• Users Online: 115
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 

 Table of Contents  
Year : 2022  |  Volume : 9  |  Issue : 4  |  Page : 252-257

Introduction of the jigsaw technique of cooperative learning in teaching pathology to medical undergraduates

1 Department of Medical Education, Army College of Medical Sciences, New Delhi, India
2 Department of Pathology, Army College of Medical Sciences, New Delhi, India

Date of Submission21-Feb-2022
Date of Decision09-Aug-2022
Date of Acceptance23-Nov-2022
Date of Web Publication17-Mar-2023

Correspondence Address:
Archna R Pahwa
A 002, Raheja Atlantis, Sector 31, Gurugram - 122 001, Haryana
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cjhr.cjhr_19_22

Rights and Permissions

Context: Medical education. Aims: This study was an effort to sensitize students and faculty with an active learning technique known as jigsaw method and study its effectiveness and feasibility. Settings and Design: A prospective observational study was conducted for 2nd-year medical undergraduates in a 2 h long session. Subjects and Methods: Eighty out of 100 students of entry batch 2017 during the third semester in 2018 participated in this study with the supervision of five faculty members. The session was evaluated using prevalidated anonymous questionnaires filled by faculty and students. Statistical Analysis Used: Questionnaire used comprised nine questions for students and seven for faculty questionnaire to which the responses were to be marked on a 5-point Likert scale. The percentage of students/faculty with each response was calculated and analyzed. Results: More than 85% of the class agreed that jigsaw classroom guided them to take responsibility of their own learning and was helpful in developing their information-synthesizing skills. Almost the same percentage of students was interested in participating in a similar active learning technique in future as well. Conclusions: Student-centered learning approaches like jigsaw technique aim to develop learner autonomy and independence by putting responsibility for the learning path in the hands of the student. Such techniques promote learning and foster respect among students from diverse backgrounds.

Keywords: Cooperative learning, jigsaw, medical education

How to cite this article:
Pahwa AR, Dudani S, Gangadharan V, Gulati R. Introduction of the jigsaw technique of cooperative learning in teaching pathology to medical undergraduates. CHRISMED J Health Res 2022;9:252-7

How to cite this URL:
Pahwa AR, Dudani S, Gangadharan V, Gulati R. Introduction of the jigsaw technique of cooperative learning in teaching pathology to medical undergraduates. CHRISMED J Health Res [serial online] 2022 [cited 2023 Mar 31];9:252-7. Available from: https://www.cjhr.org/text.asp?2022/9/4/252/371934

  Introduction Top

Students try and learn concepts in basic sciences just to pass the examinations and often fail to understand disease pathogenesis or basis of disease. As a result, they experience difficulty in understanding the reason behind the appearance of various signs/symptoms in patients with various diseases they come across in clinical subjects. The traditional method of taking didactic lectures can become mundane and does not demand active involvement, or encourage critical thinking and analysis of information.

Trainers prefer lectures as a tool due to its numerous advantages in terms of the ability to deliver high volume of topics in less time, lack of need to be at a particular physical space, and implementation in large classes. However, it is the one-way training which tends to become dull and prevent effective learning. Bousari et al. compared the effect of team member teaching design (TMTD) versus lecture and concluded that TMTD as an active teaching method had positive effects on students' learning, Sadeghi et al. compared the students' learning and satisfaction in the combination of lecture and e-learning with conventional lecture methods and observed that students' satisfaction in blended learning method was higher than lecture method.[1],[2]

When lectures are used as the sole method, students only learn or at least represent what they have already learned but teachers now should be trying to help students to become self-directed and lifelong learners. There is a rising concern that the traditional methods of teaching often fail to encourage problem-solving and critical thinking skills in students which is imperative to acquire in medicine which has been acknowledged with introduction of Competency-Based Medical Education by National Medical Council (NMC).

It is necessary to explore the utility of relatively newer and active methodologies of teaching which stimulate the students to be curious and raise queries in their minds which is relatively difficult to achieve with passive techniques.

