Enhancing stress physiology learning in MBBS students through peer-assisted and case-based learning: A mixed-methods study

Objectives: Stress physiology is a fundamental yet challenging topic for medical students. Traditional didactic methods often fall short in promoting deep understanding and application. Peer-Assisted Learning (PAL) and Case-Based Learning (CBL) are active learning approaches shown to improve engagement and knowledge retention. A cross-sectional interventional study with a single-group pre-post design was conducted among 200 MBBS Phase I students who completed both pre- and post-tests to evaluate the effectiveness of a combined PALCBL session on improving knowledge of stress physiology. Materials and Methods: A validated questionnaire comprising multiple-choice questions (MCQs) was administered before and after a structured PAL-CBL session facilitated by senior medical students. The session revolved around a relatable case scenario, “The Exam Panic”, exploring physiological and psychological stress responses. Qualitative feedback highlighted improved conceptual clarity, peer relatability, and reduced anxiety around the topic. Statistical analysis included paired t-tests, McNemar’s test, and chi-square tests. Post-intervention scores showed a statistically significant improvement in knowledge p < 0.05. Results: The average number of correct responses per student increased from 165 (82.5%) (pre-test) to 196 (98%) (post-test). Each item showed a significant improvement p < 0.05 using McNemar’s test, while the overall chi-square value was 28.7 p = 8.45 × 10 –8 . Qualitative feedback highlighted the increased understanding, relevance of the case, and appreciation for the peer-led facilitation. Conclusion: The combined PAL-CBL approach significantly enhanced understanding of stress physiology and offered relatable strategies for managing academic stress , making it a valuable tool in early medical education.