Jigsaw Method for Non-technical Skills in Cardiac Arrest: a Novel Application of This Active Learning Pedagogy

Introduction: There has been increased recognition of the importance of non-technical skills (e.g., communication and leadership) for cardiac arrest management. However, training is often insufficient to cultivate the requisite level of proficiency of these non-technical skills. Methods: We evaluated non-technical and technical skills performance of internal medicine residents in simulated cardiac arrest cases prior to and following a novel application of an interactive teaching strategy known as the Jigsaw Method. This method is one of the several established teaching strategies intended to actively engage learners. Internal medicine residents participated in pre- and post-intervention medical knowledge quizzes and cardiac arrest simulation cases. Technical skills (i.e., medical knowledge) were assessed by multiple-choice quizzes and non-technical skills (i.e., leadership, communication) with performance scoring. Results: Fifty-six residents, including 50 of 53 (94%) matriculated senior residents from within the internal medicine program, participated. There was statistically significant improvement in quiz scores (median 63.3 vs. 80.0, p <.0001) and mock code performance scores (median 58.4 vs. 72.1, p = 0.01), comprising both leadership and communication components. Conclusions: Application of the Jigsaw Method resulted in improved technical and non-technical cardiac arrest management skills. Our findings support the implementation of this active teaching-learning technique into graduate medical education (GME) for non-technical skills training.