We conducted this study with the aim to acquaint the faculty and students with the jigsaw technique in training undergraduate students studying pathology in 2nd year.

Active learning is generally defined as any instructional method that engages learners in the learning process.[3]

Cooperative learning is one of the active learning techniques. One such active student-centered approach is the jigsaw classroom technique introduced by Elliot Aronson in the early 1970s.[4]

“When you teach, you learn twice.” jigsaw and other cooperative and active learning techniques are based on this fact.

There are many strategies in informal cooperative learning such as note checking and think-pair-share. Cooperative learning strategies are based on five basic principles of being peer assisted, having individual accountability, group processing, positive interdependence, and interpersonal relationships.[5],[6]

The jigsaw technique is a method of organizing classroom activities that makes students dependent on each other to succeed. It breaks classes into groups and breaks assignments into pieces that the group assembles to complete the jigsaw puzzle. The technique splits classes into mixed groups to work on small problems that the group collates into an outcome.

We conducted the jigsaw technique of cooperative learning on the topic of amyloidosis in 2nd year in pathology. This study aimed to

  1. Ensure the active participation of all students
  2. Sensitize the department faculty to adopt the jigsaw method
  3. Make students accept responsibility for their own learning by making them teach their peers
  4. Gather feedback to assess the perceptions of both the students as well as faculty toward this technique.

  Subjects and Methods Top

The prospective observational study was conducted in the Department of Pathology with undergraduate students of 3rd semester in 2nd-year MBBS. All necessary permissions were sought which included the dean and institute ethical committee's approval. The project plan was discussed with department faculty as well as members of the institute's Medical Education Unit (MEU) 3 months before the scheduled class. A 30 min session for the departmental faculty using a PowerPoint presentation was taken and inputs regarding the topic to be chosen were sought. The topic was finalized depending on the degree of difficulty, length of topic, and its dependence on other topics. Since amyloidosis is a topic of appropriate length and difficulty level, by common consensus it was decided to be covered using this technique.

A feedback questionnaire was formulated and prevalidated by various faculties from other departments and MEU members.

A 2 h slot was scheduled for conducting the class on amyloidosis.

Students were sensitized by briefing them regarding the peer-assisted learning session being planned for them during the previous practical class for 5–10 min.

A diagrammatic representation of the procedure, in brief, was circulated in their class WhatsApp group so that students have clarity regarding the technique.

All students were instructed to bring their textbooks along with them for this class and photocopies of the material were also kept ready if required.

We conducted a session on the topic of amyloidosis by dividing it into five subheadings.

The subtopics included:

  1. Chemical and physical properties
  2. Pathogenesis with primary and reactive amyloidosis
  3. All other clinical forms
  4. Morphology
  5. Clinical features.

Steps in conducting the session were as follows

  1. A total strength of 80 students participated and five faculty members facilitated the session
  2. Eighty students were divided into 16 small groups of five students each. This was their home group, all students of the home groups were allotted one of the five subtopics. This allotment took around 15 min after which they were given 15 min to read their allotted subtopic individually without discussion
  3. After reading their subtopic, the students were directed to assemble in such a way that students allotted the same subtopic from all home groups formed one new larger group called the expert group. This way five expert groups were formed with five different subtopics in each. The students were asked to choose a leader of their respective expert groups and brainstorm on their topic. This took around 30 min to complete with faculty members guiding students in case of any doubts or problems
  4. Subsequently, students were asked to go back into their home groups to present and teach their subtopics in sequence to their home group members. This took 30 min to complete
  5. Finally, one student from each expert group was asked to present their subtopic to the whole class. This was done by the group leader or any other member on voluntary basis. Doubts raised by students were addressed by faculty and other students after the presentations
  6. A prevalidated feedback questionnaire was given to the students and faculty members to fill anonymously. It included open-ended questions for suggestions on improvement for the session.

A jigsaw organizer form (supplementary file) was given to each student to fill later on and submit the next day. This included columns to fill-central ideas learned in the expert group and in the home group. This was reviewed by departmental faculty and feedback was given to students who needed.

