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

Purpose 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. Method 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.