Peer feedback serves as a pedagogical methodology that actively engages students throughout their academic journey. Developing metacognitive competences of students in a clinical training context motivates student’s engagement and active participation in the learning and assessment processes as added value for academic success. It is particularly effective in fostering competences that are crucial for future professional practice. This study introduces the design and development of a peer feedback model tailored for the assessment and development of metacognitive competences among nursing students undergoing clinical training, named PEERFEED-EClínico 1.0. The research employs a constructivist case study approach using a multi-method design comprising two stages: Stage 1 (S1) involves development and modeling, conducted through the first and second cycles of participatory action research (PAR); Stage 2 (S2) focuses on validity and feasibility, employing a quasi-experimental study (before and after) to validate the model’s requirements, receptivity, and potential compliance among teachers and students. Data were collected from 2018 to 2021 and involved 163 nursing students and 24 teachers/supervisors enrolled in curricular units related to clinical training during the 3rd and 4th years of their undergraduate nursing degrees. The findings highlight the PEERFEED-EClínico 1.0 model, which features four levels of implementation. The model emphasizes self-knowledge, self-reflection, and self-regulation along with communication, interpersonal relationships, and teamwork, all of which are deemed essential for students’ future professional practice. The peer feedback model promotes a centered student approach, allows the alignment of pedagogical methodologies with international frameworks of quality assurance in higher education, and contributes significantly to nursing education and science knowledge.