https://orcid.org/0000-0001-8849-8920
Abstract
Introduction
To achieve quality in medical education, peer teaching, understood as students taking on roles as educators for peers, is frequently used as a teaching intervention. While the benefits of peer teaching for learners and faculty are described in detail in the literature, less attention is given to the learning outputs for the student-teachers. This systematic review focuses on the learning outputs for medical undergraduates acting as student-teachers in the last decade (2012–2022).
Aim
Our aim is to describe what learning outputs student-teachers have from peer teaching, and map what research methods are used to assess the outputs. We defined learning outputs in a broad sense, including all types of learning experiences, intended and non-intended, associated with being a peer teacher.
Methods
A literature search was conducted in four electronic databases. Title, abstract and full text were screened by 8 independent reviewers and selection was based on predefined eligibility criteria. We excluded papers not describing structured peer teaching interventions with student-teachers in a formalized role. From the included articles we extracted information about the learning outputs of being a student-teacher as medical undergraduate.
Results
From 668 potential titles, 100 were obtained as full-texts, and 45 selected after close examination, group deliberation, updated search and quality assessment using MERSQI score (average score 10/18). Most articles reported learning outputs using mixed methods (67%). Student-teachers reported an increase in subject-specific learning (62%), pedagogical knowledge and skills (49%), personal outputs (31%) and generic skills (38%). Most articles reported outputs using self-reported data (91%).
Conclusion
Although there are few studies that systematically investigate student-teachers learning outputs, evidence suggests that peer teaching offers learning outputs for the student-teachers and helps them become better physicians. Further research is needed to enhance learning outputs for student-teachers and systematically investigate student-teachers’ learning outputs and its impact on student-teachers.
Introduction
Peer teaching, defined as teaching performed by “A person who is the same age or has the same social position or the same abilities as other people in the group” is being used worldwide both in undergraduate and postgraduate medical education.Citation1,Citation2 Studies have shown that students learn as much from being taught by peers as they do from expert teachers.Citation3,Citation4 In addition, it has been argued that the social and cognitive congruence that characterize the student-learner and student-teacher relationship creates psychological safe learning spaces, mutual understanding of difficulties and customized models for explaining the learning content.Citation5–7 Also, it is argued that peer teaching alleviates teaching pressure for faculty.Citation6
Whitmans description of “teaching as learning twice” from 1988Citation8,Citation9 suggests that peer teaching also benefits the student-teacher. Previous studies point to improved written and/or practical examination scores for students that were teaching peers in basic sciences,Citation10 participated in a small-group based Gastroenterology/Hematology course where they alternated being group facilitatorsCitation11 and students acting as student-teachers in musculoskeletal ultrasound interpretation compared to their same year peers.Citation12 Burgess et alCitation13 found that the benefits of peer teaching for the student-teacher can be described in two main categories: Development in understanding of knowledge content and development of professional attributes. The two categories include increased awareness of facilitation, teaching and feedback techniques, leadership qualities, confidence, open-mindedness and autonomy. Finally, a review conducted in 2020 by Bower et alCitation14 documented opportunities for student-teachers to consolidate their own learning while contributing to the medical school community. However, the 2020 review focused on informal near peer teaching and not formalized peer teaching initiatives.Citation14 For peer teaching to have positive learning outputs for the student-teacher, the literature highlights the need for teacher training and support from faculty.Citation15
Many of the competencies used to evaluate learning outputs of student-teachers are reflected in medical curricula worldwide as part of the CanMEDS framework designed by the Royal College of Physicians and Surgeons of Canada. CanMEDS identifies and describes the competences required of medical doctors to meet the health care needs of patients. The competences are organized under a set of roles: medical expert, communicator, collaborator, leader, health advocate, scholar and professional.Citation16 This framework enables us to organize the potential learning outputs gained from peer teaching and to explore how being a peer teacher can facilitate the development of core competencies among student-teachers.
