Peer Learning Has Double Effects in Clinical Research Education: A Qualitative Study

Table 2

Extracted process from qualitative analysis.

Label by activity theory	Extracted process	Text examples (in italics)
(a) Instrument: research design	Awareness that difficult research designs can be learned when encountering the required objects (CQ/RQ)	If I experienced the same kind of difficult design for my own research, I would probably be able to understand.; I have tried various designs and thought that the final design was quite good and mastered it.
	The importance of knowing that there is a wide variety of research designs	If you have a clinical question, there are a number of things you can do.; What you can and cannot say depends on design.; As long as you know that there are different designs, you can consult the experts.
	The importance and difficulty of match of design with CQ/RQ and the significance of experiences	When there is a clinical question, the most difficult part is to decide what kind of research design to use.; I had a hard time in this area, so I have the experience of overcoming this difficulty.
(b) Outcome: research result	Reexamining the designs by looking backward from the expected results	Since you are interested in this, would you be happy if you could get this kind of data from that design, for example?; Does this result from this design change clinical practice?
	Expression of frustration with the timeline of the required outcomes	The goal is clear, and the deadline is imminent, so I feel it’s necessary to move fast toward that goal.; I think I must speed up the process.
(c) Community: seminar	Moments of silence in the seminar due to the gap in the participants’ background knowledge of the instruments (research design and its match with CQ/RQ)	Eventually there was a moment of silence at the end. Maybe it’s because something like a research framework is not formed for beginners and experienced participants have experience and a framework.; Frankly, I did not feel that it rang a bell.
	The significance and interest of presentations beyond one’s specialty	They’re talking about areas that are completely unfamiliar to me, outside of my area of expertise, and I think it’s fun to hear about other areas.; I thought the presentation conveyed the importance of the research to non-specialist physicians.
(d) Division of labor: roles of participants and staff	Different roles between staff and “experienced” participants	I think “experienced” participants are going to encourage, or rather stimulate, or interact with beginners and get the discussion going. Finally, staff will put a sort of seal on it.; Staff was talking about the bigger goals of the research, not just the small point in front of me.
	The role of “experienced” participants: (1) presentation providing concrete examples of CQ/RQ, designs, and process to outcomes	In their presentation, I was very glad to see the precedent of how “experienced” participants have done this kind of process and had these problems.; I know the name of AMED or ERB, but have no idea what steps to take, so watching their presentation, I would say, “Oh, so that is the way to do it”.
	The role of “experienced” participants: (2) specific and concrete questions based on recent experiences	I think that was probably the point they were struggling with so much, so they asked us that question.; The questions are probably questions that “experienced” participants themselves were asked last year and I think they are very important and helpful.

This table shows the charting results of the qualitative analysis. In the analysis, interview texts were intercepted, decontextualized, and coded using the labels generated in Figure 2 based on the activity theory by Engestrӧm. Then, the texts were recontextualized and process-formed. Shown from left to right are labels, extracted processes, and text examples. CQ: clinical question; RQ: research question.