EFFECTIVENESS OF PEER-ASSISTED LEARNING ON KNOWLEDGE RETENTION AND ACADEMIC SELF-EFFICACY IN PRECLINICAL MEDICAL STUDENTS: A RANDOMIZED CONTROLLED STUDY

Abstract

Background: Peer-assisted learning (PAL) has emerged as an effective educational strategy in medical education, promoting active learning through structured interaction among students. In preclinical training, where learners face substantial cognitive load and transition challenges, PAL may enhance knowledge retention and foster academic self-efficacy by encouraging collaboration, feedback, and self-regulated learning. However, evidence from randomized controlled studies in preclinical medical students remains limited, necessitating systematic evaluation of PAL’s educational impact. Objectives: To compare the effectiveness of PAL and traditional didactic lectures on knowledge retention, procedural skills, and academic self-efficacy among first-year preclinical medical students, with primary emphasis on Physiology teaching. Methods: A prospective randomized controlled study was conducted among 150 first-year medical students, allocated using a computer-generated random sequence to either a PAL group (n = 75) or a traditional lecture group (n = 75). The intervention was implemented during selected core modules of Cardiovascular Physiology, with supportive integration of related gross anatomical concepts where required for physiological understanding. Outcomes included pre- and post-intervention theory assessments, Objective Structured Practical Examination (OSPE) scores focusing on physiology practical skills, and academic self-efficacy measured using the validated Medical Achievement Self-Efficacy Scale (MASS). Long-term knowledge retention was assessed using a surprise re-test conducted six months after the intervention. Results: Post-intervention theoretical scores improved significantly in the PAL group compared to controls (Mean percentage improvement from baseline: 18.9% vs. 6.8%; p < 0.001). OSPE performance related to physiology practical competencies was higher in the PAL group (mean score: 50.2 vs. 33.5; p < 0.001). At six months, the PAL group retained a greater proportion of post-test knowledge (76%) compared to the control group (52%). Academic self-efficacy scores were significantly higher among PAL participants (p < 0.001; effect size = 0.95). Conclusion: Peer-assisted learning demonstrated significant advantages over traditional lectures in improving knowledge retention, physiology practical skills, and academic self-efficacy among preclinical medical students and may serve as an effective adjunct to conventional physiology teaching.