According to the
Accreditation Council for Pharmaceutical Education (ACPE) Standards, graduates
from pharmacy schools must be active, lifelong learners.1 Pharmacists
are playing an increasinging role in team-based patient care, according
to a new study from the Pharmacy Workforce Center.2 Thus, student pharmacists must become effective communicators as well.3 Yet,
most teaching methods used during pharmacy school emphasize content delivery
rather than developing the skills a health professional needs on a team. Ideally
instructional methods should not only deliver content, but also build
communication and self-directed learning skills. The jigsaw technique appears to be
an excellent way to achieve all of these aims.1
The jigsaw
technique requires students to explore the content by bringing together multiple
pieces of information, like a jigsaw puzzle. In order to master the material, students
must gather all the “pieces” of the puzzle. Once the instructor determines the
theme or content area to be explored, students are randomly divided into several
small groups that are called “teaching” groups. Then, each student in the
teaching group is assigned a portion of the material to be learned. Next, students in the various "teaching" groups who have been assigned the
same material form an “expert group.”
The expert group works together and decides how best to deliver,
communicate, and teach the material to the members of their respective “teaching”
group. Finally, the teaching groups reconvene so each group member teaches
others about their piece of the puzzle until all the experts have presented and all
of the material has been covered.1 Using this strategy, each student
has a piece of the topic’s puzzle. And
like a health professional team, working together they complete the puzzle to
achieve the goal.
Instructors at the Midwestern University Chicago College
of Pharmacy used the jigsaw technique during a clinical skills pharmacy
practice laboratory.3 The goal of the laboratory was to give
students the opportunity to evaluate the literature regarding switching
oxybutynin transdermal from a prescription to a nonprescription product. Students
were asked to make a recommendation based on the evidence they found in the
literature. The instructors provided readings regarding the disease (over
active bladder), drug (oxybutynin), and regulatory aspects of a potential
prescription to OTC switch. Teaching groups of 5 to 7 students were randomly
assigned. Each member of the teaching group was given a different reading.
Expert groups collectively discussed the material then students reunited with
their teaching group to inform the group about the assigned materials. The
teaching group came to a consensus on whether they would support the
nonprescription switch. At the conclusion of the workshop, each student took a
quiz. The questions covered all the “puzzle pieces” covered in the reading
assignments. The average score on the
quiz was 10.5/12, demonstrating that the technique was successful in teaching
the concepts. Students performed equally well regardless if they were members
of the expert group that was assigned the specific reading material. Most students
preferred (74%) the jigsaw technique in terms of the ability to enhance
understanding of the concepts, applying the information, stimulating interest
in the topic, encouraging feedback, and developing communication skills. Further,
65% of students reported they would enjoy using the jigsaw technique more often
throughout the pharmacy curriculum.1
Teachers
at the University of North Carolina School of Pharmacy used the jigsaw technique
to teach pharmacokinetics.4 In one
module, students learned about renal drug clearance. Each student was assigned a drug that was
renally eliminated but by different mechanism such as filtration, active
tubular secretion, and passive tubular reabsorption. A select list of drugs
banned by the International Olympic Committee (IOC) and the National Collegiate
Athletic Association (NCAA) were chosen, including atenolol, methamphetamine,
and nandrolone – all of which are renally eliminated, but by different
mechanisms. Students propose a way to beat a urine screen for their assigned
drug and were expected to teach other members of their “teaching group.” Following the activity,
students’ comprehension was assessed on a comprehensive exam (which covered a
number of content areas in the course). The average score on the renal
subsection of the exam was 8.7 out of 10 (87%).4 Student surveys
indicated they enjoyed the jigsaw technique; however 43.5% of students preferred
traditional lectures and only 11% of students wanted the jigsaw technique
incorporated more frequently throughout the curriculum.4,5. These
data suggests that although students comprehended the material, it wasn’t a
technique that everyone enjoyed or preferred.
Although
the jigsaw technique has several advantages in terms of learning and skill
development, it isn’t a panacea. Some students find teaching others difficult/burdensome
and their work in other classes suffers due to the amount of time required preparing
to teach others. Based on past negative experiences
doing group work where members failed to do their fair share, some students may
feel apprehensive about participating in a group project. Scheduling can also
be a barrier – especially if the students are expected to meet in their “expert
groups” outside of class time.4
The
jigsaw technique is a discussion protocol that encourages peer-to-peer
collaboration, content exploration, and skill development. It is best employed
when there is a large amount of content to teach, when students can meet with
their assigned “expert” groups at times conducive to their schedules, and when
students are given plenty of time to digest the material.5 The
jigsaw technique make students accountable for not only their own learning
but also each other’s learning. This teaching strategy helps students hone their
listening, communication, and problem-solving skills, which are essential in
practice. The jigsaw technique not only helps students develop their factual
knowledge for exams but leads to long-term retention and promotes self-directed
learning. As healthcare professionals we
certain cannot know everything, but it is important that we know how and where
to find information and use problem solving skills. So, next time you
are preparing a lecture on a complex topic, consider implementing the jigsaw instead.
After all, “learning together is the thing for all of us.”5
References:
- Phillips J and Fusco J. Using the Jigsaw Technique to Teach Clinical Controversy in a Clinical Skills Course. American Journal of Pharmaceutical Education. 2015; 79 (6): Article 90.
- American Pharmacists Association. Pharmacists’ roles on the health care team are expanding. April 9, 2015. [Internet]. Accessed on September 30, 2015.
- Howard M and Persky A. Helpful Tips for New Users of Active Learning. American Journal of Pharmaceutical Education. 2015; 79 (4): Article 46.
- Persky A. and Pollack G. A Hybrid Jigsaw Approach to Teaching Renal Clearance Concepts. 2009; 73 (3): Article 49.
- Social Psychology Network. Jigsaw Classroom. December 10, 2000. [Internet]. Accessed on September 30, 2015.
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