This was a completely new technique in our institute which none of the students had experienced earlier. The students were subjected to only jigsaw methodology for this topic because conducting a didactic lecture on the same topic for all students would increase the teaching hours and would not be justified.

Hence, no direct comparison was done with any other teaching methodology; however, students and faculty perceptions were gathered for this cooperative learning method through feedback questionnaires as shown below.

  Results Top

On the day of the session, 80 students and five faculties were present who took part in the study.

At the end of the session, a feedback questionnaire was provided to the students as well as faculty. They had options to respond on a five-point Likert scale as shown in [Table 1] and [Table 2].
Table 1: Results of student response to questionnaire

Click here to view
Table 2: Result of faculty response to questionnaire

Click here to view

The class strength which turned up for the day was 80% which was similar to attendance over the past month (78%). The perceptions of the students regarding various aspects of the jigsaw technique are shown in [Table 1] and [Figure 1].
Figure 1: Original – Student perception regarding the jigsaw classroom in pathology (n = 80)

Click here to view

As is evident from the table above 66 out of 80 (82%) students agreed that preparing before the thermoluminescence (TL) method stimulated interest in the topic.

Seventy-eight percent of students felt that learning through this method helped in understanding the topic in a sequential orderly manner. The majority of students (86%) felt that this active learning method guided them to take responsibility of their own learning.

Many students (77.5%) seemed to enjoy the teamwork and individual presentations in the group. Most of the students (87.5%) agreed that the team members support each other to build answers to questions raised.

Sixty-one out of 80 (76.25%) students agreed that this methodology promoted critical thinking and decision-making.

There were 40 (50%) students who agreed that this method was time-consuming. Seventy out of 80 (87.5%) students agreed that this technique was helpful in developing their information-synthesizing skills. There was a good majority of 83.75% students who agreed that they would like to participate in similar active learning method in future.

A few statements of response by students:

“Please arrange similar sessions for other topics in Pathology as well.”

“I had got subtopic of Clinical features. So initially when I was told to read I couldn't figure out but when I went back to my home group things fell in place.”

The faculty also had to fill a questionnaire which was similar to the one for students. Response is as shown in [Table 2] and [Figure 2].
Figure 2: Original – Faculty perception regarding jigsaw classroom in pathology (n = 5)

Click here to view

Individual faculty responses were:

“Time-consuming but worth it”

“Very interesting and a pleasure to see students support each other in learning.”

  Discussion Top

The study aimed at promoting cooperative learning among medical students through jigsaw classroom. It included group discussion, peer teaching, and presentations of the learned topic in front of the whole class.

This technique has an effective role in changing passive students to active ones and enhancing participation and enthusiasm in learning. Students' opinion on this method is positive and they prefer to experience more such sessions in their courses which represents an increase in student satisfaction. It also develops self-confidence, communication among students, student support, logical thinking, ability in problem- solving, motivation, and critical thinking.[4],[7],[8]

In a study conducted by Phillips, a problem was given to pharmacy students, to evaluate the literature regarding a prescription-to-nonprescription product change for the oxybutynin transdermal system and make a recommendation for this “controversial issue” based on evidence reviewed by the group. They concluded that it was successful in teaching the concepts involved in the clinical controversy. Group members rated themselves and fellow participants' level of engagement as high during both the expert group and teaching group sessions.[7]

Jigsaw is an efficient way for students to become engaged in their learning, sharing information with other groups, and be individually accountable for their learning. Since each group needs its members to do well and participate actively so that the whole group does well, jigsaw maximizes interaction and establishes an atmosphere of cooperation and respect for other students.

The jigsaw learning technique assigns each group member an equally important role in their learning of a final product.[9]

However, a literature search returns limited evidence of its use in medical education.

It also is not intimidating for pupils as they are given a designated time to read on their own first in the class and then discuss. It does not demand prior preparation as in many other active learning techniques.

