ISSUES IN NURSE EDUCATION

Peer learning partnerships: exploring the experience of pre-registration

nursing students
Angela Christiansen and Amelia Bell

Aims and objectives. This paper explores the impact of a peer learning initiative developed to facilitate, purposefully, mutually
supportive learning relationships between student nurses in the practice setting.
Background. Finding effective strategies to support learning in the practice setting has been the focus of professional concern for
a considerable time. In the UK clinical mentorship is seen as pivotal to ensuring fitness to practice; however, recent debate on the
nature of learning has revealed the clinical workplace as a rich learning environment where learning occurs not only through
hierarchical relationships, but also from a network of peer relationships. Formalising peer relationships through peer assisted
learning is increasingly suggested as a strategy to support workplace learning and support novice students’ transition to the
clinical setting. Despite the developing literature in this field there is limited understanding about how students experience
facilitated peer relationships.
Design. An interpretive qualitative design.
Methods. Focus group interviews were used to collect interactive and situated discourse from nursing students who had recently
participated in peer learning partnerships (n = 54). Narrative data were analysed thematically.
Results. Findings suggest that active support from a fellow student reduced the feelings of social isolation experienced by novice
students in initial clinical placements, helping them to deal more effectively with the challenges faced and reducing the factors
that have an impact on attrition. In addition, the reciprocity of the peer learning partnerships facilitated understanding of
mentorship and created a heightened sense of readiness for registration and professional practice.
Conclusions. Peer learning partnerships facilitated by mentors in clinical practice can support the transition to nursing for first
year students and can help more experienced students gain a confidence and a heightened readiness for mentorship and registered
practice.
Relevance to practice. Facilitated peer learning partnerships can enhance the student experience in the practice setting and can
help maximise opportunities for learning and support. This suggests that peer assisted learning is a legitimate area for innovation
and further research.

Key words: education, focus groups, nurses, nursing, peer learning, students

Accepted for publication: 15 April 2009

may experience loneliness and alienation and many do not

Introduction
complete their studies (Yorke & Thomas 2003). For students
It is increasingly recognised that many students encounter in nursing programmes, issues are compounded as students
difficulties when making the transition to university. Students must also engage as learners in the practice setting. Nursing

Authors: Angela Christiansen, BSc, MSc, RGN, RNT, PGDipEd,
Head of Department, Pre-Registration Nursing, Faculty of Health,
Edge Hill University, Ormskirk; Amelia Bell, BSc, MSc, RGN, RNT,
PGDE, Lecturer, Faculty of Health, Edge Hill University, Ormskirk,
Lancashire, UK
Correspondence: Angela Christiansen, Head of Department,
Pre-Registration Nursing, Faculty of Health, Edge Hill University,
St Helens Road, Ormskirk, Lancashire, UK. Telephone:
01695 650776.
E-mail: christia@edgehill.ac.uk

 2010 The Authors. Journal compilation  2010 Blackwell Publishing Ltd, Journal of Clinical Nursing, 19, 803–810 803
doi: 10.1111/j.1365-2702.2009.02981.x
A Christiansen and A Bell
students can experience significant anxiety, uncertainty and
feelings of abandonment when first exposed to the chaotic
and complex health care environment and may at this point
reconsider the appropriateness of their career choice (Beck
1993, Chesser-Smyth 2005).
Learning in the practice setting is essential to prepare
nursing students for the challenges of professional practice
and to ensure fitness for practice prior to registration. Indeed
supporting learning in the clinical setting has been the focus
of professional debate for a considerable time (Lauder et al.
2008). In the UK clinical mentorship is seen as pivotal to
ensuring fitness for practice (Spouse 2001). A Nursing and
Midwifery Council (NMC) mentor is a registrant who,
following successful completion of an approved preparation
programme has demonstrated the knowledge, skills and
competence required to organise, support, monitor and assess
student learning in the practice setting (NMC 2008).
However, recent debate on the nature of learning has
revealed the workplace as more than purely an environment
in which to apply prior skills and knowledge (Lave & Wenger
1991). It is increasingly recognised as a rich learning
environment where learning and support occurs not only
from within hierarchical relationships but also from a
network of peer relationships (Andrews et al. 2008). Indeed
factors likely to have an impact on the learning experience in
the practice setting include the quality of mentorship and peer
support available (Chesser-Smyth 2005).
