- Online peer review is helpful for people who are not good at confrontation or being verbally critical of somebody else's work to their face.
- It is easier to be honest in the online environment.
- [In online peer review, I] cannot interact with peer or see their body language.
The online peer review methodology allowed for increased objectivity and time efficiency. Students identified the need for further development of communication skills that increase confidence and comfort with giving and receiving peer feedback. Purposeful and timely instruction about the value and best practices in nursing peer review, prior to an experiential exercise, is needed to develop and solidify peer feedback skills.
Carolyn Schubert, DNP, CNE, RN-BC
Mary Alice Momeyer, DNP, ANP-BC,
Joni Tornwall, MEd, RN
Ohio State University College of Nursing
- American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author.
- Ohaja, M., Dunlea, M. & Muldoon, K. (2013). Group marking and peer assessment during a group poster presentation: The experiences and views of midwifery students. Nurse Education in Practice, 13, 466–470. doi:10.1016/j.nepr.2012.11.005 [CrossRef]
- Sethares, K.A. & Morris, N.S. (2016). Learning about and benefiting from peer review: A course assignment for doctoral students at two different universities. Journal of Nursing Education, 55, 342–344. doi:10.3928/01484834-20160516-07 [CrossRef]
- Tornwall, J. (2018). Peer assessment practices in nurse education: An integrative review. Nurse Education Today, 71, 266–275. doi:10.1016/j.nedt.2018.09.017 [CrossRef]