Training peer supporters in a single-centre medical school: a mixed-methods evaluation using Kirkpatrick’s Four-Level model

BACKGROUND: Medical students face high levels of psychological distress but often hesitate to seek formal support. Peer support programmes offer a student-centred approach to fostering well-being and resilience. This study examines the educational impact of the Ramathibodi Peer Support Programme (Rama PSP), a student-led initiative in Thailand, with a focus on the development of peer supporters. METHOD: Thirty-seven medical students across all six years participated in a 10-week training programme. A mixed-methods design was employed, guided by Kirkpatrick’s Four-Level Model of Training Evaluation. Quantitative data were collected using the mid- and end-course assessments, Rama PSP aptitude assessment, PHQ-9 and GAD-7. Qualitative data were obtained through post-training interviews and analysed using content analysis. RESULTS: Peer supporters demonstrated self-reported significant improvements in key competencies, including clarifying questions, referrals and boundary-setting. No significant changes were observed in PHQ-9 and GAD-7 levels, consistent with the programme’s educational–not therapeutic–focus. Qualitative findings revealed substantial growth in self-awareness (96.2%), self-esteem, self-management and social awareness. Peer supporters reported applying their skills in both formal and informal peer interactions. CONCLUSIONS: Rama PSP suggests that structured peer support training may be associated with perceived improvements in interpersonal competencies and developmental outcomes among medical students. By focusing on peer supporters, the programme may support professional identity formation and complement traditional curricula. Integrating such training could help foster empathy, resilience and a supportive learning environment; however, further research using objective measures is needed.