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 Table of Contents  
Year : 2021  |  Volume : 10  |  Issue : 2  |  Page : 97-102

Assessing the outcome of implementation of jigsaw technique as a learning tool and its effect on performance of 1st year medical students in anatomy

1 Professor, Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
2 Professor, Departments of Pathology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India

Date of Submission09-Oct-2020
Date of Decision27-Jan-2021
Date of Acceptance18-Feb-2021
Date of Web Publication09-Apr-2021

Correspondence Address:
Monika Lalit
House No. 24, Lane 5, Gopal Nagar, Majitha Road, Amritsar - 143 001, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/NJCA.NJCA_57_20

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Introduction: Multiple factors in the contemporaneous trends in curriculum and medical education demand changes in teaching–learning methods with a dramatic change in the paradigm of teacher-centered teaching methods to student-centered learning methods. The jigsaw technique is an active learning methodology that involves active participation by the students in the learning process where they learn by teaching one another. It is an excellent potential tool to grasp an outsized load of information in a brief period or shorter time frame. The objective of the present study was to assess the effectiveness of the implementation of the jigsaw method as a learning tool during a graduate medical education setting. Methodology: The study was conducted among 150 phase I MBBS students during dissection in the department of anatomy. Two topics were decided and taught by didactic lecture. After taking the pretest, the topics were again taught by the jigsaw technique. After completion of the topic with this technique, students' knowledge regarding the topics was judged by taking a posttest. Pre- and postjigsaw technique assessment scores were calculated. The difference in the mean of pre- and posttests was estimated and compared by applying a paired-t-test to know the effectiveness of teaching methods. Results: The difference in the performance of the students in pre- and postjigsaw technique assessment scores test was calculated by applying paired-t-test which was found to be statistically significant (P < 0.001). About 100% of faculty members readily accepted the suggestion of implementing the jigsaw method. About 88% (132) of students showed enthusiasm and interest to take up the activity. Conclusion: There was an eloquent difference in the performance of the students in pretest and posttest knowledge scores. The results indicate a better performance by the students when they are involved actively in learning and found this method very helpful, interesting, and motivating.

Keywords: Assessment, cooperative learning, didactic lecture, jigsaw method, teaching and learning

How to cite this article:
Lalit M, Piplani S. Assessing the outcome of implementation of jigsaw technique as a learning tool and its effect on performance of 1st year medical students in anatomy. Natl J Clin Anat 2021;10:97-102

How to cite this URL:
Lalit M, Piplani S. Assessing the outcome of implementation of jigsaw technique as a learning tool and its effect on performance of 1st year medical students in anatomy. Natl J Clin Anat [serial online] 2021 [cited 2021 Jun 18];10:97-102. Available from: http://www.njca.info/text.asp?2021/10/2/97/313513

  Introduction Top

Each student's aptitude, caliber, learning and thinking potential, motivational levels, and interests differ from one another. The purpose of education is not only to make a student literate but also to add proficiency, logical thinking, and self-reliance[1],[2] Since 1998, the Medical Council of India has reduced undergraduate 1st-year MBBS course duration from 1½ years to 1 year Students often find it difficult to grasp and understand the Anatomy in this short duration.[3] The formal didactic lectures and similar teacher-driven learning activities do not gassure the knowledge acquisition of each student. The drawback of current education practice is inadequate in learning abilities development.[4] This scenario illustrates the necessity for amendments in the conventional teacher-oriented approach using student-centered teaching methods and techniques to assist students' knowledge to be permanent.[2] With the intention of the shift from an educator to a learner-centered paradigm; peer tutoring, peer-assisted learning has been widely assimilated into the medical curriculum.[5] Cooperative learning or active learning methods are the educational techniques during which students engage in goal oriented activity that forces them to believe and comment upon the knowledge presented.[6] It fosters the development of professional skills such as interaction, public speaking, collective effort deciding, commanding, self-reliance, and respect for fellow students.[7] During this study, the jigsaw technique of cooperative learning method was used. The jigsaw method may be a sort of cooperative learning, during which students build small mixed groups and are actively involved within the teaching–learning process.[8] This method has not only shown to create comprehension but also encourages cooperation and self-worth among students and is further known to enhance their listening abilities, communication skills, and problem-solving capacity.[9] This method has been successfully tried in various areas of education such as elementary or primary education, nursing education, pharmacy, and in other fields but less so in medical subjects.[10],[11],[12],[13] Literature search could not yield any published articles on the utilization of the jigsaw method for anatomy teaching. This study was undertaken with an objective to encourage, promote, and augment the learning within the subject of anatomy using the jigsaw method as a learning tool together with didactic lecture and also to assess the outcome of the implementation of jigsaw technique or students' knowledge in understanding the topic by pre- and posttest questionnaire.

