Design and Delivery of the Clinical Integrative Puzzle as a Collaborative Learning Tool.

Well-designed collaborative learning tools can provide an opportunity for engaging student experiences that foster deep learning and act as a scaffold for enculturation to the profession through refinement of professional collaborative skills. The clinical integrative puzzle is a paper-and-pencil or computer-based teaching and learning activity that combines disciplinary knowledge with clinical reasoning and problem solving. Effective design and implementation of clinical integrative puzzles requires a multidisciplinary approach to design, a positive classroom climate, and a set of illness scripts (e.g., clinical cases or scenarios) that are similar yet have key differentiating features that provide students with the opportunity to exercise clinical reasoning skills. The tool allows students to co-construct knowledge and develop professional competencies and allows instructors to assess and respond to student learning in a safe and supportive environment, even with large student numbers. The tool can also be used in a summative fashion. This article provides a brief review of the use of this instructional tool and offers tips for design and implementation.