While the CanMEDS framework provides a useful basis for identifying key competencies, systematizing the available knowledge about learning outputs of student-teachers is challenged by overlapping definitions of peer teaching in the literature. Peer teaching is often used as an umbrella term including both collaborative learning, peer-assisted learning, near-peer teaching, teaching assistants, peer and near-peer supervision, mentoring and more. As a result, the student-teachers role can become unclear as it can both entail being a collaborative resource for fellow students within the same program and having a dedicated role as an educator for same level or more junior students. While recognizing that the role of an educator might entail assessment, feedback and supervision, we limited our screening to studies that described teaching activities where students had a clear and formalized role as an educator. This means that peer assessment, peer feedback and reciprocal learning activities, where peers take turns teaching each other or engage in group learning activities, were excluded. While previous reviews have focused more broadly on the effectiveness of peer teaching, this systematic review focuses on the learning outputs for student-teachers in formalized peer teaching settings. To further limit our review, we focused on undergraduate medical education, thus excluding postgraduate education, residency training and interdisciplinary studies. Previous reviews provide sufficient summaries of evidence prior to 2012,Citation13 hence, we limit our review to qualitative and quantitative studies focusing on learning outputs for student-teachers published between 2012 and 2022. Knowledge regarding outputs of peer teaching for the student-teachers might help medical faculties design peer teaching regimes with benefits for all the parties involved. Thus, our aim was to describe what learning outputs student-teachers have from peer teaching, and map what research methods are used to assess these outputs.
Materials and Method
To achieve our aim, a systematic search in four databases was conducted. The findings from the studies were summarized in tables, and the results were set up against CanMEDS framework.
The literature search was conducted during October and November 2021, and updated in November 2022, in Embase, ERIC databases, MEDLINE and PubMed. The search was conducted using search terms: “near peer teaching”, “peer assisted learning”, “peer mentor”, “peer tutor” and “peer teacher(s)”, additionally the search was restricted to undergraduate medical education (). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines 2020 was used as a guide to record the review process ().Citation17 All articles were retrieved in the bibliography management program EndNote X9. Duplicates were removed before the remaining articles were uploaded in Rayyan AI where the articles were screened using the inclusion and exclusion criteria outlined below (). The inclusion and exclusion criteria were developed based on our aim to gather information about student-teachers at undergraduate medical education level.
Table 1 Search Terms and Keywords Used in the Literature Search
Table 2 Inclusion and Exclusion Criteria for Screening of Articles
Figure 1 Flow chart displaying the whole process of assessing and selecting articles for this review.
One reviewer (first author) screened all the 668 articles that were retrieved in the original search, whereas the co-authors (four researchers from University of Bergen, and three researchers from Karolinska Institutet) screened approximately 100 articles each, ensuring a double blinded review process. Conflicts were resolved by discussion between four of the authors (MAT, TM, MK and HHA). Out of 668 records, 100 articles were contained initially and subjected to full-text screening. After the initial full-text screening and data extraction 40 articles were selected. After the updated search 45 articles were included in this review as the final material.
To ensure reliable and valid data, the quality of the quantitative studies included was evaluated by two reviewers (MAT, IGS) using The Medical Education Research Study Quality Instrument (MERSQI).Citation18–20 The instrument is based on 10 items, reflecting six domains of study quality: (1) study design, (2) number of institutions studied and response rate, (3) data type, (4) validity evidence for evaluation instrument, (5) data analysis sophistication and appropriateness, and (6) outcome level. The maximum domain score is 3, and a minimum of 0–1, producing a potential range of 5–18 MERSQI scores.Citation20
The results were critically synthesized by multiple reviewers using categories based on past literature and CanMEDS framework. The findings from the studies are summarized in tables, giving an appropriate schematic informative focus to this review.
Results
A total of 45 articles were included in the review. gives an overview of the included articles and presents each publication with authors, quality assessment using MERSQI score, country of origin, number of student-teachers and student-learners, study design, and teacher training intervention. Furthermore, dimensions of teaching encounters are described using three subcategories: frequency and dimension, group size and teaching subject. The last category reports learning outputs for student-teachers and what methods that were used to assess the outputs.