  Methodology Top

The present study was undertaken in the department of anatomy among 150 first professional MBBS students. Prior permission for the study was sought from the Ethical Committee vide letter reference no. Patho 644/15 dated 21.10.15 and dissection hall was selected as the venue for the study.

Sensitization of faculty and students

  • All the faculty members of the department of anatomy were sensitized toward the concept of jigsaw technique which is one of the small group active teaching–learning methods
  • Two topics from the abdomen (stomach and uterus and its supports) were chosen to be taught for the study in consultation with other faculty members
  • After the didactic lecture of the chosen topics for the study, brief interaction was held with the students in the dissection hall about the current studying pattern of the students and various methods of learning adopted by them and a pretest of the topic taught by didactic lecture was announced for the next day. Next day, a pretest comprising of short answer questions (SAQs) and multiple-choice questions (MCQs) was conducted in the dissection hall
  • Following this, the students were sensitized to the jigsaw technique and were encouraged to learn the chosen topics by jigsaw technique
  • All the students were subjected to posttest on the same pattern
  • A second session with the faculty members was also held to apprise them of the results of students' performance in the tests conducted.

Description of the jigsaw technique

The jigsaw strategy is a group-work method for learning and participating in learning activities. It is a cooperative learning strategy developed by Elliot Aronson, that enables each and every student of a group to study intensively in one topic or one aspect of a learning unit. To achieve learning objectives, the jigsaw technique uses a planned step-by-step linear process.[14],[15],[16] Out of 150 students, 132 participated and 18 students were absent and therefore, were excluded from the study. The first selected topic was taught by a traditional didactic lecture by one of the faculty members and the students were informed about a class test of the same the next day which was named pretest.

Step 1: The students underwent pretest questionnaire comprised of SAQs and MCQs. Thereafter, to strengthen the topic, Active Learning Methodology (ALM)-Jigsaw technique was taken up in the dissection hall teaching.

Step 2: The process of the jigsaw technique was thoroughly described to the students. Thereafter, the students were divided into 26 small groups or subgroups (A-Z) having 5 students each where each and every student per group was assigned a number 1, 2, 3, 4, and 5 (Only in the Y and Z subgroups there were 6 students). The reason for five students in each subgroup was that the subtopics decided from the main topic were 5 in number. All these subgroups were named “Home Groups” [Figure 1].
Figure 1: Formation of home groups and expert groups of 1st year MBBS students where jigsaw technique was applied. HG – home group, EG – expert group

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Step 3: After each student had a number, the home groups were broken apart, were reorganized by numbers allotted to them into new “Expert Groups.” Like all, the ones, twos, threes, fours, and fives constituted expert groups, respectively [Figure 1].

Step 4: A specific subtopic centering to the overall topic was allotted to each student in each expert group. The subtopic distribution with respect to cadaveric dissection was as follows: Expert group 1 – gross features, peritoneal and visceral relations of the stomach, and stomach bed; Expert group 2 – blood supply of the stomach; Expert group 3 – lymphatic drainage and nerve supply of stomach; Expert group 4 – (and additional students) embryology and histology of stomach; Expert group 5 – applied anatomy.

Step 5: The expert groups allowed all the students to discuss the subtopic among themselves, share the ideas, search the Internet, consult books in the library. This way they clarified their doubts and understood the concepts of the common topic they all have read.

