title: A study of the effect of dyad practice versus that of individual practice on simulation-based complex skills learning and of students' perceptions of how and why dyad practice contributes to learning.
abstract: OBJECTIVE
  The aims of this study were (1) to explore the effectiveness of dyad practice compared with individual practice on a simulator for learning a complex clinical skill and (2) to explore medical students' perceptions of how and why dyad practice on a simulator contributes to learning a complex skill.
  
  
  METHODS
  In 2011, the authors randomly assigned 84 medical students to either the dyad or the individual practice group to learn coronary angiography skills using instruction videos and a simulator. Two weeks later, participants each performed two video-recorded coronary angiographies on the simulator. Two raters used a rating scale to assess the participants' video-recorded performance. The authors then interviewed the participants in the dyad practice group.
  
  
  RESULTS
  Seventy-two (86%) participants completed the study. The authors found no significant difference between the performance scores of the two groups (mean±standard deviation, 68%±13% for individual versus 63%±16% for dyad practice; P=.18). Dyad practice participants noted that several key factors contributed to their learning: being equal-level novices, the quality of the cooperation between partners, observational learning and overt communication, social aspects and motivation, and meta-cognition.
  
  
  CONCLUSIONS
  Dyad practice is more efficient and thus more cost-effective than individual practice and can be used for costly virtual reality simulator training. However, dyad practice may not apply to clinical training involving real patients because learning from errors and overt communication, both keys to dyad practice, do not transfer to clinical practice.
authors: Dr. Räder is a fellow in cardiology, Centre for Clinical Education, University of Copenhagen and Capital Region, Copenhagen, Denmark. Ms. Henriksen is advisor/consultant, Centre for Clinical Education, University of Copenhagen and Capital Region, Copenhagen, Denmark. Dr. Butrymovich is a cardiologist, Cardiac Catheterization Laboratory, Department of Cardiology, University Hospital Rigshospitalet, Copenhagen, Denmark. Dr. Sander is a cardiologist, Cardiac Catheterization Laboratory, Department of Cardiology, University Hospital Rigshospitalet, Copenhagen, Denmark. Dr. Jørgensen is a cardiologist, Cardiac Catheterization Laboratory, Department of Cardiology, University Hospital Rigshospitalet, Copenhagen, Denmark. Dr. Lönn is professor, Departments of Vascular Surgery and Radiology, University Hospital Rigshospitalet, Copenhagen, Denmark. Dr. Ringsted is professor, Department of Anesthesia, director and scientist, Wilson Centre, and BMO chair in health professions education research, University of Toronto and University Health Network, Toronto, Ontario, Canada.
authors: Sune B E W
authors: SB
authors: Räder
authors: Ann-Helen
authors: AH
authors: Henriksen
authors: Vitalij
authors: V
authors: Butrymovich
authors: Mikael
authors: M
authors: Sander
authors: Erik
authors: E
authors: Jørgensen
authors: Lars
authors: L
authors: Lönn
authors: Charlotte V
authors: CV
authors: Ringsted
mesh_terms: D002983:Clinical Competence; D003071:Cognition; D003198:Computer Simulation; D003299:Cooperative Behavior; D017023:Coronary Angiography; D003718:Denmark; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D017145:Models, Educational; D010465:Perception; D013337:Students, Medical / Q000523:psychology*