The following steps should be taken into consideration when planning a Peer Observation or a Peer-to-peer Learning on AMR/AMS:

1. Define Clear Learning Objectives and Scope for AMR/AMS P2P Learning: Identify specific AMR/AMS topics, skills (e.g., applying a new prescribing guideline, performing an IPC technique, interpreting an antibiogram, communicating AMR risks), or problem-solving challenges that are well-suited for peer exchange and collaborative learning.
2. Select Appropriate P2P Model and Structure: Choose a P2P model that aligns with the objectives and target audience. This could include:
   • Peer Teaching/Tutoring: More experienced peers (or those who have mastered a specific AMR/AMS concept) teach or tutor less experienced peers.
   • Peer-Assisted Learning (PAL)/Study Groups: Small groups of peers work together to understand complex AMR/AMS material, solve problems, or prepare for assessments.
   • Peer Coaching: Peers provide each other with support, feedback, and encouragement to achieve specific AMR/AMS practice goals.
   • Peer Observation and Feedback: Peers observe each other performing a task (e.g., a clinical interaction related to antibiotic prescribing, an educational session on AMR, an IPC procedure) and provide structured, constructive feedback.
   • Technology-Enhanced Peer Learning: Utilize online platforms for virtual P2P discussions, collaborative projects, or peer assessment of submitted work.
3. Participant Pairing or Grouping: Carefully pair or group participants. This can be based on similar roles, mixed experience levels (for peer tutoring), shared learning goals, or random assignment for diverse perspectives. Ensure groups are small enough to facilitate active participation.
4. Provide Training and Clear Guidelines (for Peer Tutors/Observers/Facilitators): If some peers take on teaching, coaching, or observation roles, provide them with adequate training on how to facilitate learning, provide effective feedback, and manage group dynamics. Clearly outline roles, responsibilities, ground rules for respectful interaction, and any specific protocols for the P2P activity (e.g., observation checklists, feedback frameworks). (Markowski et al., 2021, note the importance of adequate preparation for peer learners).
5. Resource Provision: Make relevant AMR/AMS learning materials, guidelines, case studies, or problem sets available to support the P2P interactions.
6. Facilitation: While P2P learning emphasizes learner autonomy, a facilitator may be needed to set up the structure, provide initial guidance, monitor progress, troubleshoot issues, and potentially guide reflective debriefing sessions to synthesize learning. The level of facilitation can vary.
7. Foster a Supportive and Safe Learning Environment: Crucially, create an atmosphere of trust, mutual respect, and psychological safety where peers feel comfortable asking questions, admitting uncertainties, sharing challenges related to AMR/AMS, and giving/receiving constructive feedback without fear of judgment.

Facilitator’s role (Educator/Program Coordinator): Design and structure the P2P learning experience. Select and prepare appropriate AMR/AMS learning tasks or topics. Train peer tutors/facilitators/observers if applicable. Provide necessary resources and clear guidelines. Create a supportive learning climate. Monitor group dynamics and provide support when needed. Guide overall reflection and help synthesize collective learnings.

Participant’s role (Peer Learner/Peer Teacher/Peer Observer): Actively engage in the learning process by sharing their own AMR/AMS knowledge, experiences, and perspectives. Listen attentively and respectfully to their peers. Provide constructive, specific, and non-judgmental feedback. Ask clarifying questions. Engage in collaborative problem-solving and knowledge co-construction. Take responsibility for their own learning and for supporting the learning of their peers. Reflect on the P2P experience and its impact on their understanding and practice.

Methods

• Peer Assessment/Feedback: Peers evaluate each other’s contributions, understanding, skill performance, or presentations using structured rubrics or feedback forms.
• Self-Reflection: Participants reflect on their own learning, the effectiveness of the P2P interaction, and how they will apply AMR/AMS learnings.
• Observation of P2P Interactions: Facilitators may observe group dynamics, quality of discussion, and collaborative problem-solving skills.
• Knowledge/Skill Application: Assessment of collaboratively produced outputs (e.g., solutions to AMR case studies, shared understanding of a guideline, co-developed educational materials).
• Pre- and Post-Intervention Assessments: If P2P learning is part of a structured intervention, changes in AMR/AMS knowledge, skills, attitudes, or confidence can be measured. (Heidarpoor and Mousavikashi, 2023, used pre-post tests to assess effectiveness of P2PL).
• Participant Satisfaction Surveys: Gathering feedback on the P2P learning experience, perceived benefits, and challenges.

Tools

Peer assessment rubrics or checklists. Structured feedback forms. Observation guides for facilitators. Group project evaluation criteria. Reflective journal prompts. Online platforms with peer review functionalities. Validated questionnaires for assessing teamwork, communication skills, or specific AMR/AMS knowledge/attitudes.