Table 3 Schematic Overview of Included Articles
Description of the Student-Teachers
The included studies describe peer teaching activities set in 14 different countries with the USA, Australia and the UK as the most predominant. Student-teachers in the articles reviewed were recruited from all levels of medical school. Most of the studies reported having a one-year gap between the student-teachers and student-learners. Number of student-teachers included in the studies ranged from 3 student-teachersCitation55 to 481 student-teachers,Citation35 and number of student-learners included in studies ranged from 5 student-learnersCitation55 to 1053 student-learners.Citation42
Anatomy, clinical skills and communication were the most frequent subjects taught by the student-teachers. The amount of teaching sessions varied in frequency from only one teaching sessionCitation48 to 26 sessions.Citation57 They also varied in duration from 30 minutesCitation51,Citation60 to 4 hours.Citation53 Furthermore, peer teaching was deployed in various group sizes of learners ranging from 4 students in the smallest groupCitation47,Citation49 to 25 in the biggest group.Citation48 Some articles did not specify group sizes.
Reported Learning Outputs
Most of the studies reported multiple learning outputs for the student-teachers (see ). In the following section, outputs for the student-teachers are reported in four domains set by the reviewers based on previous literature and CanMEDS framework: subject-specific learning outputs, pedagogical knowledge and skills, personal outputs and generic skills.
Table 4 Overview of Studies Reporting Types of Learning Outputs
Subject-Specific Learning Outputs
Several studies reported that student-teachers increased their learning about the content they were teaching. Additionally, improved skillset and technical performance were also frequently reported. One article reported better results in objective structured clinical examination (OSCE)Citation39 and another article reported better results in anatomy examinations.Citation21 Furthermore, two articles reported that student-teachers felt better prepared for OSCE after completing the peer teaching program.Citation38,Citation41
Pedagogical Knowledge and Skills
Improved pedagogical knowledge and skills were reported in several articles, where student-teachers reported developing better understanding and awareness of the teaching process and feedback strategies. In one study the student-teachers reported improved teaching skills, which they in turn considered helpful to their future roles as residents and attendings within the field of surgery.Citation43
Personal Outputs and Generic Skills
Many of the studies found teaching activities to be useful related to personal outputs such as confidence, self-awareness and courage. In one longitudinal mixed method study within anatomy, student-teachers reported strengthened confidence, optimism and resilience.Citation24 In several studies, student-teachers thought of the experience as helpful in improving their generic skills such as communication, teamwork, leadership and becoming role models for their junior peers. The teaching experience was also considered as supporting students’ professional identity formation.Citation55,Citation57,Citation64
Three studies reported unwanted outputs of peer teaching.Citation29,Citation30,Citation34 Two of those found that student-teachers experienced lack of control and authority.Citation29,Citation30 One of the three studies found that student-teachers felt uncomfortable teaching their peers due to the lack of necessary skills.Citation34 The authors suggested that this is likely caused by student-teachers receiving inadequate training before taking on the teacher role.Citation34
Methodological Quality of Studies
Quality Assessment
All the included quantitative studies were quality assessed using MERSQI. The scores ranged from 6 (lowest)Citation50,Citation58,Citation64 to 13 (highest),Citation22,Citation40 and the average score for all the included quantitative studies was 10. As eight of the studies reported qualitative research, they were not subjected to MERSQI score assessment.Citation26,Citation27,Citation32,Citation33,Citation48,Citation49,Citation55,Citation57 No articles were excluded based solely on their MERSQI score.
Study Design
A mixed-method study design was used in 67% (30/45) of the included studies, with qualitative and quantitative data extracted from student-teacher(s) and/or student-learner(s). Qualitative study design was used in 18% (8/45) of the studies, and 16% (7/45) had a quantitative study design. As shown in , most of the studies included in this review used self-reported data to gather information about learning outputs from peer teaching experiences. Questionnaires and interviews were the most frequently used data collection methods. Most questionnaire-based studies included closed-ended questions with Likert scale response options, whereas some also used open-ended questions or comments to collect qualitative data. Six studies included external data sources such as exams, practical/oral exams, and evaluation by student-learners.
Table 5 Overview of Studies Reporting Learning Outputs for Student-Teachers Using Various Data Sources
Relation Between Learning Outputs and Data Source of Studies
Among studies using self-reports as data source, 61% (25/41) reported subject-specific learning outputs, 49% (20/41) reported learning outputs related to pedagogical knowledge and skills, 34% (14/41) reported learning outputs related to personal outputs and 44% (18/41) reported learning outputs related to generic skills. Of the studies using external data sources, 4/6 reported subject-specific learning outputs, 4/6 reported increased pedagogical knowledge and skills and 1/6 reported learning outputs related to personal outputs.
