Sat, Jul 19, 2025
[Archive]
Volume 18, Issue 2 (2025)
JMED 2025, 18(2): 27-35 |
Back to browse issues page
Ethics code: IR.JUMS.REC.1401.098
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Badiyepeymaiejahromi Z, Faselehjahromi M, Rahmanian S, Hojat M. The effect of near-peer-assisted learning on self-efficacy and clinical performance of undergraduate nursing students during clinical internship: A quasi-experimental study. JMED 2025; 18 (2) :27-35
URL: http://edujournal.zums.ac.ir/article-1-2242-en.html
URL: http://edujournal.zums.ac.ir/article-1-2242-en.html
1- Department of Medical-Surgical Nursing, School of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
2- Department of Community Health Nursing, School of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
3- Department of Psychiatric Nursing, School of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
4- Department of Medical-Surgical Nursing, School of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran ,mohsenhojat.mh@gmail.com
2- Department of Community Health Nursing, School of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
3- Department of Psychiatric Nursing, School of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
4- Department of Medical-Surgical Nursing, School of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran ,
Abstract: (222 Views)
Background & Objective: Traditional clinical education methods have not been effective in improving students' clinical performance. Implementing near-peer assisted learning could help address many of the challenges nursing students encounter in their pursuit of effective learning.This study aims to determine the effect of near-peer-assisted learning on self-efficacy and clinical performance of nursing students during clinical internships.
Materials & Methods: This study utilized a quasi-experimental design with a post-test control group. The statistical population included all nursing students participating in clinical internships at Jahrom University of Medical Sciences from 2021 to 2023, totaling 93 students selected through a census method. The intervention group, comprised of 52 students, participated in near-peer assisted learning, while the control group of 41 students received traditional instruction from university instructors. Students' self-efficacy was evaluated using the standard self-efficacy in the clinical performance questionnaire; thus, clinical performance was assessed using the Objective Structured Clinical Examination (OSCE) scores at the end of each period. Data analysis was performed using SPSS 22, the t-test for mean score comparisons, and Chi-square test for qualitative data.
Results: The mean self-efficacy scores were 139.16 ± 0.57 and 109.65 ± 0.89 for the intervention and control groups in post-test, respectively. The mean OSCE scores were 5.09 ± 0.29 and 4.85 ± 0.76 for the intervention and control in post-test. The independent t-test revealed a statistically significant difference in the mean self-efficacy scores between the two groups (p < 0.001, Effect Size = 0.95). However, no significant difference was found in the mean OSCE scores between the groups (p = 0.061, Effect Size = 0.43).
Conclusion: The near-peer assisted learning method has a more significant impact on the self-efficacy of nursing students during clinical internships compared to traditional teaching methods. Furthermore, this approach can be as effective as instructor-led training in enhancing students' clinical performance. Therefore, it is recommended to integrate this method with other educational approaches to further improve clinical performance among nursing students.
Materials & Methods: This study utilized a quasi-experimental design with a post-test control group. The statistical population included all nursing students participating in clinical internships at Jahrom University of Medical Sciences from 2021 to 2023, totaling 93 students selected through a census method. The intervention group, comprised of 52 students, participated in near-peer assisted learning, while the control group of 41 students received traditional instruction from university instructors. Students' self-efficacy was evaluated using the standard self-efficacy in the clinical performance questionnaire; thus, clinical performance was assessed using the Objective Structured Clinical Examination (OSCE) scores at the end of each period. Data analysis was performed using SPSS 22, the t-test for mean score comparisons, and Chi-square test for qualitative data.
Results: The mean self-efficacy scores were 139.16 ± 0.57 and 109.65 ± 0.89 for the intervention and control groups in post-test, respectively. The mean OSCE scores were 5.09 ± 0.29 and 4.85 ± 0.76 for the intervention and control in post-test. The independent t-test revealed a statistically significant difference in the mean self-efficacy scores between the two groups (p < 0.001, Effect Size = 0.95). However, no significant difference was found in the mean OSCE scores between the groups (p = 0.061, Effect Size = 0.43).