As we have mentioned above, almost 80% of students agreed that their interest in the topic developed with preparation for this class. Even after going through the whole process, a good proportion (83%) of the class was willing to participate in a similar activity in future. These observations are in agreement with those of Dhage et al. and Vinod Kumar et al.[10],[11]

This indicates that the students are willing to adapt to the active learning method and need a shift from faculty-centered-to-student-centered teaching learning strategies to stimulate higher-order thinking skills.

Although 78% of students agreed that this technique helped understand the topic in a sequential manner, there are 5% who do not agree and 16% who are neutral to this statement. There was also feedback from some students that there are some topics which are dependent on the other topics and cannot be understood well without them. So students who were allotted topics like morphology and clinical features were experiencing difficulty without knowing the pathogenesis of disease. This problem is addressed when each member presents his/her subtopic to other members of the home group.

Eighty-five percent students believed that this method guided them to take responsibility of their learning. This cannot be achieved in traditional lectures or tutorials where they heavily rely on the instructor and end up being passive recipients or silent spectators overshadowed by other students.

Seventy-six percent students enjoyed the teamwork involved in this technique and 17.5% were neutral, another 5% did not want teamwork. However, 86% of students agreed that team members helped to build answers to questions raised by fellow members. This was similar to observations by Levya-Moral and Riu Camps in nursing education.[12]

This means that although not all students are inclined to work as a team, still they believe that team members help each other in understanding concepts. This is the principle of cooperative learning which eliminates the competitive behavior and instead encourages students to support each other. Discussions have been shown to improve comprehension and learning by Freeman et al.[13]

There were 76% of students who felt that this method promoted critical thinking, whereas 17.5% were neutral and 6.25% did not agree with this. A large number (86%) of students felt that this method was helpful in developing their information-synthesizing skills. This was similar to observations by Bhandari et al., where the students were satisfied (88.75%) by this method of learning. Presenting the topic is believed to improve personal and public accountability.[14]

This also improves communication skills and confidence in students. After the presentation in the home group, there was voluntary participation for class presentation by many students who are usually not very forthcoming. Framing questions and replying to the questions raised by the presenter further improved their communication skills and enhanced learning, as proved by other authors.[15]

Three out of five faculties felt that preparing before the Teaching learning (TL) method stimulated interest among students, promoted critical thinking and decision-making, and that team member's support to build up the answers to questions. This highlights the advantages of this method perceived by faculty as well. However, most of the faculty (3/5) also felt it was time-consuming and one member disagreed that it helps in understanding topics in a sequential manner. Very few studies have documented faculty response toward this technique which I feel is equally important for the further implementation of such methods in medical education because jigsaw classroom is indeed faculty intensive and requires advanced planning for successful implementation.

This study was an effort to sensitize students and faculty with a type of cooperative learning technique and see its effectiveness and feasibility. It gave students an opportunity to read and analyze the concepts on their own which often they fail to do in their daily routine. Often students read pathology only to pass and cover Frequently Asked Questions just before the examination. This often results in incomplete knowledge and failure to understand concepts in clinical subjects. In jigsaw classroom, the division into subtopics ensured each and every member of all groups had an important part to contribute. This ensured that the concept was read, analyzed by each and every student, and discussed. It opened avenues to explore other active, cooperative, and short peer-assisted activities which can be done along with didactic lectures.

The technique is faculty intensive in terms of planning as well as execution. The choice of topic is very important as it cannot be done with complex concepts which are difficult to understand by most of the students. The jigsaw classroom is time intensive as well since a lot goes into arranging groups and allotting subtopics, after which they need time for each step. Time management is imperative and it is likely that students may overshoot the scheduled time frame in enthusiasm to teach each other. It is a good idea to ask groups to choose a leader and timekeeper to address these issues.

Another issue was the sequence and interdependence of topics. Some topics were difficult to comprehend without reading others. This results in uncertainty regarding the application of this technique for all topics.

Within the limitations of our study, jigsaw classroom technique proves to be an efficient student-centered cooperative learning method. This technique needs to be tested further using different topics of varying complexity. The efficacy of the jigsaw method in terms of retention of knowledge acquired also needs to be evaluated by future studies.