Discussion
This review included findings from 45 different studies published 2012–2022 on student-teachers in undergraduate medical education.Citation13 In line with previous review (including 19 articles published before 2012), we found improved learning outputs for student-teachers within several domains, including better knowledge retention, improved skills, improved leadership, improved communications capabilities and increased confidence.Citation13 Most of the evidence available was based on qualitative interview data or survey responses, whereas only six documented learning outputs using external data such as students’ exam results.Citation21,Citation23,Citation28,Citation39,Citation44,Citation61 We found limited, but encouraging, evidence suggesting that peer teaching programs enhance student-teachers’ performances on exams. In most cases, senior students have already passed their exams in the courses in which they later teach junior students and seldom retake the exam after having functioned as student-teachers. Therefore, comparable knowledge or skills tests are available only in designs where students are teaching fellow students and are taking the same exam, as was done in the study by Aguis et al,Citation21 or in a retrospective cohort study design such as Iwata et al.Citation39 Furthermore, final exam scores might not include testing in the topics where student-teachers have gained peer teaching related learning outputs.
We found that student-teachers tend to rate themselves higher than non-teaching students on competence areas in the CanMEDS framework related to academic knowledge. However, research suggests that student-teachers do not perform better on final exams compared to other academically well-performing students who do not participate as student-teachers, thus suggesting that students’ academic knowledge obtained by being student-teachers, can be explained by a recruitment bias rather than a peer teaching effect itself.Citation61 The evidence base for other competence areas in the CanMEDS framework, is somewhat different. The CanMEDS framework recommends physicians to promote a culture that recognizes, supports and responds effectively to colleagues.Citation16 By being a student-teacher, students become role models for their junior peers, thereby promoting the mentioned culture.Citation5 Furthermore, professional skills such as skills in leadership, communication, feedback and collaboration are all part of the CanMEDS framework.Citation16 Amongst the 45 studies we reviewed, 31 articles reported positive learning outputs related to confidence, leadership skills and professional attributes. However, only one article used the CanMEDS framework to assess student-teachers.Citation61 In 14 of the articles included, peer teaching was associated with increased confidence, which is considered important for the professional development of physiciansCitation66 and for reduced feelings of imposter syndrome.Citation67 In line with previous reviews, we identified increased learning outputs in similar domains of CanMEDS framework as a result of being a student-teacher.Citation13 A judicious suggestion may therefore be to encourage medical schools to expand teaching and learning opportunities for student-teachers and facilitate the development of their CanMEDS competencies by incorporating peer teaching into their curriculum. This approach would provide a platform for students to enhance their leadership and teaching skills, which are critical components of the CanMEDS framework.Citation6,Citation13
Three articles presented negative outputs of being a student-teacher such as lack of authority due to teachers and student-learners being at the same level,Citation29,Citation30 and feeling uncomfortable teaching their peers due to the lack of necessary skills.Citation34 Despite being reported as a negative experience for the student-teachers, the lack of authority and social congruence associated with peer teaching is elsewhere highlighted as one of the key explanations as to why peer teaching works.Citation68 Negative experiences can likely be avoided with proper training in learning facilitation and group management, clarification of expectations and attention given to building mutual respect in the student-teacher and student-learner relationship.Citation69
Future research could consider developing theory-driven designs that test students’ capabilities in all physician roles. Validated tools for assessing professional skills are readily available, yet infrequently used to test learning outputs of peer teaching for the student-teachers.Citation70 Research should look at the methodological approach of peer teaching programs including recruitment, training interventions, design and content. A deeper understanding of the factors contributing to successful student-teacher practices and outputs has the potential to inform a discussion on how peer teaching activities can be applied more systematically in undergraduate medical education programs, thus securing learning benefits for all parties involved.
Strengths and Limitations
Although we did a thorough search in four databases, our findings are likely inexhaustive due to our exclusion of articles not available in full text, not published in English or not matching the search string. Furthermore, unpublished and/or grey literature was not included. To decrease the risk of bias, eight independent reviewers screened the articles using “blind mode”.Citation71 The results were critically synthesized and interpreted by multiple reviewers to enhance the validity of our findings.
