PBL and beyond: trends in collaborative learning.

Building upon the disruption to lecture-based methods triggered by the introduction of problem-based learning, approaches to promote collaborative learning are becoming increasingly diverse, widespread and generally well accepted within medical education. Examples of relatively new, structured collaborative learning methods include team-based learning and just-in-time teaching. Examples of less structured approaches include think-pair share, case discussions, and the flipped classroom. It is now common practice in medical education to employ a range of instructional approaches to support collaborative learning. We believe that the adoption of such approaches is entering a new and challenging era. We define collaborate learning by drawing on the broader literature, including Chi's ICAP framework that emphasizes the importance of sustained, interactive explanation and elaboration by learners. We distinguish collaborate learning from constructive, active, and passive learning and provide preliminary evidence documenting the growth of methods that support collaborative learning. We argue that the rate of adoption of collaborative learning methods will accelerate due to a growing emphasis on the development of team competencies and the increasing availability of digital media. At the same time, the adoption collaborative learning strategies face persistent challenges, stemming from an overdependence on comparative-effectiveness research and a lack of useful guidelines about how best to adapt collaborative learning methods to given learning contexts. The medical education community has struggled to consistently demonstrate superior outcomes when using collaborative learning methods and strategies. Despite this, support for their use will continue to expand. To select approaches with the greatest utility, instructors must carefully align conditions of the learning context with the learning approaches under consideration. Further, it is critical that modifications are made with caution and that instructors verify that modifications do not impede the desired cognitive activities needed to support meaningful collaborative learning.