# Peer interaction and social responsibility among medical students: extracurricular activities as a mediator and achievement motivation as a moderator

## TL;DR

The study finds that peer interaction boosts medical students' social responsibility through extracurricular activities, but this effect is reduced when students are highly achievement-motivated.

## Contribution

The paper introduces a moderated mediation model showing how peer interaction influences social responsibility in medical students.

## Key findings

- Peer interaction significantly predicts social responsibility (β = 0.187, p < 0.001).
- Extracurricular activities mediate 66.51% of the peer interaction effect.
- High achievement motivation weakens the indirect effect of peer interaction on social responsibility.

## Abstract

Global healthcare challenges highlight the need to cultivate social responsibility in medical education. However, traditional teaching methods inadequately develop this competency, overlooking peer-driven mechanisms. This study proposes a moderated mediation model to explore how peer interaction impacts medical students' social responsibility, examining extracurricular activities as a mediator and achievement motivation as a moderator. Using cluster sampling, data from five waves (2014–2023) of the Student Survey of Learning and Development (SSLD) at a Chinese research university were analyzed, involving 6,546 medical students. Validated scales measured peer interaction, extracurricular activities, achievement motivation, and social responsibility. SPSS PROCESS with 5,000 bootstrap samples tested mediation and moderation effects. Peer interaction significantly and positively predicted medical students' social responsibility (β = 0.187, p < 0.001), with extracurricular activities serving as a partial mediator (indirect effect proportion: 66.51%). Crucially, achievement motivation moderated both the direct and the first half of the mediation path: Under low achievement motivation (M−1SD), the direct (simple slope = 0. 078, t = 3.723, p < 0. 001) and indirect (simple slope = 0. 387, t = 20.635, p < 0. 001) effects of peer interaction on social responsibility were statistically significant. Conversely, under high achievement motivation (M + 1SD), the direct effect became insignificant (simple slope = 0. 009, t = 0.546, p > 0. 05), and the indirect effect weakened (simple slope = 0. 295, t = 20.077, p < 0. 001). Peer interaction promotes social responsibility through extracurricular engagement, but high achievement motivation diminishes this effect. Students with strong extrinsic goals may misuse peer interaction and activities, undermining social responsibility. Structured peer support programs with reflective components are needed, especially for achievement-oriented students, to foster genuine social responsibility in medical education.