"Between formulas and freestyle" - a qualitative analysis of peer tutor preparation and its impact on peer relations.

Background: Peer tutorials are widely used in medical and health professions education. Some evidence suggests that peer tutorials can have positive effects for student peer tutors and tutees alike. To promote these positive effects, peer tutors are often prepared for their tasks. However, detailed information about this preparation is missing in the literature. The present study thus examines from the tutors' perspective how peer tutor preparation is conducted, both in interprofessional and uniprofessional contexts, and how this preparation affects peer relations.

Methods: A qualitative design was used for the study. For data gathering, three online focus group discussions were conducted with student peer tutors from uniprofessional and interprofessional settings who had a background in health professions. Data were analysed inductively via thematic analysis.

Results: A total of 19 individuals participated in three focus group discussions (n = 6/n = 6/n = 7). From the participants' perspective, preparation measures were heterogenous. Of a wide range of different measures, some were perceived as more helpful, others as less helpful. In analysing the data, three relevant themes came up which were dereived from the peer tutors' perspective: roles, eye level, and (self-)trust. All three themes were found to be closely related and appeared to have a direct influence on peer relations. This influence on the learning/teaching process was either positive or negative depending on the respondents' experiences.

Conclusion: From the peer tutors' perspective, the preparation they received affected their relationships with their peers in a variety of ways, influenced by the context and the peer tutors' needs. This finding should be taken into account when planning and implementing future preparatory activities. In addition, further pedagogical considerations and discussions about preparatory activities for peer tutors and their potential impact on social and cognitive congruence are needed.