While preparation for mentorship is undertaken post
qualification, it is has been suggested that mentorship
principles should be introduced into pre-registration pro-
grammes, to foster understanding of mentorship prior to
registration (Mallik and McGowan (2007). It would appear
then that formalising peer relationships in the practice setting
through peer learning partnerships may have the potential to
facilitate novice students’ transition to the clinical practice
setting and reduce attrition from nursing programmes while
at the same time encouraging the development of mentorship
skills for more experienced students in the pre-qualifying
period.
It is in this context that a peer assisted learning initiative
was developed and introduced into the pre-registration
undergraduate nursing programme in a UK university. The
aim of the initiative called ‘peer learning partnerships’ was to
reduce nursing attrition by maximising the peer support
available to first year students in the clinical setting and
facilitate third year students’ understanding of mentorship
principles in preparation for professional practice. Final year
students in the undergraduate pre-registration nursing pro-
gramme were facilitated under the supervision of a clinical
mentor, to form learning partnerships with more junior
804  2010 The Authors. Journal compilation  2010 Blackwell Publishing Ltd, Journal of Clinical Nursing, 19, 803–810
students in the practice setting. Nursing mentors were central
to this initiative, facilitating students to learn together,
providing ongoing support and constructive feedback to both
students. A tripartite relationship between mentor, senior
student and junior student was supported through the use of
a learning contract and clarification of roles and role
boundaries. Whilst participation in the initiative was volun-
tary, preparation to undertake the role was embedded into
the curriculum for all students. This paper reports on an
interpretive qualitative study, using focus group interviews,
to explore first and third year nursing student perceptions of
participation in peer learning partnerships and how it had
had an impact on their learning experiences in the practice
setting.
Background literature
A literature search of health related databases including
CINAHL, ERIC, Academic Search Complete and Medline
was undertaken using a combination of search terms includ-
ing ‘peer assisted learning’ ‘peer mentorship’ ‘peer coaching’
and ‘nursing/health professional education’. Citations were
followed up from reference lists of retrieved articles and only
papers referring to the use of peer learning in health
professional programmes were included. The articles
retrieved were published in the UK, Canada, Australasia
and the USA and describe peer assisted learning in medical,
nursing and allied health professional programmes.
Peer assisted learning is described as an umbrella term for a
group of strategies that include cooperative learning, collab-
orative learning and peer coaching (Ladyshewsky 2000).
Commonly it includes students learning from and with each
other in ways that are mutually beneficial through the sharing
of ideas, knowledge and experience (Topping & Ehly 2001).
The concept has recently re-emerged as a strategy to reduce
university attrition and promote key team working skills.
Indeed interest in this teaching and learning approach has
been re-energised by the requirement in Tomorrows Doctors
(GMC 2003) that medical graduates ‘be able to demonstrate
teaching skills’ (Cameron 2007).
The pedagogic origins of peer assisted learning can be
found in Vygotsky who emphasises the role of social
interaction on learning (Ladyshewsky 2000). Workplace
learning has been illuminated by theories of situated learning,
which highlight learning that derives from social processes
embedded in communities of practice (Wenger 1999, Lave &
Wenger 1991). It has been used in higher education to
support the development higher order cognitive skills and the
promotion of skills that derive from social interaction (Gill
et al. 2006, Wadoodi & Crosby 2002, Duggan 2000).
Issues in nurse education
Although benefits can accrue to both parties, it is often
suggested that the senior learner benefits most as reorganising
and communicating information can promote a deeper
understanding of the subject area.
In the context of health professional education, peer
learning approaches have been used to assist students in the
development of their clinical skills with some reported
success in terms of students self reports (Gill et al. 2006,
Goldsmith et al. 2006). Aston and Molassiotis (2003)
describe an initiative introduced into a pre-registration
nursing programme to facilitate mutually supportive rela-
tionships between first and final year students in the
practice setting. Evaluative questionnaire data collected
from students indicate that participation had supported
skill development, although preparation for students to
undertake the role of facilitator would have enhanced its
acceptability.
Many of the benefits of peer learning emanate from the
informality that junior students feel towards more senior
students. Approaching peers for assistance with skills often
causes less performance anxiety for junior students (Lady-
shewsky 2000). The informal and non-hierarchical environ-
ment may encourage students to be more open about
uncertainties and misconceptions allowing them to take steps
to address these (Goldsmith et al. 2006, Wadoodi & Crosby
2002). Pedagogic advantages derive from a more active,
interactive and participatory learning experience (Topping &
Ehly 2001). Recently, peer learning and peer-mentoring
schemes have been introduced as a strategy to reduce attrition
by supporting first year students’ transition into university
and nursing life and as a vehicle for encouraging collegial
support and inter-professional teamwork, (Kanthan & Mills
2007, Gilmour et al. 2006).