Conclusion
Results from this review indicate that serving as a student-teacher during undergraduate medical school is likely to strengthen subject-specific learning outputs, pedagogical knowledge and skills, personal outputs and generic skills. Peer teaching has the potential to foster professional development in many of the competencies outlined in the CanMEDS framework including communication, collaboration, leadership and health advocacy. Hence, peer teaching programs may be strategically planned and designed to enhance learning outputs for all parties involved, including student-teachers.
Abbreviations
CanMEDS, Canadian Medical Education Directions for Specialists; MERSQI, The Medical Education Research Study Quality Instrument; OSCE, objective structured clinical examination.
Disclosure
The authors report no conflicts of interest in this work.
Acknowledgments
Christine Tarlebø Mjøs, senior librarian at University of Bergen, Norway, helped with electronic searches in PubMed.
References
- Cambridge Dictionary [online dictionary]. Cambridge University Press; 2022. Available from: https://dictionary.cambridge.org/. Accessed June 22, 2022.
- Stigmar M. Peer-to-peer teaching in higher education: a critical literature review. Mentor Tutoring. 2016;24(2):124–136. doi:10.1080/13611267.2016.1178963
- Rees EL, Quinn PJ, Davies B, Fotheringham V. How does peer teaching compare to faculty teaching? A systematic review and meta-analysis (.). Med Teach. 2016;38(8):829–837. doi:10.3109/0142159X.2015.1112888
- Yu TC, Wilson NC, Singh PP, Lemanu DP, Hawken SJ, Hill AG. Medical students-as-teachers: a systematic review of peer-assisted teaching during medical school. Adv Med Educ Pract. 2011;2:157–172. doi:10.2147/AMEP.S14383
- Ten Cate O, Durning S. Dimensions and psychology of peer teaching in medical education. Med Teach. 2007;29(6):546–552. doi:10.1080/01421590701583816
- Ten Cate O, Durning S. Peer teaching in medical education: twelve reasons to move from theory to practice. Med Teach. 2007;29(6):591–599. doi:10.1080/01421590701606799
- Edman J, Elsabet J. Peer teaching and social interaction. Retrieved from Sophia, the St Catherine University repository; 2016. Available from: https://sophiastkateedu/maed/160. Accessed June 30, 2023.
- Whitman NA, Fife JD. Peer teaching: to teach is to learn twice. ASHE-ERIC Higher Education Report No. 4, 1988; 1988.
- Fisher D, Frey N, Fisher D, Frey N, Marsh JP, Gonzalez D. Peer tutoring: “To Teach Is to Learn Twice”. J Adolesc Adult Lit. 2019;62(5):583–586. doi:10.1002/jaal.922
- Wong JG, Waldrep TD, Smith TG. Formal peer-teaching in medical school improves academic performance: the MUSC supplemental instructor program. Teach Learn Med. 2007;19(3):216–220. doi:10.1080/10401330701364551
- Peets AD, Coderre S, Wright B, et al. Involvement in teaching improves learning in medical students: a randomized cross-over study. BMC Med Educ. 2009;9(1):55. doi:10.1186/1472-6920-9-55
- Knobe M, Münker R, Sellei RM, et al. Peer teaching: a randomised controlled trial using student-teachers to teach musculoskeletal ultrasound. Med Educ. 2010;44(2):148–155. doi:10.1111/j.1365-2923.2009.03557.x
- Burgess A, McGregor D, Mellis C. Medical students as peer tutors: a systematic review. BMC Med Educ. 2014;14(1):115. doi:10.1186/1472-6920-14-115
- Bowyer ER, Shaw SC. Informal near-peer teaching in medical education: a scoping review. Educ Health. 2021;34(1):29–33. doi:10.4103/efh.EfH_20_18
- Benè KL, Bergus G. When learners become teachers: a review of peer teaching in medical student education. Fam Med. 2014;46(10):783–787.
- CanMEDS framework website. 2022 Royal College of physicians and surgeons of Canada; 2022. Available from: https://www.royalcollege.ca/rcsite/canmeds/about-canmeds-e. Accessed June 22, 2022.
- Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71
- Reed DA, Beckman TJ, Wright SM, Levine RB, Kern DE, Cook DA. Predictive validity evidence for medical education research study quality instrument scores: quality of submissions to JGIM’s Medical Education Special Issue. J Gen Intern Med. 2008;23(7):903–907. doi:10.1007/s11606-008-0664-3
- Reed DA, Cook DA, Beckman TJ, Levine RB, Kern DE, Wright SM. Association between funding and quality of published medical education research. JAMA. 2007;298(9):1002–1009. doi:10.1001/jama.298.9.1002
- Cook DA, Reed DA. Appraising the quality of medical education research methods: the medical education research study quality instrument and the Newcastle-Ottawa scale-education. Acad Med. 2015;90(8):1067–1076. doi:10.1097/ACM.0000000000000786
- Agius A, Stabile I. Undergraduate peer assisted learning tutors’ performance in summative anatomy examinations: a pilot study. Int J Med Educ. 2018;9:93–98. doi:10.5116/ijme.5aa3.e2a6
- Ahmad SE, Farina GA, Fornari A, Pearlman RE, Friedman K, Olvet DM. Student perception of case-based teaching by near-peers and faculty during the internal medicine clerkship: a noninferiority study. J Med Educ Curric Dev. 2021;8:23821205211020762. doi:10.1177/23821205211020762
- Ahn JS, French AJ, Thiessen ME, Kendall JL. Training peer instructors for a combined ultrasound/physical exam curriculum. Teach Learn Med. 2014;26(3):292–295. doi:10.1080/10401334.2014.910464
- Alvarez S, Schultz J-H. Professional and personal competency development in near-peer tutors of gross anatomy: a longitudinal mixed-methods study. Anat Sci Educ. 2019;12(2):129–137. doi:10.1002/ase.1798
- Blohm M, Krautter M, Lauter J, et al. Voluntary undergraduate technical skills training course to prepare students for clerkship assignment: tutees’ and tutors’ perspectives. BMC Med Educ. 2014;14:71. doi:10.1186/1472-6920-14-71
- Bugaj TJ, Blohm M, Schmid C, et al. Peer-assisted learning (PAL): skills lab tutors’ experiences and motivation. BMC Med Educ. 2019;19(1):353. doi:10.1186/s12909-019-1760-2
- Burgess A, Dornan T, Clarke AJ, Menezes A, Mellis C. Peer tutoring in a medical school: perceptions of tutors and tutees. BMC Med Educ. 2016;16(1):85. doi:10.1186/s12909-016-0589-1
- Cansever Z, Avsar Z, Cayir Y, Acemoglu H. Peer teaching experience of the first year medical students from Turkey. J Coll Physicians Surgeons Pak. 2015;25(2):140–142.
- Cho M, Lee YS. Voluntary peer-mentoring program for undergraduate medical students: exploring the experiences of mentors and mentees. Korean J Med Educ. 2021;33(3):175–190. doi:10.3946/kjme.2021.198
- Chopra N, Zhou DB, Fallar R, Chadha N. Impact of near-peer education in a student-run free ophthalmology clinic on medical student teaching skills. J Surg Educ. 2020;77(6):1503–1510. doi:10.1016/j.jsurg.2020.05.012
- Clarke AJ, Burgess A, Menezes A, Mellis C. Senior students’ experience as tutors of their junior peers in the hospital setting. BMC Res Notes. 2015;8:743. doi:10.1186/s13104-015-1729-0
- Cusimano MC, Ting DK, Kwong JL, Van Melle E, MacDonald SE, Cline C. Medical students learn professionalism in near-peer led, discussion-based small groups. Teach Learn Med. 2019;31(3):307–318. doi:10.1080/10401334.2018.1516555
- de Menezes S, Premnath D. Near-peer education: a novel teaching program. Int J Med Educ. 2016;7:160–167. doi:10.5116/ijme.5738.3c28
- Dickman N, Barash A, Reis S, Karasik D. Students as anatomy near-peer teachers: a double-edged sword for an ancient skill. BMC Med Educ. 2017;17(1):156. doi:10.1186/s12909-017-0996-y
- Engels D, Haupt C, Kugelmann D, Dethleffsen K. The peer teachers’ perception of intrinsic motivation and rewards. Adv Physiol Educ. 2021;45(4):758–768. doi:10.1152/advan.00023.2021
- Gottlieb Z, Epstein S, Richards J. Near-peer teaching programme for medical students. Clin Teach. 2017;14(3):164–169. doi:10.1111/tct.12540
- Hall S, Harrison CH, Stephens J, et al. The benefits of being a near-peer teacher. Clin Teach. 2018;15(5):403–407. doi:10.1111/tct.12784
- Gandhi A, Primalani N, Raza S, Marlais M. A model for peer-assisted learning in paediatrics. Clin Teach. 2013;10(5):291–295. doi:10.1111/tct.12031
- Iwata K, Furmedge DS, Sturrock A, Gill D. Do peer-tutors perform better in examinations? An analysis of medical school final examination results. Med Educ. 2014;48(7):698–704. doi:10.1111/medu.12475
- Khaw C, Raw L. The outcomes and acceptability of near-peer teaching among medical students in clinical skills. Int J Med Educ. 2016;7:188–194. doi:10.5116/ijme.5749.7b8b
- Kumar PR, Stubley T, Hashmi Y, Ahmed U. Clinical Orthopaedic Teaching programme for Students (COTS). Postgrad Med J. 2020;97(1154):749–754.
