A problem shared is a problem halved? Enhancing learning through working in pairs

Healthcare students' education is developing as our understanding of learning processes is enlightened by social theories of learning. Increasingly, the social context of learning is being highlighted as a key variable that enhances outcomes ranging from student satisfaction to test scores. We now require concrete examples of techniques that can be used to apply our theory to practice. To that end, in this issue of Medical Education, Rotgans et al1 . explore whether learning is enhanced through dyadic explanations.

Health care students' education is developing as our understanding of learning processes is enlightened by social theories of learning.
Increasingly, the social context of learning is being highlighted as a key variable that enhances outcomes ranging from student satisfaction to test scores. We now require concrete examples of techniques that can be used to apply our theory to practice. To that end, in this issue of Medical Education, Rotgans et al 1 explore whether learning is enhanced through dyadic explanations.
The social context of learning is being highlighted as a key variable that enhances outcomes ranging from student satisfaction to test scores.
'Dyadic explanations' in Rotgans' study refer to a learning activity where pairs of medical students explain to one another the contents of a preparatory video lecture. The term has two components that are potentially powerful tools for learning: the first, Would pairing up students have the same effect regardless of the nature of the task or instructions they were given?
Rotgans et al's study does partly address these questions by examining the role of the metacognitive processes that lie behind the act of explanation. Even self-explanation without a student partner present was shown to enhance learning, though to a lesser extent.
The students' verbalisation was thought to prompt an integration of new information into existing knowledge. However, talking out loud to oneself while alone is an attempt to recreate an intrinsically social activity, which is may be an effective learning strategy on the whole. Asking questions is a social activity, so it is unsurprising that the study found that students in the dyadic group asked many more questions than students who were alone. Rotgans

Are the student interactions supervised, and what is the nature of the studentsupervisor relationship?
A next step clinical educators will now want to address is how to apply these findings in practice. That is, how can dyadic explanations be used for learning in real world environments? A common misrepresentation of collaborative learning techniques is that peers can be simply put in groups and that some form of learning will happen automatically. 4  is an expectation for the students themselves to be independent and take on responsibilities for their own and one another ' s learning. However, supervision remains important even when students learn independently, although it requires a change in the nature of the supervisor role. We have recently addressed the question of the role the supervisor plays in peer learning, 5 and our findings suggest that supervising in this context can, in its broadest sense, be seen as contributing to a learning environment that upholds working together and learning from one another as an accepted and automatised part of practice.
Supervision remains important even when students learn independently, although requires a change in the nature of the supervisor role .
Finally, it is noteworthy that Rotgans et al discuss dyadic explanations as self-study preparation for a learning activity. There are potentially wider implications since the results presented show increased knowledge unrelated to any subsequent learning activity. Moreover, dyadic explanations could have further benefits to student learning and well-being that the present study did not investigate, such as promoting professional collaboration and teamwork, practising teaching skills and building self-confidence through being able to answer questions from peers. In other words, dyadic explanations can be seen as a simple technique that has the potential to enhance learning in many different educational settings, with a clear focus for future research being reallife implementation.