Near-Peer-Assisted Learning for Hematology Education among First-Year Medical Students: A Quasi-Experimental Study with a Historical Control

Abstract Background: Hematology education during early medical training involves substantial theoretical and practical learning demands. Near-peer-assisted learning (NPAL), informed by cognitive and social congruence theories, provides a learner-centered approach in which senior students facilitate the learning of junior peers. Evidence regarding its effectiveness in practical hematology education remains limited. Objective: To evaluate changes in hematology knowledge following a structured three-phase NPAL intervention and compare practical examination performance with that of a historical control cohort among first-year MBBS students. Materials and Methods: A quasi-experimental study was conducted in May 2025 at Burdwan Medical College, West Bengal, India. The intervention cohort comprised 181 first-year MBBS students and five trained third-year student mentors. The NPAL intervention consisted of three phases: preparatory video-based learning with baseline assessment, small-group peer-led practical laboratory sessions, and post-intervention evaluation. Knowledge was assessed using a multiple-choice test, while practical performance was evaluated using an objective structured practical examination (OSPE) adapted from objective structured clinical examination principles. The OSPE comprised timed stations on hemoglobin estimation, blood grouping, differential leukocyte count, and peripheral blood smear preparation and was assessed using standardized checklists. Student perceptions were assessed using a structured feedback instrument. Post-intervention OSPE performance was compared with that of 200 first-year students from the preceding academic year who served as a historical control cohort. Results: Mean knowledge scores in the NPAL cohort increased significantly from 63.6% at baseline to 78.2% after the intervention (P < 0.0001). The mean post-intervention OSPE score was significantly higher in the NPAL cohort than in the historical control cohort (65.6% ± 13.6% vs. 49.8% ± 12.64%; t = 11.71, P < 0.0001; Cohen’s d = 1.21). More than 88% of students reported improvements in conceptual clarity, confidence, and engagement with hematology practical sessions. Conclusion: The NPAL intervention was associated with significant improvement in hematology knowledge and higher practical examination performance compared with a historical control cohort. Students also reported favorable perceptions of the learning experience. These findings support the potential utility of structured NPAL as an adjunct to undergraduate hematology education. However, the use of a historical control limits causal inference because differences between academic cohorts and other contextual factors may have contributed to the observed differences. Prospective studies using contemporaneous control groups and multicenter designs are warranted to further evaluate the effectiveness and generalizability of NPAL in medical education.