title: Collaborative learning of clinical skills in health professions education: the why, how, when and for whom.
abstract: OBJECTIVE
  This study is designed to provide an overview of why, how, when and for whom collaborative learning of clinical skills may work in health professions education.
  Collaborative learning of clinical skills may influence learning positively according to the non-medical literature. Training efficiency may therefore be improved if the outcomes of collaborative learning of clinical skills are superior or equivalent to those attained through individual learning.
  According to a social interaction perspective, collaborative learning of clinical skills mediates its effects through social interaction, motivation, accountability and positive interdependence between learners. Motor skills learning theory suggests that positive effects rely on observational learning and action imitation, and negative effects may include decreased hands-on experience. Finally, a cognitive perspective suggests that learning is dependent on cognitive co-construction, shared knowledge and reduced cognitive load.
  The literature on the collaborative learning of clinical skills in health science education is reviewed to support or contradict the hypotheses provided by the theories outlined above. Collaborative learning of clinical skills leads to improvements in self-efficacy, confidence and performance when task processing is observable or communicable. However, the effects of collaborative learning of clinical skills may decrease over time as benefits in terms of shared cognition, scaffolding and cognitive co-construction are outweighed by reductions in hands-on experience and time on task.
  
  
  CONCLUSIONS
  Collaborative learning of clinical skills has demonstrated promising results in the simulated setting. However, further research into how collaborative learning of clinical skills may work in clinical settings, as well as into the role of social dynamics between learners, is required.
authors.affiliation: Centre for Clinical Education, Capital Region and University of Copenhagen, Copenhagen, Denmark.|Department of Obstetrics and Gynaecology, Nordsjaelland's Hospital Hillerød, Denmark.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Tolsgaard
authors.affiliation: Wilson Centre, Department of Family and Community Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kulamakan M
authors.initials: KM
authors.lastname: Kulasegaram
authors.affiliation: Faculty of Health, University of Aarhus, Aarhus, Denmark.
authors.forename: Charlotte V
authors.initials: CV
authors.lastname: Ringsted
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003071:Cognition; D003299:Cooperative Behavior; D004501:Education, Medical; D004506:Education, Nursing; D006281:Health Occupations / Q000193:education*; D006801:Humans; D007398:Interpersonal Relations; D007858:Learning; D009042:Motivation; D018794:Problem-Based Learning / Q000379:methods; D020377:Self Efficacy; D066269:Social Theory