Purpose
Medical universities in the past decade have geared toward student-centered learning, creating need for development and assessment of appropriate learning protocols. The purpose of this project was to develop and implement a practical, student-centered active learning method for use by clinical and basic science faculty.

Methods
Approximately 174 medical students per year participated for five years in iterations of peer teaching in a brain and behavior course at the University of Arkansas for Medical Sciences (UAMS). Adaptations were based on Eric Mazur’s peer instruction (PI) pedagogy for 150 Harvard students. Student attitudes toward PI and TBL at Boonshoft School of Medicine, Wright’s State University were used to focus the project. Intentionally challenging questions were provided by faculty in USMLE Step 1 style. Students in randomly assigned seats had 90 seconds for individual first poll answers and 120 seconds for small group discussion and second poll answers, not requiring consensus. Use of response clickers was compared to computer software. A safe environment was provided for class discussion.

Results
Brain and behavior students expressed an overall positive attitude toward the evolving protocol. Question difficulty of < 85% was found to facilitate good peer interaction with enough students able to discuss correct rationales with students who answered incorrectly. The computer IRAT feature for both the first and second question polls was preferred to response clickers. WIFI connectivity was at times limiting, unless electronics other than laptops were kept off. A paper option was provided. Individual student difficulties were observable via statistics and used to direct discussion. Guidelines for this instructional method were developed to promote consistency among courses. Satellite campus students fully participated remotely.

Conclusions
We successfully developed a practical student-centered learning protocol, drawing from and expanding upon prior learning methods. Specific parameters need future analysis to establish the potential for this evolved protocol.