Herinek Doreen, Matthes Franziska, Woodward-Kron Robyn, Gadewoltz Pia Natalie, Ewers Michael
Charité - Universitätsmedizin, Berlin corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Augustenburger Platz 1, 13353 Berlin, Germany.
Department of Medical Education, Melbourne Medical School, The University of Melbourne, Victoria 3010, Australia.
Nurse Educ Today. 2025 Jun 25;153:106819. doi: 10.1016/j.nedt.2025.106819.
In health professions education peer tutorials - a form of peer-assisted learning - are a common approach to support students' learning. Social and cognitive congruence of the participants are key factors influencing their success. With this study we address an important gap: although tutors in peer tutorials are often prepared for their roles and tasks, little is known about how this preparation might affect tutor-tutee-congruence.
A qualitative, exploratory study was conducted. Expert interviews were used to collect the data, which was recorded and transcribed verbatim before being inductively analysed using a reflective thematic analysis approach.
Fifteen experts from seven countries were interviewed. Two main themes with corresponding sub-themes related to tutor-tutee-congruence were developed from the analysis: "Create asymmetry" and "Accept heterogeneity". Two additional themes were derived from this: "They are all the same" and "Make them all the same". Some experts viewed preparation as a hindering factor for tutor-tutee-congruence, while others saw it as simply another aspect of learner heterogeneity. These contradictory positions were bridged by participants' proposal to prepare all learners equally. Their proposal was expected to enable flexible role changes, reduce the extent of incongruences, and equip all learners with relevant competencies for their future careers.
DISCUSSION/CONCLUSION: The results on asymmetry and heterogeneity suggest that the expert informants assume that the preparation of the tutors influences social and cognitive congruence. While preparation seems essential for self-efficacy and cognitive congruence, it can unintentionally reinforce social hierarchies and thus impair the learning success. To resolve this tension, broader involvement of all students could strengthen social congruence. In addition, the balance between expertise and proximity to the learner requires a flexible design of tutoring roles. Empirical studies are needed to determine preparation thresholds and to develop effective strategies for promoting peer tutoring in health professions education.
在健康职业教育中，同伴辅导（一种同伴辅助学习形式）是支持学生学习的常见方法。参与者的社会和认知一致性是影响其成功的关键因素。通过本研究，我们解决了一个重要空白：尽管同伴辅导中的辅导者通常会为其角色和任务做好准备，但对于这种准备如何影响辅导者与被辅导者之间的一致性却知之甚少。
进行了一项定性的探索性研究。通过专家访谈收集数据，在使用反思性主题分析方法进行归纳分析之前，对数据进行记录并逐字转录。
采访了来自七个国家的15位专家。分析得出了与辅导者与被辅导者一致性相关的两个主要主题及相应子主题：“制造不对称”和“接受异质性”。由此还衍生出另外两个主题：“他们都一样”和“让他们都一样”。一些专家认为准备是辅导者与被辅导者一致性的阻碍因素，而另一些专家则将其视为学习者异质性的另一个方面。参与者提出的平等对待所有学习者的建议弥合了这些相互矛盾的立场。他们的建议有望实现灵活的角色转变，减少不一致的程度，并使所有学习者具备未来职业所需的相关能力。
讨论/结论：关于不对称和异质性的结果表明，专家受访者认为辅导者的准备会影响社会和认知一致性。虽然准备对于自我效能感和认知一致性似乎至关重要，但它可能会无意中强化社会等级制度，从而损害学习成果。为了解决这种矛盾，所有学生更广泛的参与可以增强社会一致性。此外，专业知识与与学习者的亲近程度之间的平衡需要对辅导角色进行灵活设计。需要进行实证研究来确定准备的阈值，并制定在健康职业教育中促进同伴辅导的有效策略。
