Stress and stressors of medical student near-peer tutors during courses: a psychophysiological mixed methods study

Structured peer-led tutorial courses are widespread and indispensable teaching methods that relieve teaching staff and contribute to the development of students' competencies. Nevertheless, despite high general stress levels in medical students and associated increases in psychopathology, specific knowledge of peer tutors' additional burdens is very limited.

Sixty student near-peer tutors from two structured peer-teaching programmes volunteered to participate. On multiple occasions in three different course sessions, we assessed tutors' subjective stress, affective state, heart rate variability, and salivary cortisol. Additionally, tutors named everyday and course-specific stressors, which were evaluated by means of content analyses.

The study participation rate was high (63% of all active tutors). The participating tutors are socially well adapted and resilient individuals. They report a variety of stressors such as time pressure, participant characteristics, teacher role demands, and study requirements, but nevertheless display only moderate psychological and physiological stress that decreases over sessions. Tutors' negative affect in sessions is low; their positive affect is consistently high for senior as well as novice tutors. Tutors rate their courses' quality as high and quickly recover after sessions.

Tutors successfully cope with teaching-associated and everyday life demands. The results corroborate the viability and success of current peer-teaching programmes from the tutors' perspective. This study is the first to comprehensively quantify tutors' stress and describe frequent stressors, thus contributing to the development of better peer teaching programmes and tutor qualification training.