Author Response.

We would like to thank Ms Sanders for her very positive commentary and insights into our work. She provides a very cohesive summary of our research, and her comments are very effective in focusing the reader on key issues in student supervision, whether it be individual or cooperative in nature. Ms Sanders is also very accurate in noting that cooperative learning does not happen naturally. Specific components need to be in place for group learning to be successful. Ms Sanders cites several key considerations for ensuring a positive educational outcome.

Ms Sanders noted that we did not measure the actual amount of time spent by students and clinical instructors in collaborative activities. As investigators, we had to be careful not to impose excessive record-keeping demands on the subjects. For this reason, we chose to focus on productivity because this appears to be a contentious issue among clinical instructors and administrators. We contend that the amount of time spent in cooperative activities is not necessarily central to a successful educational outcome. Instead, it is the quality of interaction that is more important. As a result, we believe that studies with a qualitative focus would be best suited for investigating what issues emerge during collaborative learning.

In Ms Sanders' commentary, she also notes that we do not mention whether the clinical instructors received any training or whether they had previous experience in a cooperative learning model. All clinical instructors were invited to attend a full-day workshop on cooperative learning and supervision prior to their involvement in this study. For the most part, the majority of clinical instructors sought out this opportunity. With respect to the second issue, we did not seek out information about the past supervisory experiences of the clinical instructors. The clinical instructors in this study tended to have several years of experience as practitioners or supervisors. From this perspective, we believe their comments come with the benefit of considerable experience. As tenured clinical instructors and clinicians, we would hope that they would be able to compare and contrast their experiences in the cooperative learning model to more traditional models of clinical education.

For the most part, our study represents an attempt to provide some insights into the differences between cooperative and individual learning experiences in the clinical education setting. There are still, however, many questions that need to be answered about learning in the clinical education setting. For example, how do learning outcomes differ among students who learn individually versus cooperatively? How does this influence independent practice? How do clinical reasoning and performance differ across the 2 models given the same task?

Ms Sanders notes that we need to educate physical therapists who can be responsive to the ever-changing demands of the health care system and clinical practice. We would also like to add that we need to ensure that our educational models reflect best practice in education and incorporate principles of contemporary adult learning theory. Evidence-based practice should not be confined to our examination and treatment practices. We also need to use evidence to guide our educational practices. We hope that the results of our study provide administrators, clinical instructors, and students with the courage to give collaborative learning a fair trial in their clinical settings.

Richard K Ladyshewsky, MHSc, BMR(PT) Simon C Barrie, BSc(Hons) Valle M Drake, MSc