This study was a pilot for introduction of other forms of active learning.It was well received by the students with some valuable and honest suggestions by them. Faculty was receptive and gave inputs on its application in a better way. Within the limitations of our study, Jigsaw classroom technique proves to be an efficient student centred cooperative learning method. This technique needs to be tested further using different topics of varying complexity.


This study was a part of the author's project in “Advanced course in Medical Education” for which Dr. Harveen K Gulati, Dr. Dinesh Badyal, and Dr. T.Singh were a constant guiding force. The author's Departmental faculty and staff at the Army College of Medical Sciences have also been instrumental in planning and conducting this study successfully.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Payami Bousari M, Fathi Azar E, Moosavinasab N. Comparing the effect of lecture combined with question and answer, and team member teaching design on nursing students' achievements. Iran J Med Educ 2006;6:45-50.  Back to cited text no. 1
Sadeghi R, Sedaghat MM, Sha Ahmadi F. Comparison of the effect of lecture and blended teaching methods on students' learning and satisfaction. J Adv Med Educ Prof 2014;2:146-50.  Back to cited text no. 2
Prince M. Does Active learning work? A review of the research. J Eng Educ 2004;93:223-31.  Back to cited text no. 3
Karimi Moonaghi H, Bagheri M. Jigsaw: A good student-centered method in medical education. Future Med Educ J 2017;7:35-40.  Back to cited text no. 4
Smith KA, Sheppard SD, Johnson DW, Johnson RT. Pedagogies of engagement: Classroom-based practices. J Eng Educ 2005;94:87-102.  Back to cited text no. 5
Sagsoz O, Karatas O, Turel V, Yildiz M, Kaya E. Effectiveness of jigsaw learning compared to lecture-based learning in dental education. Eur J Dent Educ 2017;21:28-32.  Back to cited text no. 6
Phillips J. Instructional design and assessment: Using the jigsaw technique to teach clinical controversy in clinical skills course. Am J Pharm Educ 2015;79:1-7.  Back to cited text no. 7
Raoufi S, Farhadi A, Sheikhian A. Impact of the team effectiveness design of teaching on critical thinking, self-confidence and learning of nursing students. J Med Educ Dev 2014;9:23-32.  Back to cited text no. 8
Sim SM, Foong CC, Tan CH, Lai PS, Chua SS, Mohazmi M. The use of jigsaw learning technique in teaching medical students prescribing skills. Med Teach 2014;36:182.  Back to cited text no. 9
Dhage JR, Patil MS, Pawar AB. Implementation and Feedback Analysis of Jigsaw Active Learning Method. J Eng Educ Transform 2017;30:192-9.  Back to cited text no. 10
Vinod Kumar CS, Kalasuramath S, Patil S, Kumar KG, Taj KR, Jayasimha VL, et al. Effect of jigsaw co-operative learning method in improving cognitive skills among medical students. Int J Curr Microbiol App Sci 2017;6:164-73.  Back to cited text no. 11
Leyva-Moral JM, Riu Camps M. Teaching research methods in nursing using Aronson's Jigsaw technique. A cross-sectional survey of student satisfaction. Nurse Educ Today 2016;40:78-83.  Back to cited text no. 12
Freeman S, Eddy SL, McDonough M, Smith MK, Okoroafor N, Jordt H, et al. Active learning increases student performance in science, engineering, and mathematics. Proc Natl Acad Sci U S A 2014;111:8410-5.  Back to cited text no. 13
Bhandari B, Mehta B, Mavai M, Singh YR, Singhal A. Jigsaw method: An innovative way of cooperative learning in physiology. Indian J Physiol Pharmacol 2017;61:315-21.  Back to cited text no. 14
Mehta B, Bhandari B. Engaging medical undergraduates in question making: A novel way to reinforcing learning in physiology. Adv Physiol Educ 2016;40:398-401.  Back to cited text no. 15


  [Figure 1], [Figure 2]

  [Table 1], [Table 2]


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article
Subjects and Methods
Article Figures
Article Tables

 Article Access Statistics
    PDF Downloaded23    
    Comments [Add]    

Recommend this journal