Enhancing gynecological examination training for international medical students: a comparative study of peer role-play and peer assessment

BACKGROUND: Gynecological examination training for international medical students (IMS) presents unique challenges in cultural sensitivity, patient communication, and clinical skill acquisition. Traditional teaching methods often lack realistic patient interaction and immediate feedback, limiting student engagement and competency development. OBJECTIVE: To evaluate the preliminary effectiveness of integrating peer role-playing simulation and peer assessment into a collaborative learning environment for teaching gynecological examination skills to IMS. METHODS: A comparative study was conducted with two consecutive cohorts of IMS enrolled at Zhejiang University. The 2019 cohort (n = 72) received traditional collaborative group learning, while the 2020 cohort (n = 81) underwent an enhanced curriculum featuring instructor-led demonstration and peer role-playing simulation. Clinical competency, engagement levels and course satisfaction were compared between groups. RESULTS: The 2020 cohort demonstrated significant improvements across multiple domains compared to the 2019 cohort. Specifically, the experimental group showed higher active participation rates (64.2% vs. 41.7%, p < 0.01) and course engagement (p < 0.05). While technical procedural proficiency was comparable between groups, the 2020 cohort achieved significantly higher scores in doctor-patient communication, humanistic care, and preoperative preparation (p < 0.05), with a notably large effect size observed for communication skills (Cohen’s d = 0.89). CONCLUSION: This exploratory study suggests supplementing traditional instruction with peer role-playing and assessment significantly enhances IMS engagement and non-technical clinical competencies (communication and empathy) without compromising technical skill acquisition. These findings support the feasibility of this cost-effective model in resource-limited educational settings and warrant further investigation with rigorous experimental designs.