Perceived changes in innovation and entrepreneurship competency among medical students following peer-assisted learning: an exploratory study of implementation fidelity

Background Traditional medical innovation and entrepreneurship (I&E) education faces severe faculty constraints. While Peer-Assisted Learning (PAL) offers a scalable alternative, its impact on complex I&E competencies and the reliability of peer-led instruction remain underexplored. This exploratory study evaluates the association of a structured PAL model with students' perceived I&E competency and its implementation fidelity.Methods Fifty-four medical students completed a prospective, six-workshop PAL program. Perceived I&E competency was assessed pre- and post-intervention via a validated 53-item questionnaire. Data were analyzed using paired t-tests or Wilcoxon tests (based on normality) with a Bonferroni correction (p Results Perceived overall I&E competency improved significantly (p Conclusion PAL is positively associated with improvements in medical students' perceived practical I&E competencies. Supported by standardized pedagogical training, peer-led instruction can achieve high implementation fidelity and mitigates instructional variability. This exploratory framework offers a potentially adaptable supplement to traditional faculty-led education.