Conclusion: The near-peer assisted learning method has a more significant impact on the self-efficacy of nursing students during clinical internships compared to traditional teaching methods. Furthermore, this approach can be as effective as instructor-led training in enhancing students' clinical performance. Therefore, it is recommended to integrate this method with other educational approaches to further improve clinical performance among nursing students.
Keywords: clinical education, peer-assisted learning, self-efficacy, cinical performance, nursing students
Article Type : Orginal Research |
Subject:
Medical Education
Received: 2024/08/4 | Accepted: 2025/04/23 | Published: 2025/07/13
Received: 2024/08/4 | Accepted: 2025/04/23 | Published: 2025/07/13
References
1. Rahimi Z, Badiyepeymaiejahromi Z, Taghizadeganzadeh M. 360-degree evaluation of nursing students' performance. Shiraz E-Medical Journal. 2024;25(11):e148872. [DOI]
2. Chang CY, Gau ML, Tang KY, Hwang GJ. Directions of the 100 most cited nursing student education research: a bibliometric and co-citation network analysis. Nurse Education Today. 2021;96:104645 [DOI]
3. Montaseri MA, Javadpour S, Ramezanli S, Badiyepeymaiejahromi Z. The effect of blended education on nursing students' learning and educational climate in pharmacology internship. Journal of Medical Education Development. 2023;10;15(48):52-61. [DOI]
4. Parchebafieh S, Safavi M, Mashouf S, Salehi S, Esmaeilpour Zanjani S, Bakhshandeh H. Effect of using Peer Assisted Learning approach on clinical self-efficacy of nursing students in Islamic Azad University of Tehran Medical Sciences branch. Journal of Nursing Education. 2018;6(6):8-15.[Online]. Available from: [Accessed: August. 4, 2024]. [DOI]
5. Ghafari S, Atashi V, Taleghani F, Irajpour A, Sabohi F, Yazdannik A. Comparison the effect of two methods of internship and apprenticeship in the field on clinical competence of nursing students. Research in Medical Education. 2022;14(1):64-72. [DOI]
6. Jang A, Song C. Internet of things platform technology used in undergraduate nursing student education: a scoping review protocol. BMJ Open. 2022;12(4):e058556 [DOI]
7. academic nursing education. Iranian Journal of Medical Education. 2014;14(4):323-31. [Online]. Available from: [Accessed: August. 4, 2024]. [DOI]
8. Afaghi E, Rezaei M, Beheshtifar M, Kalroozi F. The effect of peer education on nursing students’ clinical dressing skills and perceived stress scores at Aja University of Medical Sciences. Military Caring Sciences. 2023;10(3):229-37. [Online]. Available from: [Accessed: August. 4, 2024]. [DOI]
9. Omidkhoda A, Dehdarirad H, Changizi V. Planning, implementation and evaluation of active learning- teaching methods in inverted classroom,peer learning and virtual education among students in the school of allied medical sciences. Research in Medical Education. 2021;13(3):42-54 [DOI]
10. Secomb J. A systematic review of peer teaching and learning in clinical education. Journal of Clinical Nursing. 2008;17(6):703-16. [DOI]
11. Jauregui J, Bright S, Strote J, Shandro J. A novel approach to medical student peer-assisted learning through case-based simulations. The Western Journal of Emergency Medicine. 2018;19(1):193-197. [DOI]
12. 12. Hajihosseini F, Izadi A, Mahboobi M, Mohammadtabar R. Effect of peer education on practical skills learning of nursing students in clinical skill lab of Mazandaran university of medical sciences. Medical Education Journal. 2013;1(1):13-17. [Online]. Available from: [Accessed: August. 4, 2024]. [DOI]
