Design, Implementation, and Evaluation of Peer Learning in Teaching Technical Skills to Second-Year Nursing Students. (PL)

Each student's baseline knowledge will be assessed before participating in the Internship Experience (IE) Urinary catheterization. To do this, each student will complete an exam covering the content provided in the IE preparatory documentation (delivered via vitual educative platform, ADI) and from the lecture given to the entire class by a professor from the Practical Teaching Unit. The questionnaire, a multiple-choice test designed ad hoc by the researchers, will consist of 10 questions with four response options. Incorrect answers will not be penalized. The total possible score is 10 points. To prevent students from sharing exam content and to make memorization difficult, a bank of 30 questions has been created, from which different versions of the knowledge exam will be generated.

To measure the self-efficay with technical skills, the Learning Self-efficacy Scale for clinical skills (L-SES) was used. Developed by Kang et al. (2019), is a measurement instrument designed to understand the relationship between student self-efficacy and the practice of technical skills. This scale was developed under the framework of Bloom's Taxonomy and has been rigorously tested and validated in medical students. It demonstrated appropriate content validity indices (I-CVI = 0.88-1) and reliability (Cronbach's alpha of 0.931). Furthermore, results indicated that L-SES scores were not affected by gender (t = -0.049; 95% confidence interval [-,115; 0,109], p > 0.05). The L-SES comprises twelve items grouped into three distinct domains: cognitive, affective, and psychomotor. Responses are captured using a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree).

The Learning Engagement Survey, developed by members of the Foundation for the Improvement of Postsecondary Education (U.S. Department of Education, 2003) is designed to measure students' self-perceived engagement with their learning during class. This survey consists of eight items grouped into two domains: Participation and Enjoyment. Responses are collected using a 5-point Likert scale (1 = strongly disagree; 2 = disagree; 3 = neither disagree nor agree; 4 = agree; 5 = strongly agree). The survey has demonstrated adequate validity and reliability, with an overall Cronbach's alpha of 0.881. The two subscales, Participation (five items) and Enjoyment (three items), yielded respective Cronbach's alpha values of 0.807 and 0.873 (Menenga et al., 2013).

To assess proficiency development in the procedural skill of urinary catheterization, students from both the intervention (peer-learning) and control (traditional teaching) groups were evaluated by an academic tutor. The tool developed was a 10-item rubric with a "yes/yes with changes/no" response format. The rubric underwent face and content validity with academic tutors. For consistency, the first six students were evaluated by two assessors, and any discrepancies were resolved by a third evaluator.

To measure satisfaction, the General Satisfaction Survey with the Educational Activity, adapted from Hoseini et al. (2013) was used to collect information on student satisfaction with the training activity. This survey consists of 10 general satisfaction questions. Responses will be recorded using a 5-point Likert scale (1 = strongly disagree; 2 = disagree; 3 = neither disagree nor agree; 4 = agree; 5 = strongly agree).