Background: Peer feedback (PF) has attracted much attention in health profession education with growing evidence on its benefits. However, it lacks a proper framework to guide its operation, which raises concerns about its quality in nursing education. Purpose: To compare the effects of a 3-phase PF versus faculty feedback (FF) on students' reflective abilities and clinical competencies after simulated practice, and its impacts on peer tutors' feedback practices and empowerment level. Methods: This study used a 3-arm pretest-posttest quasi-experimental methodology. Results: Peer verbal feedback significantly increased students' reflective abilities and clinical competencies, while peer video feedback significantly increased clinical competencies. However, FF outcomes did not reach significance. Peer tutors' empowerment level did not significantly improve, but feedback practices were perceived as comparable with FF. Conclusions: Peer feedback can potentially improve students' reflective abilities and clinical competencies. Proper feedback training with a structured framework will likely enhance peer tutors' feedback practices.