13. 13. Kayzouri A, Yaghoutimoghaddam H, Sadeghi H, Hoseinzadeh Hesari M, Haghnazar M. The evaluation effect of peer and non-peer education methods on clinical learning of anesthesia students in Sabzevar university of medical sciences 2016-2017. Journal of Sabzevar University of Medical Sciences. 2019;26(4):487-93. [Online]. Available from: [Accessed: August. 4, 2024]. [DOI]
14. Safari M, Yazdanpah B, Mahmoudi F, Yaghobean N. Comparing students’ rate of learning through lecturing and peer group teaching and study their viewpoints. Research in Medical Education. 2018;10(3):24-34. [Online]. Available from: [Accessed: August. 4, 2024]. [DOI]
15. Eslami Akbar R, Hojat M, Badiyepeymaie Jahromi Z. Comparison of teaching through peer learning with the lecture method on the learning level of anesthesiology students at Jahrom university of medical sciences in 2013. Journal of Nursing Education. 2015;4(3):56-65. [Online]. Available from: [Accessed: August. 4, 2024]. [DOI]
16. Moaddab F, Ghanbari A, Paryad E, Jahani M, Sedighi A. The effect of using the peer assisted learning system from the perspective of nursing students: a quasi-experimental study. Horizon of Medical Education Development. 2020;11(1):26-42. [DOI]
17. Cheraghi F, Hassani P, Yaghmaei F, Alavi Majd H. Development and psychometric performance of clinical efficacy. Payesh. 2009;9(1):51-60. [Online]. Available from: [Accessed: August. 4, 2024]. [DOI]
18. Palsson Y, Martensson G, Swenne CL, Adel E, Engstrom M. A peer learning intervention for nursing students in clinical practice education: A quasi-experimental study. Nurse Education Today. 2017;51:81-7. [DOI]
19. Austria MJ, Baraki K, Doig AK. Collaborative learning using nursing student dyads in the clinical setting. International Journal of Nursing Education Scholarship. 2013;10(1):73-80. [DOI]
20. Hellström-Hyson E, Mårtensson G, Kristofferzon ML. To take responsibility or to be an onlooker. Nursing students' experiences of two models of supervision. Nurse Education Today. 2012;32(1):105-10. [DOI]
21. Bandura A. Self-efficacy: The exercise of control. Freeman; 1997. [Online]. Available from: [Accessed: August. 4, 2024]. [DOI]
22. Brannagan KB, Dellinger A, Thomas J, Mitchell D, Lewis-Trabeaux S, Dupre S. Impact of peer teaching on nursing students: perceptions of learning environment, self-efficacy, and knowledge. Nurse Eduction Today. 2013;33(11):1440–1447. [DOI]
23. Kimyai S, Jafari Navimipour E, Mohammadi N. The effect of peer education on practical skills training of dentistry students in restorative preclinic. Iranian Journal of Medical Education. 2011;11(4):418-424. [Online]. Available from: [Accessed: August. 4, 2024]. [PubMed]
24. Heckmann JG, Dütsch M, Rauch C, Lang C, Weih M, Schwab S. Effects of peer-assisted training during the neurology clerkship: a randomized controlled study. Eurpean Journal of Neurolgy. 2008;15(12):1365-70. [DOI]
25. Williams B, Reddy P. Does peer-assisted learning improve academic performance? A scoping review. Nurse Education Today. 2016;42:23-9. [DOI]
26. Goldsmith M, Stewart L, Ferguson L. Peer learning partnership: an innovative strategy to enhance skill acquisition in nursing students. Nurse Education Today. 2006;26(2):123-30 [DOI]
27. Salehi S, Safavi M, Mashoof S, Parchebafieh S, Fesharaki M. Effects of peer education on clinical skills in nursing students, including interns and trainees. Medical Science Journal of Islamic Azad Univesity-Tehran Medical Branch. 2016; 26(1): 36-45. [Online]. Available from: [Accessed: August. 4, 2024]. [DOI]
28. Jackson TA, Evans DJ. Can medical students teach? A near-peer-led teaching program for year 1students. Advance in Physiology Education. 2012;36(3):192-6. [DOI]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
