Comparing Near-Peer Instruction Modalities and Performance Trajectories in Graduate Physiology

Graduate-level human physiology courses present significant learning challenges due to rapid pacing, high content density, and cumulative assessment structures. Near-peer instruction (NPI), defined as academic support delivered by students who recently mastered the same material, has emerged as a promising supplement to traditional lecture-based pedagogy in biomedical sciences programs. This study evaluates the effect of NPI modality on exam performance trajectories in a graduate human physiology course (GMSPH730) at Boston University's Master of Science in Medical Sciences (MAMS) program. We hypothesize that students receiving ≥2 hours/week of personalized one-on-one tutoring will demonstrate greater exam score improvement compared to students receiving standardized group TA review sessions and control students, independent of total instructional exposure time, after adjusting for baseline ability, demographics, study behaviors, and psychosocial factors.Data are being collected from 196 graduate students enrolled in Fall 2025. The course offers two optional NPI components: personalized one-on-one tutoring and standardized group TA review sessions, both delivered by high-performing second-year MAMS students who previously earned A/A- grades. In previous semesters, tutor-tutee pairing lacked systematic methodology. To improve compatibility, we implemented a multi-criteria person-environment fit matching model that scores tutors based on shared personality traits and scheduling availability. To date, the NPI program has delivered 604 total tutoring hours and 11 TA review sessions (12 hours total).To assess the effectiveness of our NPI program, treatment groups will include students receiving ≥2 hours/week of one-on-one tutoring for ≥4 weeks (n=41), students attending ≥3 TA review sessions only (n=49, attendance ≥20 minutes), and control students without structured NPI (n=88). The primary outcome is exam score improvement, measured as the difference between Exam 3 and Exam 1 scores. Our analytical approach to assess includes: (1) propensity score matching (1:1 nearest neighbor, caliper=0.2 SD) to balance groups on baseline covariates, (2) multiple regression controlling for total instructional hours to isolate modality effects, (3) mixed-effects longitudinal models examining benefit accumulation across exams, and (4) subgroup analyses identifying heterogeneous treatment effects by baseline performance.Key strengths include pre-treatment covariate measurement, quantitative dosage operationalization, and explicit control for exposure time to distinguish personalization effects from contact hours. Data collection will be completed in December 2025. Results will determine whether personalized NPI improves performance beyond standardized group instruction and identify which students benefit most from individualized peer support, informing resource allocation toward high-impact peer instruction programs in graduate medical sciences curricula. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.