Pedagogically Legitimate but Faculty-Contested: Cultural and Professional Tensions in Peer-Assisted Clinical Skills...

Although evidence supporting peer-assisted learning in clinical skills education is growing, qualitative insights into stakeholder perceptions remain limited. Informed by sociocultural learning perspectives, peer-assisted clinical skills training may be pedagogically effective while simultaneously challenging established educational authority and faculty role boundaries. This study aimed to explore multi-stakeholder perceptions of peer-assisted clinical skills training in the preclinical phase of medical education.

This qualitative study employed a thematic analysis approach. Semi-structured in-depth or focus group interviews were conducted with medical students, peer educators, and faculty members following their initial exposure to peer-led clinical skills sessions. Data were analyzed iteratively to capture shared and divergent perspectives across stakeholder groups.

Peer-assisted training was perceived to enhance psychological safety and promote active learner participation. Peer educators were viewed as technically competent and effective facilitators of learning. However, faculty members expressed tensions related to educational authority, professional identity, and hierarchical norms. These concerns were not primarily linked to the perceived educational quality of peer-assisted training but rather to challenges associated with shifting instructional roles.

The findings suggest that barriers to the integration of peer-assisted clinical skills training are predominantly cultural and institutional rather than pedagogical. Conceptualized through sociocultural and professional identity lenses, faculty resistance appears to reflect role-related tensions rather than opposition to peer learning itself. A supervised hybrid model, integrating peer educators with visible faculty oversight, emerged across stakeholder groups as the most sustainable and acceptable approach for implementing peer-assisted clinical skills training.