Peer tutoring in clinical simulation for health sciences education: a systematic review

Simulation-Based Education and peer tutoring have become relevant pedagogical strategies in health sciences education, as they promote active, safe, and collaborative learning. However, studies demonstrating their combined benefits have not yet been sufficiently systematized. This systematic review analyzes the evidence on the implementation of peer tutoring and simulation-based teaching for the development of technical and non-technical skills among health sciences students, based on experimental and quasi-experimental interventions.

A search was conducted in the Web of Science, Scopus, and PubMed databases, including experimental and quasi-experimental studies published between 2020 and 2025. Eleven studies met the inclusion criteria, with a total sample of 860 students and 107 peer tutors.

The results show that most interventions were implemented in low- to medium-complexity simulation settings and primarily reached Level 2 of Kirkpatrick's evaluation model, assessing knowledge, skills, and attitudes. Peer tutoring demonstrated significant benefits in technical skills (e.g., specific clinical procedures) and in non-technical skills such as self-confidence, self-efficacy, communication, motivation, and reflection. Additionally, high levels of student satisfaction, reduced anxiety, and the creation of psychologically safe learning environments were reported. The role of the peer tutor is characterized by cognitive and social proximity to students, acting as a learning facilitator, provider of feedback, and promoter of a climate of trust. However, the studies also revealed methodological limitations, including small sample sizes, non-randomized designs, and the absence of longitudinal follow-up.

In conclusion, the combination of Simulation-Based Education and peer tutoring represents a cost-effective and pedagogically sound strategy for health professions education. Future research should incorporate more rigorous designs, larger samples, and long-term evaluations, as well as formal training programs for peer tutors under faculty supervision.