Peer Evaluation Rating Behavior in Differentiating Student Performance in Undergraduate Medical Education: An Observational Study

Peer evaluation of students' performance within teams has the potential to support the development and assessment of teamwork skills, which are critical for healthcare collaboration and patient care. Key to effectively implementing peer evaluation in undergraduate medical education is assessing medical students' ability to evaluate their peers' professional and learning behaviors. This observational study examines peer rating behaviors of medical students in differentiating their peers' professional and academic performance. Two cohorts of osteopathic medical students completed Team-Based Learning sessions in a preclinical systems course and subsequently evaluated their teammates' performance. The peer evaluation rubric consisted of eight Likert-scale items assessing students' preparedness, teamwork, and professionalism, and two open-ended questions regarding students' strengths and areas for improvement. Students rated their peers highly, with 54.9% of Cohort 1 and 83.3% of Cohort 2 giving their peers the highest possible Likert ratings. Cohort 1 exhibited greater variation in distribution of ratings than Cohort 2. Pearson correlation analysis revealed that rubric items related to individual performance such as preparation, active engagement, and dependability correlated positively with course examination scores. In response to the open-ended rubric question regarding areas for improvement, 47.7% of Cohort 1 and 29.3% of Cohort 2 provided constructive, actionable feedback in their responses. Qualitative analysis identified similar dominant themes in both cohorts, including the encouragement of active and confident participation and respectful and inclusive teamwork. Our study suggests thoughtfully designed and implemented peer evaluation can function as a reliable formative tool that fosters accountability, teamwork, and professional growth among future physicians.