Step 6: Then, the expert groups broke apart and returned to their original home groups to present and discuss the topic they have studied. Each and every student brought with them the knowledge gained (as expert group) and had command on one of the subtopics. This way every topic got taught by a peer to all the students in the home group and everybody was well versed with the complete topic. Teachers acted as facilitators to ensure the smooth transition of the development of the topic given to the students and also to monitor the healthy group processes and discussions.

Step 7: After the completion of the jigsaw exercise, the facilitators first checked that the topic is covered and then called all the students in a large group to allow time for solving their queries, questioning by other home groups, and any further clarification.

Step 8: The knowledge of students was judged by taking another test named posttest comprising of SAQs and MCQs. Pre- and posttest questionnaires were not the same and were designed in consultation with the opinion of the whole faculty, expertise in the subject of Anatomy.

Step 9: Finally, the faculty and students were requested to fill a feedback questionnaire consisting of 10 statements on their perception towards jigsaw technique. Feedback was evaluated by evaluation matrix which is based on students and faculty response on learning experience of jigsaw technique [Table 1].
Table 1: Evaluation matrix based on students and faculty response on the learning experience of the jigsaw method

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The second topic was also taught by this method of jigsaw technique and the knowledge gained was again judged by another test comprising of SAQs and MCQs. The marks obtained by the students in two tests were compiled and analyzed statistically.

  Results Top

Pre- and postjigsaw technique assessment scores

As predicted from [Table 2], there was a significant increase in marks of students by viewing the average mean, i.e., 61–71.5 of pair 1 and 62–74.7 of pair 2. The difference in the performance of the students in pre- and posttest was calculated by applying the paired-t-test which is a type of inferential statistic used to determine if there is a significant difference between the means of two groups. Paired-t-test in the present study was found to be statistically significant. A significant higher posttest score of jigsaw than the didactic lectures (P < 0.001) is shown in [Table 3].
Table 2: Pre-and postjigsaw technique assessment scores of students using the jigsaw technique

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Table 3: Paired differences between the scores with significant P

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Results of the evaluation test

After completion of each topic taught by the ALM jigsaw method, an evaluation test was taken to judge the knowledge acquired by the students. The evaluation test comprised of both MCQs and SAQs. The results as seen in [Figure 2] showed that 97 (73.48%) students in the first topic and 104 (78.78%) students in the second topic scored 70% or more marks taught by jigsaw technique as compared to pretest where only 53 (40.15%) and 68 (51.51%) students could score 70% or above marks, respectively [Figure 2].
Figure 2: Bar chart showing difference in the performance of the students in pre- and post-tests

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Views from evaluation matrix

From the evaluation matrix, it was observed that more students started participating in the academic discussions with their peers. An increase in students visiting the faculty members for clarification of their doubts was also observed by the faculty members. They also tried to make their concepts on dissected cadavers or the pro-sections in the dissection hall apart from the cadavers allotted to them. About 100% of faculty members readily accepted the suggestion of implementing the jigsaw method. About 88% (132) of students showed enthusiasm and interest to take up the activity. ALM was helpful for the students in rating their own learning standards. Using ALM was helpful in improving student's learning skills and communication skills with a transition from passive learners to active learners. Majority of students demand more topics to be taught by this method [Table 1].