Such approaches may encourage students to reflect on their
own learning needs and may assist understanding of how
effective learning occurs. It may encourage students to take
greater control of their own learning and may facilitate the
development of a more autonomous learner and practitioner.
In addition, peer assisted learning may facilitate the
development of a range of skills including enhanced commu-
nication skills, problem solving abilities, leadership and
self-management skills that are both transferable to and
required in, students’ future professional role (Gill et al. 2006,
Gilmour et al. 2006, Topping & Ehly 2001, Duggan 2000).
Despite the apparent benefits of peer assisted learning,
there are several challenges associated with its use. Estab-
lishing peer assisted learning schemes can be time consuming
and both junior and senior learners require role preparation
(Ladyshewsky 2000, Gilmour et al. 2006, Aston & Molas-
siotis 2003). The learning interaction can be difficult to
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Peer learning partnerships
quality assure as students are not and should not be,
considered subject experts (Boud & Lee 2005) and agreement
of roles and role boundaries can help to ensure that students’
primary role as learner is not negated. Further to this,
adequate provision of time to facilitate effective peer learning
relationships would appear to be a prerequisite to success
(Gilmour et al. 2006, Goldsmith et al. 2006).
The literature is supportive of the potential of peer assisted
learning to enhance achievement of learning outcomes in
both the cognitive and affective domains; however, it is an
area under researched. Secomb (2006) suggests that further
research is needed to increase the body of knowledge in this
area and influence further educational developments. Despite
the growing reference to peer assisted learning in clinical
education, there is limited qualitative research to explore how
students perceive it has had an impact on their learning
experience in the practice setting.
Method
A qualitative design informed by social constructionism, used
focus group interviews to explore in depth how students
perceived peer learning partnerships had had an impact on
their experience in the practice setting. Focus group inter-
views not only allowed access to students’ views and
experiences but also to the processes through which students
constructed social meaning through group participation
(Denzin & Lincoln 2003).
Ethical approval was obtained from the faculty research
committee and the principles of beneficence, human dignity
and respect were observed. Requests for volunteers were
made both verbally to students and posted on the student
notice board and web-site, along with an outline of the
purpose of the study, an approximate time of interviews and
a contact number for those who wished to participate. All
participants were assured that every effort would be made to
maintain the anonymity of their individual contribution and
all were fully aware of their ability to withdraw from the
study at any point. The difficulty of assuring anonymity of
participants was addressed through the identification of
ground rules prior to the commencement of the focus group
interviews.
Selection of participants
A study sample of participating students was purposively
selected to provide a rich and relevant source of data
(Parahoo 2006). To be included in the study students were
required to have participated in the peer partnership initiative
in the pre-registration programmes in the last six months.
805
A Christiansen and A Bell
Following the identification of participants, students were
assigned to a focus group event conducted in the Faculty.
Data were collected over 18 months and three cohorts of
students were eligible to participate. From this target popu-
lation four focus group interviews were conducted (n = 54).
All volunteers were assigned to a focus group event consisting
of same cohort participants to ensure pre-existing hierarchies
or power relations between students was minimised (Krueger
& Casey 2000). While the student participants were known
to each other, they had not formed as a group for other
purposes (Table 1).
Data collection
Powell and Single (1996) suggest that focus groups are key
individuals brought together to discuss from personal expe-
rience a ‘focussed’ topic. In the study, participants were
guided to focus on their recent experience of acting as a
senior or junior peer whilst learning in the practice setting.
The use of group interaction to generate data, facilitated
access to student narratives, expressed in a relatively natu-
ralistic peer setting. Encouraging participants to articulate,
clarify, challenge and respond to each other’s accounts of
their experiences, has the potential to revealed a shared
language and a common frame of reference (Krueger &
Casey 2000, Kitzinger 1995). Each focus group interview had
between 9–16 participants to ensure size was manageable in
terms of group participation. While it is often recommended
that focus group interviews are undertaken with a group
facilitator and group moderator, the interviews reported here
were conducted with a single moderator (Kitzinger 1995).
Focus group interviews are often criticised as it is suggested
that the group process at play will inevitably result in
consensus to a group norm and any deviant points of view
will be masked (Barbour 2005, Kitzinger 1995). To minimise
this, an attempt was made to control dominant participants
and encourage the less forthcoming, while allowing enough
freedom to ensure relatively free exchange. Any inconsisten-
cies in the discussion were explored and the use of probes and
requests for clarification were used to help ‘un-pack’ some of
the respondents’ answers. At the end of each interview key
ideas emanating from the discussion were identified and
verified by participants as a reasonable summary of the focus
group discussion.
