Purpose
Traditional physical examination training often lacks consistent feedback mechanisms and underutilizes peer learning. We developed a hybrid model integrating structured peer feedback into standardized patient (SP) encounters to enhance both clinical skills and feedback literacy among medical students.

Methods
This prospective educational intervention involved 180 first-year medical students at Rutgers New Jersey Medical School in Spring 2025. Students participated in three system-specific sessions (musculoskeletal, cardiovascular, pulmonary) following a standardized two-part structure: facilitator-led peer practice using standardized checklists, followed by SP encounters where students rotated through examiner and peer observer roles. Peer observers provided verbal and written feedback using validated rubrics. Pre- and post-session surveys assessed confidence and perceptions using 5-point Likert scales, alongside system-specific knowledge tests.

Results
Across 396 paired survey responses, students demonstrated significant improvements in physical examination confidence, knowledge, and feedback competency. In musculoskeletal (n=237), cardiovascular (n=122) and pulmonary (n=37) sessions, students showed enhanced confidence in performing examinations (p<.001), significant knowledge gains on system-specific assessments (p<.001), increased appreciation for SP educational value (p<.009), and greater confidence in both giving and receiving peer feedback (p<.001). Qualitative data revealed students valued the structured peer feedback as promoting reflective learning and collaborative engagement.

Conclusion
The hybrid model successfully enhanced student confidence, clinical skills, and feedback literacy. By combining authentic SP encounters with meaningful peer-to-peer learning, this approach addresses gaps in traditional physical examination training while fostering collaborative learning essential for healthcare teamwork and lifelong professional development.