Peer tutor preparations' impact on tutor-tutee-congruence: Insights from expert interviews

In health professions education peer tutorials - a form of peer-assisted learning - are a common approach to support students' learning. Social and cognitive congruence of the participants are key factors influencing their success. With this study we address an important gap: although tutors in peer tutorials are often prepared for their roles and tasks, little is known about how this preparation might affect tutor-tutee-congruence.

A qualitative, exploratory study was conducted. Expert interviews were used to collect the data, which was recorded and transcribed verbatim before being inductively analysed using a reflective thematic analysis approach.

Fifteen experts from seven countries were interviewed. Two main themes with corresponding sub-themes related to tutor-tutee-congruence were developed from the analysis: "Create asymmetry" and "Accept heterogeneity". Two additional themes were derived from this: "They are all the same" and "Make them all the same". Some experts viewed preparation as a hindering factor for tutor-tutee-congruence, while others saw it as simply another aspect of learner heterogeneity. These contradictory positions were bridged by participants' proposal to prepare all learners equally. Their proposal was expected to enable flexible role changes, reduce the extent of incongruences, and equip all learners with relevant competencies for their future careers.

The results on asymmetry and heterogeneity suggest that the expert informants assume that the preparation of the tutors influences social and cognitive congruence. While preparation seems essential for self-efficacy and cognitive congruence, it can unintentionally reinforce social hierarchies and thus impair the learning success. To resolve this tension, broader involvement of all students could strengthen social congruence. In addition, the balance between expertise and proximity to the learner requires a flexible design of tutoring roles. Empirical studies are needed to determine preparation thresholds and to develop effective strategies for promoting peer tutoring in health professions education.