Data analysis
It is often suggested that the data generated by the focus
groups can be problematic. Participants often speak at the
same time and once the data is transcribed it is difficult to
806  2010 The Authors. Journal compilation  2010 Blackwell Publishing Ltd, Journal of Clinical Nursing, 19, 803–810
identify individual responses. However Krueger and Casey
(2000) suggest that it is the group rather that the individual
that is the focus of analysis as data generated from focus
groups represents situated accounts, providing an in-depth
insight into contextualised social interaction.
The transcripts and audio-tapes were analysed following
the steps outlined by Ritchie and Spencer (1994). Data
analysis began during data collection through careful group
facilitation and following transcription, reflexive engagement
with the data enabled familiarity with it as a whole, prior to
its deconstruction. A selection of focus groups were analysed
independently by two researchers to identify key themes
coded onto transcripts. These narrative units were subse-
quently subjected to a more detailed sub-coding of substan-
tive content (Kidd & Parshall 2000). Following negotiation
and discussion an index or thematic framework was con-
structed to facilitate comparisons both within and between
group interview data.
The process of giving meaning to qualitative data requires
a certain level of interpretation and qualitative research can
be criticised for the space afforded to the subjectivity of the
researcher (Ritchie & Spencer 1994). To validate and
maximise the trustworthiness of initial findings, a descriptive
overview of the final analysis was presented to a group of
participants to confirm it as a realistic interpretation of their
views. However, it is acknowledged that in the paradigm of
social constructivism the idea of a reality that can be
confirmed is rejected and validity or credibility must be
judged by the degree in which the researcher’s impact on the
findings is made explicit (Denzin & Lincoln 2003).
Findings and discussion
Following data analysis several key themes were constructed
relating to ‘the challenges of initial practice experiences’,
‘gaining acceptance’, ‘learning with peers’ and ‘personal
growth and development’.
Challenges of initial practice experiences
Participants reflected on what it meant to be a learner in a
complex and unpredictable working environment. It was
evident that many students had experienced difficulties when
first exposed to the clinical setting of nurses. Entering a new
and busy working environment had caused the students
significant anxiety as illustrated by the comment ‘it was
crazy, it was really busy but just coming into the hospital
alone, it’s massive… loads of people… I felt lost at first and
had knots in my stomach’. Others described their initial fears
in a similar way ‘I’ve never had any ward experience and it
Issues in nurse education
was daunting for me going on the ward because we were
supposed to know the way out and everything’ and ‘we had
to ask to go to the toilet, all the doors got locked and things
like that, all the knives were put away and it was just like
‘what the hell am I doing here?’.
In addition to reacting to the new environment, partici-
pants suggested that being a novice in this environment
caused them to feel inadequate, anxious about staff expec-
tations of them and intensely worried about their perceived
lack of knowledge and skill, ‘I felt really embarrassed because
I didn’t know anything. I’d gone from a background where I
was so used to knowing it all and here I didn’t even know
how to make a bed’. This is consistent with the concept of
‘envisioning the self as incompetent’ identified as an anxiety
producing aspect of students initial clinical experience by
Beck (1993) and suggests that students had significant
difficulty transferring previous life skills into the health care
delivery context.
Anxiety was further heightened by a sense of social
isolation caused by the temporary nature of students’
engagement with the health care team and the feeling of
being an outsider, as this comment suggests ‘I think it is hard
getting to know the staff because they are together all the
time and you come in as the new person all the time’.
Participants suggested that qualified staff often referred to
them as ‘the student’ which not only made them feel
dehumanised but also implies a transient role. Melia (1987)
describes transience as a feature of nursing students’ clinical
experience and suggests that the phenomena of ‘just passing
through’ impact not only on the nature of the relationship
between students and permanent health care staff but
requires students to develop coping strategies to help them
function in this system.
Gaining acceptance
Participants described the difficulties of being a learner in a
working environment, for instance ‘you are just pulled in
every direction. The auxiliaries want you to do their work
with them and you are supposed to be working with the staff
nurses and learning something, it is hard to reach a balance’.
Student developed strategies to help them cope with the
situation they found themselves in and help them gain
acceptance and membership of the nursing team.
