Effectiveness of Self-Directed Learning through Nesting by Near - Peer Teaching for Phase I MBBS Students: An Interventional Study

Abstract

Background: Self-directed learning (SDL) is a learner-centered educational strategy that promotes autonomy, critical thinking, and lifelong learning. Near-peer teaching, in which senior students facilitate learning for junior students, has emerged as an effective approach to enhance engagement and understanding. Integrating near-peer teaching with a nesting approach that introduces higher-phase concepts into Phase I teaching may further strengthen SDL.

Objective: To evaluate the effectiveness and acceptability of near-peer-assisted SDL through nesting among Phase I MBBS students and compare learning outcomes with conventional SDL.

Methods: This interventional educational study was conducted in the Department of Biochemistry at Netaji Subhash Chandra Bose Medical College, Jabalpur,MP,India, from March to October 2025. A total of 250 Phase I MBBS students were enrolled. Ten Phase III MBBS students served as near-peer tutors. Students were divided into conventional SDL and near-peer-assisted SDL groups. The intervention incorporated nesting by integrating simplified higher-phase concepts into SDL sessions. Learning outcomes were assessed using pre- and post-tests, while student and tutor perceptions were evaluated using validated structured feedback questionnaires. Comparative analysis of post-test scores was performed using paired t-tests, with p < 0.05 considered statistically significant.

Results: Students exposed to near-peer-assisted SDL through nesting achieved significantly higher post-test scores than those undergoing conventional SDL across all batches (Batch A: 25.23 ± 1.12 vs. 15.96 ± 2.49; Batch B: 25.42 ± 1.70 vs. 14.28 ± 3.10; Batch C: 25.91 ± 2.70 vs. 14.18 ± 1.41; p < 0.0001 for all comparisons). Most students reported improved conceptual understanding, motivation, critical thinking, retention, and engagement. Open-ended feedback highlighted interactive discussions, effective doubt resolution, and clinical integration as key strengths. Near-peer tutors also reported enhanced communication skills and reinforcement of their own knowledge.

Conclusion: Near-peer-assisted SDL through nesting significantly improved learning outcomes and was highly acceptable to both learners and tutors. Integrating near-peer teaching with nesting represents an effective educational strategy for enhancing self-directed learning and promoting vertical integration within the Competency-Based Medical Education curriculum.