  Discussion Top

Active teaching methods play a very important role in new curriculum where students are the active participants and play the principal role in learning. Jigsaw is one of the important and popular teaching–learning methodologies. It improves thoughtfulness, dyadic communication, reasoning ability, and teamwork. In the medical colleges' setting, there seems to be limited use of application of the jigsaw technique. Students rated the utility of the jigsaw method as 3.53 on a 5-point scale and had several positive comments in a study which used jigsaw approach instead of a standard journal club.[17] The present study also revealed that the active learning by the jigsaw method was refreshing and encouraged active student participation and gave a clearer in-depth understanding of the topics. This is further proven by difference in the performance of the students in pre- and posttests. The results also showed that 97 (73.48%) students in the first topic and 104 (78.78%) students in the second topic scored 70% or more marks taught by the jigsaw technique as compared to pretest. The true impact of learning might not be reflected through this method of evaluation because most of the instructional approaches may temporarily increase the knowledge of students, giving higher posttest scores. Persky and Pollack assessed and showed that the jigsaw approach was successful in enabling learning among medical students in teaching renal clearance concepts.[18] Saleh et al. observed a positive attitude among students toward interactive sessions and also noted that students performed better in small group teaching as compared to didactic lectures.[19] A significant difference in the posttest scores by interactive teaching–learning method was noticed by Srivastava and Waghmare as compared to traditional pedagogics.[20] Similarly, Phillips and Fusco demonstrated the successfulness of the jigsaw technique, with high posttest score of 88% among pharmacy students.[21] In a study of innovative teaching methods to reinforce teaching and learning in forensic medicine, Parmar and Rathod found a significant increase in mean posttest score for the innovative teaching methods for all the topics taught.[22] There was a significant difference between pretest scores (52.5%) and posttest scores (80%) in a study conducted on psychology students following the jigsaw method of teaching.[23] However, during a study among medical students, the jigsaw method of teaching showed a substantial increase in posttest scores as compared to the standard tutorial method of teaching (12.4 vs. 9.7, P ≤ 0.001) and showed appreciable preservation of knowledge and learning among the students.[24] In the present study, it was observed that there was a significant improvement in the posttest scores after using the jigsaw approach and these findings of posttest score improvement are in accordance with the previous studies. Koprowski and Perigo in their study have concluded that students strongly endorsed the cooperative technique with 84.8% of the opinion that the cooperative technique was superior to learning anatomy by the traditional method. About 12.1% preferred the traditional method and 3.1% did not prefer either method.[25]

The findings of the evaluation matrix and feedback also revealed that more students started participating within the academic discussions with their peers. An increase in students visiting the faculty members for clarification of their doubts was also observed by the faculty members. The students were in favor of the jigsaw technique because it was helpful in improving the learning skills and communication skills [Table 1]. One of the competencies required by Indian medical graduates, as per MCI “GMR 2019” document, is communication skills.[3] The jigsaw method has played a major role in transforming the students from passive learner to active learner by improving their communication skills and also by helping the students to overcome the fear and hesitation due to peer interactions and presentations.[21] Active learning by the jigsaw method was refreshing and encouraged active student participation, discussions, and gave a clearer and in-depth understanding of the topic. Students were in favor that ALM was helpful in improving the learning skills, problem-solving abilities, and communication skills.[26] About 100% of faculty members readily accepted the suggestion of implementing ALM. About 88% (132) of students showed enthusiasm and interest to take up the activity. Majority of students demanded more topics to be taught by ALM [Table 1]. Jigsaw technique has been shown to be effective in teaching reasoning skills, abstract thinking skills, especially in pharmaceutical sciences, and clinical problem-solving skills required for their clinical education and later medical practice and long-term patient care.[18],[21],[24],[27],[28]

In the present study, though majority of the students had positive attitude toward the jigsaw approach, few disadvantages were also noticed which should not be disregarded. Time constraint was one among the most important challenges of using the jigsaw technique because it was experienced to be a time-consuming process. Another challenge was the noncooperation of a number of the students, could also be, they were not able to express themselves fully to their peers which affected the success of the group in completion of the entire topic. Persky and Pollack and Kumar et al. have also specified the same disadvantages in their studies.[18],[24]

  Conclusion Top

Active learning by the jigsaw method utilized in this study showed active participation by both faculty and students. The jigsaw technique has motivated the students to undertake this newer method of learning. Students also reported feeling benefitted from this alteration as evident from the results indicating better performance by the students once they are involved actively in learning. The interactive techniques are also need of the hour and should be adopted alongside didactic lectures for important topics of clinical relevance in Anatomy. To beat the drawback of time constraints, the topics can be announced before the students in order that the students can come prepared with the subtopic allotted to them for the step of expert group preparation in the jigsaw approach. The viewpoint of faculty was also in favor of jigsaw and opined that jigsaw can be included in the prevailing teaching curriculum along with the didactic teaching method.


There was no control group with traditional teaching method in the present study. The long-term outcome of students' learning and understanding of the subject taught with the jigsaw technique has yet to be measured.

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Conflicts of interest

There are no conflicts of interest.

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  [Figure 1], [Figure 2]

  [Table 1], [Table 2], [Table 3]


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