A key determinant of a students’ success in gaining
acceptance was perceived to be the approval of health care
assistants, who often acted as gatekeeper to team member-
ship. A comment from a participant is illustrative of this
process ‘I always find and this is just my personal opinion, I
pick the worst auxiliary, the one who doesn’t like the student
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Peer learning partnerships
and by the end of the time I’m there, she likes the students
because the students will help her do everything she does. She
is usually the one who is like that (intimate) with all the staff
nurses and she’s the one who says ‘‘oh she’s really good you
know she’ll help you do anything’’ and then it (acceptance)
follows on’. As Melia (1987) notes students enter clinical
areas as short term member of the patient care team with a
different reason for involvement in patient care from perma-
nent staff. It is interesting to note that despite many years of
supernumerary status the precarious position of many
students in terms of gaining a sense of balance between
doing and learning persists.
Learning with peers
In this environment students found relationships with more
senior students a source of emotional support in adversity
and a protection against social isolation. Recognition that
other students were on the same educational journey
reinforced senior students as a powerful role model and
legitimate source of reassurance. This was illustrated by the
one participant who suggested ‘students just gravitate
towards one another; it’s like being back in your comfort
zone’. In terms of learning with peers it was suggested that
‘learning with a peer is not always about skills but sometimes
just saying, look it will be alright, things will get better’ and
‘students understand what is important, they understand that
all those little things are really big things’. This is a student
perspective illuminated by Chapman (2001) who found
nursing students considered that only other students could
really understand their experiences enough to help them get
through it.
When asked to provide examples of how they had used
peer leaning partnerships to facilitate the learning of others,
interestingly it was not learning that arose from an informal
context such as emotional support that was primarily
identified. These findings concord with Eraut (1994) who
highlights how informal, unplanned learning, embedded in
workplace processes, often remains at a subconscious level.
Indeed participants in the study, in common with Aston and
Molassiotis (2003), highlighted the much more tangible
learning that occurred when facilitating the development of
another’s clinical skills especially the taking and recording of
clinical observations. While for most students, partnerships
had been formed with more junior nursing students brought
together by a nursing mentor, learning relationships had also
occurred with cadet nurses, health care assistants and
students returning from a break in studies. Other learning
situations in which students acknowledged engagement in
peer learning included assisting with client/patient assessments
807
A Christiansen and A Bell
and completion of documentation. Undressing a patient when
attached to intravenous infusions and ensuring students were
emotionally prepared before caring for a client after death
were also given as illustrations.
While all activities identified had been previously under-
taken in the clinical skill centre, participants suggested that
learning with other students enhanced their learning because
it provided a non-threatening learning context in which to
learn and rehearse before working under direct supervision of
a mentor responsible for student assessment. Students felt
safe because the student relationship was bound up with
feelings of empathy and friendship as indicated by the
comment ‘I think it’s about seeing a friendly face, it’s just
having someone smile at you and you feel that someone
knows who you are, knows how vulnerable you are feeling in
that situation, once you are comfortable with that, learning
just happens along the way’. Similarly, Boud and Lee (2005)
suggest that when communication barriers of power and
difference are reduced, as when peers interact, more open
communication can occur, allowing for fuller engagement
and potentially greater opportunity for learning.
The informality inherent in the student to student rela-
tionship and the reduced anxiety meant students felt safe to
ask questions and disclose areas of uncertainty. Comments
such as ‘you don’t feel dumb asking stupid questions’ and ‘it’s
like being able to fail in good company and not be humiliated
or feel small’ are typical of this. Eraut (1994) suggests that
novices in the workplace often feel diffident about asking
questions of senior colleagues for fear of becoming labelled as
a ‘weak’ student. However, this does not apply to asking
questions of peers.
Participants also suggested that learning happening be-
tween students was less hurried, more individualised and
articulated in shared language that made the subject more
accessible to the novice student. The learning process
described accords with contemporary theories of learning
that emphasise the situated nature of learning and highlight
how learning can be understood as an outcome of social
interaction and collaboration with a more experienced peer.
Cognitive apprenticeship is an example of situated learning
where learners participate in a community of practice
Table 1 Demographic characteristics of focus group participants
Focus group Participants Male Female
Total population (n = 54) 5 49
A 9 1 8
B 16 2 14
C 13 2 11
D 14 1 13
808  2010 The Authors. Journal compilation  2010 Blackwell Publishing Ltd, Journal of Clinical Nursing, 19, 803–810
through active involvement and social interaction (Wenger,
1998, Lave & Wenger 1991).
