Do Students Learn From Playing the Patient? A Study of Peer Role-Play in Prehospital Simulation

INTRODUCTION: Peer role-playing, in which medical students alternate between provider and patient roles, is a core component of peer-assisted learning. While the educational value of playing the provider is well established, the extent to which students gain medical knowledge through acting as patients remains unclear.

METHODS: In this quantitative study with qualitative components, 178 first-year medical students portrayed patients during a high-fidelity prehospital simulation. Medical knowledge was assessed with a 21-item multiple-choice test after simulation (162 responses; 91.0% response rate). An open-ended reflection prompt captured students' perceived learning. Chi-square analyses compared knowledge performance between students who portrayed a given scenario ("Actors") and those who did not ("nonactors"). Qualitative data were analyzed using reflexive thematic analysis.

RESULTS: Quantitative analysis revealed no statistically significant differences in performance between actors and nonactors across test items (P = 0.17-0.99). However, 160 students (89.9%) reported perceived gains in medical knowledge. Thematic analysis identified 3 primary learning mechanisms: observational learning, experiential learning, and direct instruction.

CONCLUSIONS: Although knowledge gains specific to patient roles were not captured through multiple-choice testing, students perceived substantial learning through peer role-play. The student-as-patient role may be intentionally designed to support cognitive as well as affective learning in simulation-based medical education.