Background: Social–emotional learning (SEL) is crucial to the development of professional identity and collaborative competence in medical education. However, research exploring how teaching assistants (TAs) act as affective mediators to support SEL in project-based service-learning (PjBL-SL) is lacking. The present study investigated two research questions: (1) How do the roles and facilitation strategies adopted by TAs in PjBL-SL influence the development of medical students’ SEL competencies? and (2) How do TAs interpret students’ SEL growth trajectories during the course? Methods: This qualitative study was conducted in a required PjBL-SL course at a Taiwanese medical school. In August 2022, semi-structured interviews were conducted with 11 TAs. Thematic analysis was used to examine their observations and strategies to support student SEL competency development. Results: The TAs reported observing substantial student growth across all five SEL competencies defined by the Collaborative for Academic, Social, and Emotional Learning: self-awareness, self-management, social awareness, relationship skills, and responsible decision-making. The TAs described how students engaged in perspective-taking, reflective practice, and collaborative problem-solving. The TAs viewed themselves as affective mediators, providing emotional safety, attentive feedback, and tailored guidance throughout the learning process. A dual-layer TA support system—consisting of precourse training grounded in the sequenced, active, focused, explicit principles and ongoing in-course reflective dialogue—was a key enabler of this emotional support role. Conclusion: TAs in PjBL-SL courses are crucial to supporting medical students’ SEL competency development by offering emotionally attuned, context-sensitive guidance. This study’s dual-layer model of TA preparation and engagement can enhance the emotional dimensions of learning in medical curricula. © © 2025 Liao, Hung, Chen, Chen, Ting and Chang.
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