Peer relationships buffer the negative association of online education with education satisfaction and subsequently with study engagement among undergraduate medical students

Background
Due to the COVID-19 pandemic, undergraduate medical students had to follow high amounts of online education. This does not match their preferences and might negatively affect their education satisfaction and study engagement. As low levels of education satisfaction and study engagement are risk factors for burnout and dropout, resources that mitigate these possible negative consequences of forced online education need to be identified. Therefore, the current study investigated 1) the associations of the amount of online education with education satisfaction and study engagement, and 2) whether quantitative (i.e., network size) and qualitative (i.e., perceived support) aspects of peer relationships can buffer the expected negative associations.

Methods
In a cross-sectional study, 372 undergraduate medical students from all eight Dutch medical schools (79.8% female; mean age: 20.4 years) completed an online survey assessing the relevant variables. Data were analysed using correlation and moderated mediation analyses.

Results
The amount of online education was significantly negatively related to education satisfaction and study engagement. Additionally, higher amounts of online education were indirectly associated with lower levels of study engagement through lower levels of education satisfaction. More importantly, both quantitative and qualitative aspects of peer relationships significantly buffered this negative indirect association. Specifically, among medical students with a large peer network or high levels of perceived peer support, the amount of online education was no longer significantly negatively related to education satisfaction and subsequently to study engagement.

Conclusions
The current study underlines the importance of peer relationships in the educational context, since our findings indicate that both the peer network size and the perceived peer support protect medical students’ education satisfaction and study engagement when confronted with study demands, such as forced online education during the COVID-19 pandemic. These findings may be translated into educational efforts that stimulate collaborative learning and the formation of formal peer networks.