Assessing Medical Student Perceptions of a United Kingdom Medical Licensing Examination (UKMLA) Aligned Applied Knowledge Test (AKT) -Focused Teaching Programme: A Longitudinal Study

Abstract Background The United Kingdom Medical Licensing Assessment (UKMLA), introduced in 2024, establishes a national standard for medical graduate competence and is compulsory for registration with the General Medical Council. Evidence from similar licensing examinations supports near-peer teaching as an effective preparatory approach. This study assesses a longitudinal, near-peer, UKMLA-aligned teaching programme delivered by OSCEazy, evaluating its perceived impact on student knowledge, confidence, preparedness, motivation, and anxiety. The findings inform scalable strategies to enhance UKMLA readiness. Methods A longitudinal 23-session, near-peer, UKMLA-aligned teaching programme was delivered online by medical students from September 2024 to January 2025. Sessions focused on AKT preparation and were mapped to the UKMLA content framework. Pre- and post-intervention questionnaires assessed perceived knowledge, confidence, preparedness, motivation, and anxiety. Quantitative data were analysed using descriptive statistics and Wilcoxon signed-rank tests, with thematic analysis applied to free-text responses. Results A total of 496 responses were analysed (224 pre- and 272 post-intervention), with no baseline differences. Post-intervention, students demonstrated significant improvements in UKMLA understanding, confidence, preparedness, knowledge, and motivation (all p≤0.01), along with reduced exam-related anxiety (p