Personal growth and development
A defining characteristic of peer learning is its reciprocity and
senior students were very aware of the benefits that had
accrued to them, as a consequence of the learning partner-
ship. The process of organising, simplifying and clarifying an
explanation or skill to explain to another, had necessitated a
review of existing knowledge and has facilitated a reflective
process. This is illustrated by a student who suggested that
‘going over things with others really helps you learn yourself’
and ‘you do things without thinking and it’s done before you
have even thought about what you have done, but when
you are showing someone else you have to think about what
you are doing’.
In addition, sharing responsibility for the development of
another, if successful, brought affective gains to the senior
learner who acted as facilitator. This was in part a
consequence of internal positive feedback, for example ‘it
made me realise I had a lot more knowledge than I thought’.
In this way senior students were able to build personal
confidence in their own knowledge and skills. The creation of
positive relationships and the act of helping another often
resulted in positive verbal feedback from junior learners ‘I felt
good when a first year came up to me and said ‘thanks I’ve
really learned a lot today, you really did well’… it felt great
to get that kind of recognition’. Indeed for Eraut (1994) an
important factor relevant to learning in the workplace is how
an individual’s performance is perceived by others and
themselves and how feedback is given and received.
It would appear that the encouragement and support of a
peer enhanced students’ self esteem and increased their
confidence, as they recognised that success was an outcome
of their own efforts. Self esteem involves a positive appraisal
of oneself and is often associated with self respect, increased
confidence and reduced stress (Burnard 2001). This is also
reflected in a study by Glass and Walter (2000) who suggest
that the engagement of students in peer mentoring processes
of encouragement and support enhanced personal growth,
Age 21–30 Age 31–40 Age 41+
20 16 17
4 3 2
5 4 7
4 3 6
7 6 1
Issues in nurse education
self worth and belonging. Indeed, Begley and White (2003)
highlight how self esteem in nursing is an integral part of
personal and professional identity and is essential for those
engaged in compassionate and caring roles.
Students discussed whether participation had had an
impact on their own professional development. Some partic-
ipants suggested that they had increased their sense of
readiness for registration ‘It made me think about being a
safe practitioner, about delegation and leadership and it’s
helped me feel prepared for when it’s really going to happen’.
It was suggested that supporting the learning of another had
enhanced their understanding of how learning occurs and had
given them a greater awareness of the role of the mentor ‘it
made me feel ready to qualify and made me think about being
a mentor in the future’.
Limitations of the study
The strength of qualitative research lies in its ability to
explore the role of underlying processes and context in
shaping individual behaviour or beliefs and its ability to
develop meaning and explanation inductively from the data
(Ritchie & Lewis 2003). However, when interpreting results
it is necessary to consider some inherent limitations to the
transferability of findings (Lincoln & Guba 1985). The small
sample and context specific nature of this study require
tentative conclusions to be drawn when considering the
application of findings to other settings. The study was
restricted to understanding the experience of nursing students
and the views of mentors were not sought. In addition, all
participants had self selected for participation in the peer
learning partnership initiative and having invested in the
initiative may have been more inclined to regard their
experience as positive and developmental.
Conclusion
This paper explores the impact of a peer learning initiative
developed to purposefully facilitate mutually supportive
learning relationships between student nurses in the practice
setting. Findings suggest that students continue to face many
challenges when making the transition to learning in an
increasingly complex health care environment. The active
support from a fellow learner, who has an empathetic
understanding, appears to have a positive impact on students’
sense of social isolation and students are able to deal more
effectively with the challenges faced through the creation of
a safe and non-threatening learning community.
The reciprocity inherent in peer learning is evident and the
initiative is perceived as mutually beneficial. The situated
 2010 The Authors. Journal compilation  2010 Blackwell Publishing Ltd, Journal of Clinical Nursing, 19, 803–810
Peer learning partnerships
discourse of participating students suggests that peer learning
partnerships have brought both affective and cognitive gains
in terms of increased self esteem, the development of
nurturing relationships essential to successful mentorship
and a heightened sense of readiness for registration and future
professional practice.
Implications for practice
This study contributes to a growing literature that illuminates
students experience of peer assisted learning. The study
suggested that formalising peer relationships in peer learning
partnerships has the potential to enhance the student learning
experience in the practice setting. Peer learning is therefore a
legitimate focus for learning and teaching innovation. How-
ever, understanding would be further enhanced by further
research to explore the impact of peer learning on mentors in
the workplace.
Contributions
Study design: AC, AB; data collection and analysis: AC, AB
and manuscript preparation: AC.
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