Comparison of the effectiveness of peer-assisted learning and small-group discussions in teaching forensic medicine in an undergraduate medical program

Introduction: Forensic medicine requires the application of analytical reasoning and medico-legal principles rather than rote memorisation. With the shift to Competency-Based Medical Education (CBME), active learning strategies are increasingly emphasized. Small Group Discussion (SGD) and Peer-Assisted Learning (PAL) are widely used approaches; however, direct comparisons in forensic medicine remain limited.
Objectives: This study compared the effectiveness of PAL and SGD in achieving immediate learning outcomes and sustaining delayed knowledge retention among undergraduate medical students, while also evaluating student engagement and feedback.
Methods: A quasi-experimental crossover study was conducted among 60 MBBS Phase 3 Part 1 students in the Department of Forensic Medicine, P.K. Das Institute of Medical Sciences, Kerala, India. Participants were randomly assigned to two groups and exposed to both PAL and SGD across six modules using a crossover design with a washout period. Immediate post-tests and one-month delayed tests assessed knowledge gain and retention, while engagement and feedback were measured using a validated 5-point Likert-scale questionnaire. Data were analysed using independent sample t-tests and chi-square tests.
Results: Immediate post-test scores were significantly higher with PAL compared to SGD (7.90 ± 1.92 vs. 7.42 ± 2.46; p = 0.042), with a significant advantage in the “Age Estimation” module (p = 0.009), while other modules showed no significant differences. Knowledge retention at one month was comparable (p = 0.475). Engagement scores were high for both strategies, with PAL demonstrating higher proportions of strong agreement.
Conclusions: PAL improves immediate learning outcomes and engagement more than SGD, while both methods achieve similar delayed knowledge retention, supporting a blended approach in forensic medicine teaching.