From Learner to Pedagogue: How operating room nursing students develop pedagogical competence through peer-assisted...

To explore how postgraduate operating room (OR) nursing students interpret their experiences of peer-assisted learning and near-peer teaching and how these shape pedagogical competence, professional identity and sense of responsibility.

Peer-assisted learning and near-peer teaching are widely used in health professions education to develop supervisory, communication and interpersonal skills. In OR nursing, where practice is complex, interdependent and safety-critical, pedagogical competence is integral to professional performance.

A qualitative, hermeneutically oriented design using reflexive thematic analysis was employed.

Data comprised reflective notes from 27 third-semester students following structured peer-assisted learning and near-peer teaching sessions, during which they supervised first-semester peers in a clinical skills laboratory. Reflexive thematic analysis used inductive coding, iterative theme development and ongoing reflexivity.

Three interconnected themes emerged: (1) Internal meaning-making: Students engaged in identity work marked by tensions between mastery and vulnerability. Mentoring enhanced awareness of learning and fostered pedagogical agency. (2) Interpersonal practice: Teaching shifted from directive instruction to dialogic, relational and ethically responsive facilitation, with authority grounded in sensitivity and calibrated guidance. (3) Learning environment: Students fostered psychological safety through clarity, reassurance and balance between support and autonomy; collaborative supervision enhanced confidence and reduced pressure.

Pedagogical competence in OR nursing is contextual and relational, developing through identity work and stewardship of the learning environment. Peer-assisted learning and near-peer teaching provide authentic opportunities to practise communication, feedback and supervisory judgement. Educational programmes should integrate theory-informed approaches, structured mentor preparation and systematic reflection.