- Liew SC, Sow CF, Sidhu J, Nadarajah VD. The near-peer tutoring programme: embracing the ‘doctors-to-teach’ philosophy--a comparison of the effects of participation between the senior and junior near-peer tutors. Med Educ Online. 2015;20(1):27959. doi:10.3402/meo.v20.27959
- Lin JA, Farrow N, Lindeman BM, Lidor AO. Impact of near-peer teaching rounds on student satisfaction in the basic surgical clerkship. Am J Surg. 2017;213(6):1163–1165. doi:10.1016/j.amjsurg.2016.09.030
- Lufler RS, Lazarus MD, Stefanik JJ. The spectrum of learning and teaching: the impact of a fourth-year anatomy course on medical student knowledge and confidence. Anat Sci Educ. 2020;13(1):19–29. doi:10.1002/ase.1872
- Mohd Shafiaai MSF, Kadirvelu A, Pamidi N. Peer mentoring experience on becoming a good doctor: student perspectives. BMC Med Educ. 2020;20(1):494. doi:10.1186/s12909-020-02408-7
- Naeger DM, Conrad M, Nguyen J, Kohi MP, Webb EM. Students teaching students: evaluation of a “near-peer” teaching experience. Acad Radiol. 2013;20(9):1177–1182. doi:10.1016/j.acra.2013.04.004
- Nelson AJ, Nelson SV, Linn AM, Raw LE, Kildea HB, Tonkin AL. Tomorrow’s educators. today? Implementing near-peer teaching for medical students. Med Teach. 2013;35(2):156–159. doi:10.3109/0142159X.2012.737961
- Nshimiyimana A, Cartledge PT. Peer-teaching at the University of Rwanda - a qualitative study based on self-determination theory. BMC Med Educ. 2020;20(1):230. doi:10.1186/s12909-020-02142-0
- Prunuske A, Houss B, Wirta Kosobuski A. Alignment of roles of near-peer mentors for medical students underrepresented in medicine with medical education competencies: a qualitative study. BMC Med Educ. 2019;19(1):417. doi:10.1186/s12909-019-1854-x
- Reyes-Hernandez CG, Carmona Pulido JM, De la Garza Chapa RI, et al. Near-peer teaching strategy in a large human anatomy course: perceptions of near-peer instructors. Anat Sci Educ. 2015;8(2):189–193. doi:10.1002/ase.1484
- Sahoo S, Venkatesan P, Myint KT, Moe S. Peer-assisted learning activities during undergraduate ophthalmology training: how the medical students of Asia Pacific region perceive. Asia-Pac J Ophthalmol. 2015;4(2):76–79. doi:10.1097/APO.0000000000000094
- Siddiqi HS, Rehman R, Syed FF, Martins RS, Ibrahim MT, Alam F. Peer-Assisted Learning (PAL): an innovation aimed at engaged learning for undergraduate medical students. J Pak Med Assoc. 2020;70(11):1996–2000. doi:10.5455/JPMA.29714
- Silbert BI, Lake FR. Peer-assisted learning in teaching clinical examination to junior medical students. Med Teach. 2012;34(5):392–397. doi:10.3109/0142159X.2012.668240
- Srivastava TK, Waghmare LS, Mishra VP, Rawekar AT, Quazi N, Jagzape AT. Peer Teaching to Foster Learning in Physiology. J Clin Diagn Res. 2015;9(8):Jc01–Jc06. doi:10.7860/JCDR/2015/15018.6323
- Tamachi S, Giles JA, Dornan T, Hill EJR. “You understand that whole big situation they’re in”: interpretative phenomenological analysis of peer-assisted learning. BMC Med Educ. 2018;18(1):197. doi:10.1186/s12909-018-1291-2
- Walser J, Horneffer A, Oechsner W, Huber-Lang M, Gerhardt-Szep S, Boeckers A. Quantitative and qualitative analysis of student tutors as near-peer teachers in the gross anatomy course. Ann Anat. 2017;210:147–154. doi:10.1016/j.aanat.2016.10.007
- Yang MM, Golden BP, Cameron KA, et al. Learning through teaching: peer teaching and mentoring experiences among third-year medical students. Teach Learn Med. 2021;2021:1–8.
