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Background: Delivering case-based collaborative learning (cCBL) at scale using technology that both presents the clinical problem authentically and seeks to foster quality group discussion is a challenge, especially argumentation which is critical for effective learning. The aim of this study was to investigate the presence of essential conditions to capitalize on a technology-enhanced cCBL scenario for teaching radiology and facilitating quality group discussion., Methods: A questionnaire was administered to 114 fourth-year medical students who completed a technology-enhanced cCBL scenario for teaching neuroradiology. It consisted of individual online pre-class work and face-to-face in-class work, where group discussion followed individual work at a workstation. Items from the "Heedful Interrelating in Collaborative Educational Settings" scale and "positive emotional engagement" questionnaire assessed the quality of social-cognitive processes and emotional engagement during the group discussions. Structured interviews were used to explore the teachers' awareness of and engagement with the technology., Results: The mean scores of most "heedfulness" items were below 3.5 (7-point scale), suggesting that participants did not enter the debriefing with a mindset conducive for argumentation. However, for the affective states "interest" and "enjoyment" the mean scores were above 5. Free text comments suggested participants enjoyed the superficial interactions, but did not necessarily engage in argumentation. Structured interviews revealed teachers were aware of the possibilities of the learning dashboard and used it as a common frame of reference, but did not really succeed to use it as a springboard for discussion., Conclusion: A technology-enhanced cCBL scenario is useful for teaching radiology in undergraduate medical education, but the added value of acquiring in-depth knowledge will only be achieved when students are aware of the importance of an "heedful" mind-set., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Aims: To meet the flexible learning needs of pathology residents preparing for national board examinations, a joint distance learning approach was developed using both asynchronous and synchronous activities with whole slide images, drawing on empirical educational research on online distance learning., Methods: In a case study of an implementation of the designed joint distance learning approach with a geographically dispersed group of pathology residents in Finland, the participants' perceptions were measured with a 12-item questionnaire covering the value of the learning opportunity, the quality of the sociocognitive processes and their emotional engagement and social cohesion. Communication during the online session was also recorded and analysed to provide objectivity to the self-report data., Results: The effectiveness of joint online learning for knowledge acquisition and preparation for national board examinations was highly rated. However, despite strong emotional engagement during synchronous activities, participants reported minimal interpersonal interaction, which was also reflected in the recordings of the online session., Conclusion: Using a technology integration framework and guided by the principles of self-determination theory, joint distance learning is emerging as a beneficial addition to postgraduate pathology programmes in preparation for national examinations. However, to realise the full potential of interpersonal interaction, participants should be prepared for an appropriate mindset., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

In medical education, the use of flipped classrooms is on the increase. The complex, interdependent active- and social learning activities often built into the 'in-class' phase of this new approach may, however, cause cognitive overload, impeding learning. Computer-supported collaborative learning could play a role in reducing such cognitive load. The current study investigated how four constituent factors of 'in-class' scenarios for 'flipped' classrooms affect the intrinsic, germane and extraneous cognitive load for students. After participating in a computer-supported 'in-class' scenario for a radiology training course that combined face-to-face individual activities, small-group work and class-wide activities, undergraduate medical students ( n  = 135) completed a questionnaire rating the cognitive load perceived. Computer support comprised a program for radiology assessment and a learning dashboard that captured and visualized the assessment results. Total intrinsic load, germane load, and extraneous load (EL) were calculated from the results obtained. The 'high' intrinsic load, 'high' germane load, and 'low' EL indicate that the computer-supported 'in-class' scenario was cognitively challenging but that sufficient mental effort could be spent on task performance and learning. We attribute the successful management of the cognitive load imposed by this complex in-class scenario to the specially designed learning dashboard.

Aim: To examine how collaborative diagramming affects discussion and knowledge construction when learning complex basic science topics in medical education, including its effectiveness in the reformulation phase of problem-based learning., Methods: Opinions and perceptions of students (n = 70) and tutors (n = 4) who used collaborative diagramming in tutorial groups were collected with a questionnaire and focus group discussions. A framework derived from the analysis of discourse in computer-supported collaborative leaning was used to construct the questionnaire. Video observations were used during the focus group discussions., Results: Both students and tutors felt that collaborative diagramming positively affected discussion and knowledge construction. Students particularly appreciated that diagrams helped them to structure knowledge, to develop an overview of topics, and stimulated them to find relationships between topics. Tutors emphasized that diagramming increased interaction and enhanced the focus and detail of the discussion. Favourable conditions were the following: working with a shared whiteboard, using a diagram format that facilitated distribution, and applying half filled-in diagrams for non-content expert tutors and\or for heterogeneous groups with low achieving students., Conclusion: The empirical findings in this study support the findings of earlier more descriptive studies that diagramming in a collaborative setting is valuable for learning complex knowledge in medicine.