Sir, cooperative learning leads students to a higher level of reasoning through critical creative thinking, problem-solving and interpretation, and we have incorporated the so-called Jigsaw approach or Aronson's Puzzle into this technique for dental undergraduates.

The Jigsaw approach was introduced in the early 1970s by Elliot Aronson at the Universities of Texas and California as a way of reducing racial conflict among students and increasing positive educational outcomes. We have incorporated it for the resolution of clinical cases by undergraduates in the subject areas of special needs in dentistry and comprehensive dental care in adults using two different study designs.1

In both subjects, four three-hour sessions in the first three months of the academic year were applied using the Jigsaw approach. Additionally, the teaching methodology consisted of lectures, in which the teacher presented and discussed diagnoses and treatment plans for different clinical cases, as well as clinical training sessions with patients. In order to evaluate the effectiveness of using Jigsaw cooperative learning, we compared the marks obtained in the final exam for each group as well as the students' perception using a questionnaire. Our findings support that the Jigsaw cooperative learning technique contributes to enhance clinical reasoning and decision-making, as well as the resolution of clinical case problems in dentistry. From the students' perspective, this technique helps them to understand the complexity and depth involved in solving dental clinical cases.