Leveraging near-peer teaching: the impact of cognitive and social congruence on naloxone training

Equipping future clinicians to recognize and reverse opioid overdoses requires experiential training and access to naloxone. Near-peer instruction may leverage cognitive and social congruence to enhance learning compared with traditional faculty-led models. This study evaluated whether near-peer teaching yields superior knowledge gains and attitudes in a naloxone training workshop.

Preclinical medical students completed a 60-minute session comprising a high-fidelity inpatient opioid overdose simulation and hands-on naloxone administration practice. Immediately pre- and post-workshop, participants completed the Opioid Overdose Knowledge Scale (OOKS) and Opioid Overdose Attitudes Scale (OOAS). We compared near-peer-led versus faculty-led sessions using descriptive statistics and independent t-tests. Using an explanatory sequential design, 10 students completed semi-structured interviews exploring preferences for near-peer teaching. Interviews were transcribed and analyzed using grounded theory, applying the concepts of cognitive and social congruence as an analytical lens.

From 2019 to 2022, 537 students attended the workshop, and 288 students provided complete survey data. Near-peer facilitation was associated with higher OOKS scores (84.5% ± 0.09 vs 80.2% ± 0.10 correct; p < 0.001) and more favorable OOAS totals (105.5 ± 8.4 vs 102.4 ± 13.7; p = 0.02) compared with faculty-led sessions. Interviewees highlighted a shared knowledge framework, familiar language/explanations, and understanding of learning challenges. Additionally, interviewees noted informal communication, reduced anxiety, and interest in near-peer students' experiences.

A brief, near-peer-led overdose simulation and naloxone skills workshop was associated with an improvement in medical students' knowledge and attitudes compared to faculty-led delivery. Integrating trained near-peer educators into preclinical curricula may accelerate acquisition of overdose recognition and response skills while promoting clinical readiness. Programs seeking scalable strategies to expand skill-based, practical competencies should consider near-peer models that benefit from students' diverse prior experiences.