This quasi-experimental, mixed model study will be conducted at Department of Anesthesiology and Critical Care, AIIMS, Bhubaneswar after taking approval from Institute Ethics Committee over a period of 6-9 months. Resident doctors of Department of Anesthesiology and Critical Care will be enrolled for the study. Any resident doctor who refuses to participate and appearing for final examination within 6 months will be excluded.

Learning model: This peer-assisted learning model involves creating a WhatsApp (WA) group for all eligible residents and participating faculty members, with one faculty member assigned weekly to facilitate learning and assessment. A teaching roster covering basic anatomy, physiology, pharmacology, monitoring, and equipment will be prepared for six months in advance. Anaesthesiology trainees, from the same or different semesters, will discuss these topics during clinical postings in the OT or ICU, with faculty facilitating on-table or bedside discussions to address doubts. Each evening, junior residents will share their learning points (at least 2) on the WA group to foster peer motivation. Faculty will supervise these learning points weekly roaster basis. Every Friday evening, an online reflection meeting will be held to resolve any lingering doubts. Faculty will also supervise the active engagement of students in peer learning by ensuring that students put the learning points in WA. We aim for at least 60% of students to respond each week. If the response rate falls below 50%, faculty will actively encourage and motivate students to read and contribute their learning points.

A pre-quiz before commencement of the PASTLE learning model will be carried out. It will consist of 50 MCQs covering all topics to be covered during model implementation over 1 hour period. Each MCQ will carry one point. A baseline score of each participant will be calculated.  Every week a quiz of 20 multiple-choice questions (10 prepared by two students and 10 by faculty) for ongoing assessment every Sunday evening. Students might use social media platforms to answer the quiz questions, however it will ultimately foster learning. At the end of the quiz, there will be questions regarding ongoing peer learning and the challenges encountered, such as:

1. Did you engage in peer learning during this week?
2. If yes, how many days out of the total possible days?
3. If no, please describe the challenges or barriers you faced.

Total number of days out of total possible days, a student engaged in peer learning will be calculated at the end of six months. At the end of six months, a comprehensive assessment with 50 multiple-choice questions, prepared by a faculty member not involved in the research, will be administered and score of each participant will be calculated. A delta score of each participant will be calculated by subtracting final score from the baseline score. Finally, semi-structured interviews will be conducted to evaluate perceived changes in participants’ attitudes and learning outcomes from this model.

To evaluate impact of PASTLE model, Kirkpatrick evaluation model will be used.