Abstract
BackgroundDyad learning has been shown to be an effective tool for teaching procedural skills, but little is known about how dyad learning may impact the stress, anxiety, and cognitive load that a student experiences when learning in this manner. In this pilot study, we investigate the relationship between dyad training on stress, anxiety, cognitive load, and performance in a simulated bradycardia scenario.MethodsForty-one fourth-year medical school trainees were randomized as dyads (n = 24) or individuals (n = 17) for an education session on day 1. Reassessment occurred on day 4 and was completed as individuals for all trainees. Primary outcomes were cognitive load (Paas scale), stress (Cognitive Appraisal Ratio), and anxiety levels (abbreviated State-Trait Anxiety Inventory). Secondary outcomes were time-based performance metrics.ResultsOn day 1 we observed significant differences for change in anxiety and stress measured before and after the training scenario between groups. Individuals compared to dyads had larger mean increases in anxiety, (19.6 versus 7.6 on 80-point scale, p = 0.02) and stress ratio (1.8 versus 0.9, p = 0.045). On the day 4 post-intervention assessment, no significant differences were observed between groups. Secondary outcomes were significant for shorter time to diagnosis of bradycardia (p = 0.01) and time to initiation of pacing (p = 0.04) in the dyad group on day 1. On day 4, only time to recognizing the indication for pacing was significantly shorter for individual training (hazard ratio [HR] = 2.26, p = 0.02).ConclusionsDyad training results in lower stress and anxiety levels with similar performance compared to individual training.
Highlights
Dyad learning has been shown to be an effective tool for teaching procedural skills, but little is known about how dyad learning may impact the stress, anxiety, and cognitive load that a student experiences when learning in this manner
This study is a randomized prospective trial to compare the effects of dyad versus individual learning during a simulation-based bradycardia scenario on emotional state, cognitive load, and educational benefit
Baseline characteristics including gender as well as stress and anxiety levels assessed prior to starting the first session on day 1 were similar among both groups (Table 1)
Summary
Dyad learning has been shown to be an effective tool for teaching procedural skills, but little is known about how dyad learning may impact the stress, anxiety, and cognitive load that a student experiences when learning in this manner. There is a nascent body of evidence in HPE that clinical and procedural skills can be developed via collaborative learning Most of this emerging, collaborative learning literature examines simulation based medical education (SBME) of dyads (paired collaborative learners) versus individuals, with results demonstrating higher learner satisfaction, an equivalent educational effect, and more efficient and cost-effective training for dyads [4,5,6,7,8]. Proposed mechanisms of dyad learning include social interaction, positive interdependence among trainees, observational learning (action imitation), and shared knowledge [9, 10] These potential benefits come at the cost of reduced individual “hands-on” time, which may lessen the benefits of dyad learning [9]. The optimum type of content and means for implementing dyad learning has not yet been clarified; the majority of published studies are on procedural topics, where motor learning is the primary objective
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