Peer-assisted learning with peer evaluation feedback in abdominal paracentesis training: a randomized controlled trial

Background Abdominal paracentesis is a core procedural skill for medical undergraduates and a mandatory component of the National Medical Licensure Examination. Traditional clinical skills teaching usually comprises three sequential stages: instructor demonstration, student practice, and instructor-led summative assessment. This model is time-consuming and restricts students’ active participation in the learning process. Peer-Assisted Learning (PAL) has been shown to enhance learning outcomes through collaborative and feedback-rich environments. However, evidence on the application of structured peer evaluation feedback in procedural skills training remains limited. Methods This prospective randomized controlled study enrolled 60 undergraduate interns who attended the abdominal paracentesis practical course at the Clinical Skills Center of Guangdong Provincial People's Hospital between January and December 2025. Participants were randomly allocated to an experimental group ( n = 30) or a control group ( n = 30). The control group received traditional instruction and instructor-led one-by-one assessment. The experimental group received the same instruction but with a structured peer evaluation feedback model based on PAL during the assessment phase: students worked in groups of three, rotating through the roles of operator, evaluator, and assistant. Outcomes included skills performance scores (7 dimensions, 100-point scale) and teaching satisfaction (6-item Likert scale). Results The experimental group achieved significantly higher total operation scores than the control group (88.17 ± 3.53 vs. 83.77 ± 3.63, t = 4.80, P < 0.001). Significant improvements were observed in the dimensions of preparation, disinfection and draping, puncture procedure, and medical ethics ( P < 0.05). In teaching satisfaction, the experimental group scored significantly higher across all six dimensions (cognitive engagement, feedback value, role identification, learning efficiency, psychological safety, and overall acceptance), with all P values <0.001. Conclusion The PAL-based peer evaluation feedback model significantly improves undergraduate interns’ abdominal paracentesis skills and teaching satisfaction. This approach integrates evaluation into the learning process itself: students learn by assessing, and assessment serves as a vehicle for deeper cognitive processing rather than merely a terminal judgment of performance. This model is resource-efficient, easy to implement, and represents a practical pathway for reforming clinical skills training curricula.