Training Clinical Skills in Pairs

Abstract

To the Editor—Tolsgaard et al. have reported their small but remarkably well-executed randomized study demonstrating that when clinical skills training was done in pairs (“dyad-practice”), the students were able to achieve significantly higher performance scores than students who encountered their four simulated patients’ scenarios alone.1 The principle behind these impressive results has been known for centuries by Jewish scholars, who have been using a system of studying in pairs for the study of the ‘Talmud’, the immense volumes of Rabbinical texts which form one of the most ancient and essential core writings of Judaism. The many complex intricate discussions between sages of the most correct interpretation of a rule under different conditions and their logical arguments are sometimes very hard to follow and understand. Rabbinical students of the ‘Talmud’ used to study in pairs, called ‘Havruta’, or ‘Chavruta’ from ‘haver’, (a friend) spending countless hours together in the study of the ‘Talmud’ since the time of its inception in Jerusalem and the diaspora in Babylon in the era of the Roman Empire. This method is still going on today in ‘Yeshivot’ (academies for the advanced learning of Jewish writings) worldwide and the interaction between two learners constitutes the accepted ‘best’ way to analyze, understand and memorize complex issues.2 Thus, I was not surprised to find that this time-tested method works for medical education too.