Pedagogy in practice: a qualitative analysis of evidence-based teaching methods used by graduate-entry near-peer medical educators.

Introduction: Near-peer teaching (NPT) has become a fundamental component of modern medical education, theoretically supported by principles of social and cognitive congruence. While the benefits for both learners and educators are well-documented, the actual pedagogical craft including the specific teaching strategies and philosophies employed by Near-Peer Educators (NPEs) remains largely unexamined. This study aims to explore this pedagogical perspective within a cohort of Graduate-Entry Medicine (GEM) students delivering foundational anatomy and physiology teaching. Methods: This study employed a qualitative research design utilizing reflexive thematic analysis of retrospective written reflective accounts. Participants were GEM students employed as Senior Teaching Assistants at Swansea University Medical School. Over two academic cohorts (2022/23 and 2023/24), NPEs completed a brief 'Clinical Educators Programme' and submitted reflective essays on their teaching experiences. A total of 82 essays were analyzed to identify emergent themes regarding the NPEs' teaching practices. Results: Near-Peer Educators engaged in a sophisticated pedagogical craft characterized by two central, interconnected themes. They employed a Cognitive Toolkit wherein they deliberately applied evidence-based cognitive science principles such as retrieval practice, dual coding, and concrete examples to manage cognitive load. A second theme of the development of a Humanistic Framework to foster a supportive learning environment was also identified. This included the active establishment of psychological safety, the use of universal design, and adaptive teaching strategies to prioritize learner wellbeing and inclusivity. Discussion: The findings characterize GEM NPEs as reflective practitioners who move beyond intuitive teaching to blend the science of learning with a deeply relational, humanistic approach. The use of the Cognitive Toolkit demonstrates the efficacy of brief formal pedagogical training, while the Humanistic Framework suggests that NPEs actively construct social congruence rather than relying solely on inherent peer traits. Furthermore, the latter mirrors the values of relationship-centered clinical care. We conclude that NPE training should evolve from instruction in techniques to the development of communities of practice. NPE training should be reconceptualized not merely as academic preparation, but as a foundational element of clinical training that develops medical professionals and educators who are as relational as they are technical.