A novel instrument of cognitive and social congruence within peer-assisted learning in medical training: construction of a questionnaire by factor analyses

Background Peer-assisted learning is effective due to cognitive and social congruence. Cognitive congruence is created by sharing a similar knowledge base between students and student tutors. Social congruence is defined as having similar social roles. A questionnaire of these concepts was newly constructed, and this study explored the factor analysis of the instrument. Methods In a cross-sectional method design cognitive and social congruence were operationalised by exploratory and confirmatory factor analyses. Cognitive and social congruence were assessed by validated questionnaires and through self-developed items that were collected through semi-structured interviews.. The questionnaire consisted of 26 items that were rated on a five-point Likert scale, from 0 = I strongly disagree to 4 = I strongly agree. Results 676 medical students participated in the study. Exploratory factor analysis for students resulted in a two-factor solution with cognitive and social congruence as confirming factors. New findings showed that the items non-judgmental learning atmosphere and informal communication were associated to cognitive congruence, effectiveness and comprehensible explanations belonged to social congruence. Confirmatory factor analysis for student tutors confirmed the resulting two-factor solution. Conclusions As one of the largest investigation of cognitive and social congruence, this study investigated the underlying mechanisms of effective PAL using factor analysis. Cognitive congruence was created by sharing the same knowledge. Knowledge transfer might play a relevant role in cognitive congruence. Social congruence focused on the relationship between student tutors and students, which might impact the content level. Practical recommended actions (using the same language) could be implemented.