Peer influence in clinical workplace learning: A study of medical students’ use of social comparison in clinical practice

Undergraduate students in clinical workplace frequently compare their own experiences with those of peers. The research reported in this thesis shows that these so called social comparisons are vital to the process of learning in clinical practice. The first study confirms students’ tendency to compare themselves with peers and shows that their responses to the comparisons are more often stimulating for learning than discouraging. After that, an experimental study demonstrates how students’ estimates of their future performance in clinical situations are influenced by peer comparisons. Following, a qualitative study shows that students’ comparisons with peers are about the abilities to perform clinical tasks, and to interact with others such as patients and staff, and about issues of the self, such as behaviours, and attitudes. This study reveals that comparison peers are used as benchmarks against which students appraise themselves at their current stage of development and determine what they can aspire to in the near future. The effect of these comparisons is mainly positive but negative outcomes, like distress, are also reported. Therefore, the last study is about differences in comparison behaviours between students expressing low and high levels of distress in order to be able to help high-distress students develop better comparison strategies. The thesis ends with implications for educational practice like the advice to support peer encounters and to talk with students about their comparison behaviours in mentoring conversations. Such conversations provide opportunities to reveal assumptions worth encouraging and to watch for less positive comparison outcomes.