- Young I, Montgomery K, Kearns P, Hayward S, Mellanby E. The benefits of a peer-assisted mock OSCE. Clin Teach. 2014;11(3):214–218. doi:10.1111/tct.12112
- Nomura O, Onishi H, Kato H. Medical students can teach communication skills - a mixed methods study of cross-year peer tutoring. BMC Med Educ. 2017;17(1):103. doi:10.1186/s12909-017-0939-7
- Zuo SW, Cichowitz C, Shochet R, Venkatesan A. Peer-led, postanatomy reflection exercise in dissection teams: curriculum and training materials. Med Ed PORTAL. 2017;13:10565.
- Avonts M, Michels NR, Bombeke K, et al. Does peer teaching improve academic results and competencies during medical school? A mixed methods study. BMC Med Educ. 2022;22(1):431. doi:10.1186/s12909-022-03507-3
- Aydin MO, Kafa IM, Ozkaya G, Alper Z, Haque S. Peer-assisted skills learning in structured undergraduate medical curriculum: an experiential perspective of tutors and tutees. Niger J Clin Pract. 2022;25(5):589–596. doi:10.4103/njcp.njcp_1410_21
- Diebolt JH, Cullom ME, Hornick MM, Francis CL, Villwock JA, Berbel G. Implementation of a Near-Peer Surgical Anatomy Teaching Program into the Surgery Clerkship. J Surg Educ. 2022;80(1):1–6. doi:10.1016/j.jsurg.2022.08.005
- Orsini E, Quaranta M, Mariani GA, et al. Near-peer teaching in human anatomy from a tutors’ perspective: an eighteen-year-old experience at the University of Bologna. Int J Environ Res Public Health. 2022;19(1):398. doi:10.3390/ijerph19010398
- Shah S. Evaluation of online near-peer teaching for penultimate-year objective structured clinical examinations in the COVID-19 era: longitudinal study. JMIR Med Educ. 2022;8(2):e37872. doi:10.2196/37872
- Kerr J. Confidence and humility: our challenge to develop both during residency. Can Fam Physician. 2007;53(4):704–707.
- Khan M. Imposter syndrome-a particular problem for medical students. BMJ. 2021;375:n3048. doi:10.1136/bmj.n3048
- Loda T, Erschens R, Loenneker H, et al. Cognitive and social congruence in peer-assisted learning – a scoping review. PLoS One. 2019;14(9):e0222224. doi:10.1371/journal.pone.0222224
- Thompson C. The construct of “Respect” in teacher-student relationships: exploring dimensions of ethics of care and sustainable. J Leadersh Educ. 2018;17:42–60. doi:10.12806/V17/I3/R3
- Bandiera G, Sherbino J, Frank JR. The CanMEDS Assessment Tools Handbook. An Introductory Guide to Assessment Methods for the CanMEDS Competencies. Ottawa: The Royal College of Physicians and Surgeons of Canada; 2006:0-9739158-6–2.
- Day SJ, Altman DG. Statistics notes: blinding in clinical trials and other studies. BMJ. 2000;321(7259):504. doi:10.1136/bmj.321.7259.504