Healthcare professionals are responsible for providing education to both healthcare consumers and the peers with whom they work. As such, specific teaching skills must be developed during prelicensure training to facilitate the transition from classroom to clinical practise. The realistic environment that simulation-based learning (SBL) activities utilise is a powerful enabler of translating theory to practise. The aim of this study was to explore the experiences of prelicensure physiotherapy students acting in either peer teacher or peer learner roles during a peer-assisted learning (PAL) activity delivered using SBL. Following preparatory training, over two days in 2018, a group of six final-year physiotherapy students (peer teachers) taught concepts around communication to a group of 126 of their junior physiotherapy colleagues (peer learners) during an SBL activity. Data were collected from all participants using written reflections (peer teachers) and the “Measure of quality of giving feedback scale” (peer learners). Three themes emerged from open coding of written reflections: preparation and training, perceptions peer teachers held of themselves as teachers, and perceptions peer teachers held of their learners. These themes are described with verbatim quotations used to support coding choices. Peer teachers reported value from the training and teaching experiences and felt they met the challenges of peer teaching, particularly with respect to being adaptable to learner performance. Peer learners rated the feedback quality highly with frequencies of responses demonstrating an overall mean score of 6.3 out of a possible 7 (SD1.1) for all scale questions. Peer-assisted learning using simulation was a positive experience with a perception of reciprocal benefit from both groups.