1. QIPP: Simulation Peer
Evaluation
By: Caitlin McCabe, Emily Hanges, Vanessa Katsma,
Anna Groh, Alex Santoro, and Amy Szukalski

2. Problem Statement
● The current grading rubric utilized by peer evaluators is difficult to follow and
ineffective for providing feedback to simulation group members.

3. PDSA-Plan
1. Contact Lisa Green about revising peer evaluation form.
2. Create a questionnaire pertaining to the quality of the current rubric in place that
will be handed to students/peer evaluators who have used the rubric.
3. Create the revised rubric based around what students said they would like to see in
the survey
4. Distribute rubric to be used during simulation

4. PDSA-Plan
Our prediction is that:
● At least 50% of students/peer evaluators will believe our rubric is more helpful than the one currently in
place.
● We believe that the peer evaluators will make more of a contribution to the team by using the guidelines
of our rubric.
In order to measure our prediction we will:
● Ask the same questions we asked prior to creating the new rubric but this time the questions will pertain
to the new one we created and implemented.
● Based on responses to the questionnaire, we will calculate the amount of students/peer evaluators that felt
our rubric was more helpful than our previous rubric.

5. PDSA-Do
1. Group member sent out questionnaire via email with a link to survey monkey to ask peer evaluators who
participated in simulation if they felt the current rubric in place is effective and easy to follow.
2. Based on results and feedback about what could be changed, the rubric was revised rubric and then sent to
peer evaluators participating in simulation to use as the peer evaluator form instead of the one currently in
place.
3. Following the use of the rubric during simulation, another email was sent out with a link for survey
monkey that asked the peer evaluators if they felt that our rubric was more helpful than the one currently
in place.

6. PDSA-Study
● Based on the following suggestions given by peer evaluators, we created a new version utilizing these
suggestions and emailed it to the peer evaluators to use during their next simulation (these responses from
peer evaluators are anonymous):
o “Make it more of a check-list type of form. Also, have an area for the care plan, goals,
interventions.”
o “A more simplistic layout that is more specific to what they are looking for.”
o “Give us a sheet similar to the ATI check offs with the skills needed in the scenario and let us mark
along as they go with simple check marks.”

7. PDSA-Study
● The suggestions for change following our implementation of the new rubric are as follows: (responses are
anonymous)
o “Use different fonts to acknowledge different sections.”
o “Have a section on the form that lists the specific skills that need to be performed in each
simulation”
 This is difficult because we never know which specific skills will be addressed in each
simulation
o “Simplify it”
 The wording was taken directly from the original evaluation form

8. PDSA-Act
● Based on our results, we made changes based on suggestions for improvement to the new peer evaluator
form.
● We implemented the new form.
● After this implementation, we reevaluated the results.

9. Evidence Based Practice
Article #1: Peer feedback as an aid to learning – What do we want? Feedback. When do we want it?Now!
● Purpose: To explain that peer feedback is a necessity for competence in core communication and when using in the
classroom, helps students to learn more effectively.
● Significance: In the study groups of medical and nursing students went through simulations and switched roles, so each
gave peer feedback to another group member and also received peer feedback at that time.
● Limitations: Small sample size and unequal sample sizes between experiments.
● Application: Our group used this information as motivation to improve our current peer evaluation sheet to improve peer

10. Evidence Based Practice
Article #2: Peer-to-Peer Teaching: Improving Communication Techniques for Students in an Accelerated Nursing Program
● Purpose: To use peer-to-peer teaching and evaluation to to increase learning and confidence of students.
● Significance: Non-threatening learning environment requires decreased anxiety and encouragement of reflection. Peer
evaluation highlights key concepts of communication, collaboration, and teamwork.
● Limitations: Small sample size
● Application: We used the ideas presented in this article to prove that peer evaluation in nursing programs is necessary for
student nurses to feel competent and lessen anxiety.

11. National Context
● Also, the practice of peer review is required to attain Magnet status. American Nurses Credentialing Center states, “The
peer review process stimulates professionalism through increased accountability and promotes self-regulation of the
practice” (Haag-Heitman & George, 2011).
● The U.S. Department of Health and Human Services states, “Ideas about health and behaviors are shaped by the
communication, information, and technology that people interact with every day…These processes make up the context
and the ways professionals and the public search for, understand, and use health information, significantly impacting their
health decisions and action” (US DHHS, 2015).

12. Interventions
● The changes we made to the peer evaluation form were based off of feedback given via a survey about the effectiveness of
the current form.
● Our group modified the layout of the NRS 432 simulation peer evaluator form for Simulation 4 and 5 based upon the
survey suggestions
● We provided a second survey regarding the pros and cons of the revised evaluation form
● We offered a comment section for students to verbalize any additional changes they saw pertinent
● We compared the results of the initial survey and post survey regarding the effectiveness of the changes we implemented

13. Evaluation
● The first survey that asked if the peer evaluators felt the current rubric in place was effective and easy to follow and the
results are as follows;
o 25% yes
o 75% no
● After the implementation of our new rubric, we sent out a similar survey asking if the peer evaluators felt our rubric was
easier to follow than the one currently in places and the results are as follows:
o 90.01% yes
o 9.09% no

14. Recommendations
● We would recommend implementing our QIPP project a second time to ensure that all groups are given specific
instructions regarding when and how to use both the initial and revised evaluation forms.
● We recommend using the initial form for Simulation 1 and implementing our revised form during Simulation 2 related to
difficulty in using the form for Simulations 3-5
● The instructors conducting the simulations could format the evaluation form to include the specific skills that will be
performed, this would make the checklist format be easier to follow
● Evaluating students would not receive the specified evaluation form until the day of simulation in order to prevent students
from only specific skills listed
● Communication posed a barrier, and we recommend closely corresponding with faculty about our group process

15. Summary
● Problem
● Quality Improvement Process
● Evaluation/Recommendations

16. References
Cooper, J. R., Martin, T., Fisher, W., Marks, J., & Harrington, M. (2013). Peer-to-Peer Teaching:
Improving Communication Techniques for Students in an Accelerated Nursing Program. Nursing Education Perspectives,
34(5), 349-350.
Cushing, A., Abbott, S., Lothian, D., Hall, A., & Westwood, O. R. (2011). Peer feedback as an
aid to learning -- What do we want?? Feedback. When do we want it?? Now!. Medical Teacher, 33(2), e105-e112.
doi:10.3109/0142159X.2011.542522
Haag-Heitman B., & George V. (2011). Peer Review in Nursing: Principles for Successful
Practice. Sudbury, MA: Jones and Bartlet.www.jblearning.com. Reprinted with permission.
U.S. Department of Health and Human Services. (2015, April 6). 2020 topics & objectives.
Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/health-communication-and-health-information-