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Background: Due to the COVID-19 pandemic, undergraduate medical students had to follow high amounts of online education. This does not match their preferences and might negatively affect their education satisfaction and study engagement. As low levels of education satisfaction and study engagement are risk factors for burnout and dropout, resources that mitigate these possible negative consequences of forced online education need to be identified. Therefore, the current study investigated 1) the associations of the amount of online education with education satisfaction and study engagement, and 2) whether quantitative (i.e., network size) and qualitative (i.e., perceived support) aspects of peer relationships can buffer the expected negative associations., Methods: In a cross-sectional study, 372 undergraduate medical students from all eight Dutch medical schools (79.8% female; mean age: 20.4 years) completed an online survey assessing the relevant variables. Data were analysed using correlation and moderated mediation analyses., Results: The amount of online education was significantly negatively related to education satisfaction and study engagement. Additionally, higher amounts of online education were indirectly associated with lower levels of study engagement through lower levels of education satisfaction. More importantly, both quantitative and qualitative aspects of peer relationships significantly buffered this negative indirect association. Specifically, among medical students with a large peer network or high levels of perceived peer support, the amount of online education was no longer significantly negatively related to education satisfaction and subsequently to study engagement., Conclusions: The current study underlines the importance of peer relationships in the educational context, since our findings indicate that both the peer network size and the perceived peer support protect medical students' education satisfaction and study engagement when confronted with study demands, such as forced online education during the COVID-19 pandemic. These findings may be translated into educational efforts that stimulate collaborative learning and the formation of formal peer networks., (© 2022. The Author(s).)

Objectives: Due to an increased infection rate among young adults, they need to adhere to the preventive guidelines to stop the spread of COVID-19 and protect vulnerable others. The purpose of this mixed methods study was to explore the role of risk perception and affective response in the preventive behaviours of young adults during the COVID-19 outbreak., Setting: This study followed a convergent mixed methods design, in which a quantitative online survey (n=1081) and 10 qualitative in-depth semistructured video interviews were conducted separately in the Netherlands during April-August 2020., Participants: 1081 participants filled in the online survey, and 10 participants participated in the interviews. Eligibility criteria included being a university student., Primary and Secondary Outcome Measures: Data on risk perception, affective response, that is, worry, and adherence to preventive guidelines were combined and analysed during this study. There were no secondary outcome measures., Results: The results showed that young adults perceived their risk as low. Their affective response for their own well-being was also low; however, their affective response was high with regards to vulnerable others in their surroundings. Due to their high impersonal risk perception (ie, perceived risk to others) and high affective response, young adults adhered to most preventive guidelines relatively frequently. However, young adults sometimes neglected social distancing due to the negative effects on mental health and the uncertainty of the duration of the situation., Conclusions: In conclusion, high impersonal risk perception and high affective response regarding others are key motivators in young adults' preventive behaviour. To maximise adherence to the preventive guidelines, risk communication should put emphasis on the benefits to vulnerable others' health when young adults adhere to the preventive guidelines., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)