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Peer-assisted learning in simulation-based medical education: a mixed-methods exploratory study
  1. Leo Nunnink1,2,
  2. Andrea Thompson1,2,
  3. Nemat Alsaba3,
  4. Victoria Brazil3
  1. 1Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
  2. 2Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  3. 3Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
  1. Correspondence to Dr Leo Nunnink, Faculty of Medicine, The University of Queensland, Saint Lucia, QLD 4067, Australia; l.nunnink{at}


Introduction Peer-assisted learning (PAL) is well described in medical education but there has been little research on its application in simulation-based education (SBE). This exploratory study aimed to determine the perceptions of senior medical students at two universities to teaching and learning in SBE using PAL (PAL-SBE).

Methods Ninety-seven medical students at two universities working in small groups with facilitator oversight wrote, ran and debriefed a simulation scenario for their peers.

This was a mixed-methods study. Participants completed a written free-text and Likert survey instrument, and participated in a facilitated focus group immediately after the scenario. Thematic analysis was performed on the free-text and focus group transcripts.

Results Student-led scenarios ran without major technical issues. Instructor presence was required throughout scenario delivery and debrief, making the exercise resource intensive. Participant responses were more positive regarding learning as peer teachers in simulation than they were regarding participation as a peer learner. Five themes were identified: learning in the simulated environment; teaching in the simulated environment; teaching peers and taking on an educator role; learning from peers; and time and effort expended. Perceived benefits included learning in depth through scenario writing, improved knowledge retention, understanding the patient’s perspective and learning to give feedback through debriefing.

Conclusion PAL in SBE is feasible and was perceived positively by students. Perceived benefits appear to be greater for the peer teachers than for peer learners.

  • simulation based education
  • simulation
  • medical education
  • interprofessional relations
  • patient experience

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  • Contributors AT, LN and VB determined the study design. All authors contributed to data collection, performed thematic analysis, reviewed and contributed to the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was granted by University of Queensland Low and Negligible Risk Subcommittee (approval number 2017001094) and by Bond University Human Research Ethics Committee (application ID 16172).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplemental information. Key findings of the research are included in the study. Non-identified focus group interview transcripts are available upon request.

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