Cognitive and social congruence between students and student tutors: An investigation of peer-assisted learning in medical school

Abstract

‘I would definitely trust my student tutor. I trust that she can estimate her professional competence of what she does know and is able to teach us’ (Loda al., 2020b, p.4). This statement from a medical student shows that peer-assisted learning (PAL) is a well-established concept in the medical training. Moreover, PAL is the teaching of students by students. Based on the previous literature PAL is effective due to the cognitive and social congruence between students and student tutors. Cognitive congruence occurs when students and student tutors share the same language and knowledge framework. Student tutors are perceived as socially congruent by students when tutors have similar social roles and are considered role models. However, the previous literature did not consider behavioural and practical elements of cognitive and social congruence. Thus, this doctoral thesis aims to investigate cognitive and social congruence on behavioural levels.

The thesis is divided into three subprojects. First, a scoping literature review on cognitive and social congruence was conducted for an overview. Second, semi-structured interviews on cognitive and social congruence were conducted with medical students as participants, student tutors as teachers, and lecturers as supervisors. Based on the review and interviews, a novel instrument for cognitive and social congruence was developed and tested using exploratory and confirmatory factor analyses. Using this new instrument, cognitive and social congruence can be assessed and operationalised on a behavioural level from the perspectives of students and student tutors. The results reveal that cognitive congruence is represented by student tutors sharing a familiar language and similar knowledge framework and explaining topics at an appropriate level with high expertise. Social congruence was displayed by sharing similar social roles, being supportive and empathic, asking questions, experiencing an open, stress-free learning atmosphere, sharing experiences, giving tips, and enjoying the tutorial. New findings were that an open, stress-free learning atmosphere and trust in the student tutors belong to both cognitive and social congruence. Furthermore, easy and informal communication or informal contact were associated with cognitive instead of social congruence. The effectiveness of the tutorial and student tutors belongs to social congruence.

Relevant and practical recommendations for action can be derived to train student tutors based on the findings. Future research could also focus on the influence of cognitive and social congruence on further relevant PAL factors, such as small group functioning or individual learning performance.