Are You Already a Small Group Teacher?

Derived from Thomas L. Schwenk & Neal Whitman (1993), Residents as Teachers: A Guide to Educational Practice and Henry Walton (1997), Medical Education Booklet No. 1, Small Group Methods in Medical Teaching.

Small group teaching is typically associated with medical student discussion groups or problem-based learning sessions. However, small group teaching/learning situations can also occur quite frequently in other settings. Clinical rounds (bedside teaching), students gathering around a cadaver, research seminars, and journal clubs are all examples of small group settings. In all of these settings, opportunities for enhanced student learning occurs through group discussion. Becoming adept in small group teaching techniques can help the instructor seize or heighten all those teachable moments that might otherwise be missed.

Some of these settings may not be the ideal situation for distributing information, but they are useful for helping studentsrelate concepts and develop new approaches to communication processes, problem-solving, and decision-making. By applying small group teaching techniques instructors create an opportunity to increase student understanding and promote active learning.

Small Group Teaching in Medical Education

Because most adults learn more efficiently when they engage in active learning, small group discussion sessions are becoming more prevalent in medical education.¹ For UASOM, documents such as the Medical Education Committee’s Curriculum 2000 encourage integrating active learning into the curricula (http://www.uab.edu/uasomume/MEC/mec_curr2000.htm).

One goal of Curriculum 2000 is "to instill in students life-long learning attitudes and skills, reduce students' passive learning while increasing their independent learning and improving their problem-solving skills, . . ." ² The lecture as an instructional method does not support the achievement of this goal as well as does small group, interactive instructional methods.

1. Gelula, M.H. (1997). Clinical Discussion Sessions and Small Groups. Surg. Neurol. 47, 399-402.
2. Medical Education Committee (1997). Curriculum 2000. The University of Alabama School of Medicine.

Small Group Techniques

Derived from Henry Walton (1997), Medical Education Booklet No. 1, Small Group Methods in Medical Teaching

Before the session. . .

• Assign documents to read in advance. This may help the student begin to think about some insightful ideas and/or questions to bring to the group, organize his/her readiness to think about something new, and provide a common basis for the discussion.

Starting the session. . .

• Present a prepared problem or controversy. Ask an open-ended question or several questions to encourage group participation at the start of the session. Refrain from asking questions with yes or no answers – this type of questioning prevents discussion. Encourage students not just to give the correct answer, but to explore ideas.

• Establish the group’s task. Begin each session by clarifying the group’s goals and objectives for the session (e.g., Is the task to solve a problem or merely to discuss an issue?). Establishing the task at the beginning will help to focus the discussion on relevant issues.

During the session. . .

• Talk less and listen more. Once the questions are asked at the beginning of the session, be quiet. Only continue questioning if the members need prompting or if they deviate too far from the point. Try to deflect questions that are directed toward you back to the group for consideration by the other group members. Encourage students to talk among themselves and not to direct everything to you.

• Allow periods of silence to occur. The silence may indicate that the students are thinking.

• Encourage students to explain/support their statements. Ask the students to elaborate on their assertions, even if the statements are incorrect. By justifying his/her own answer, the student may develop a more complete understanding for himself/herself and may help others to more fully understand the view. If however the answer is incorrect, the student may self-correct during the attempt to explain his/her statement.

• Minimize the influence of dominant students. Gently (become more vigorous if necessary) encourage more dominate students to allow others an opportunity to participate. If this does not work, begin redirecting the discussion to specific group members.

• Increase participation of quiet students. Quiet students tend to passively think, listen, and form ideas. As the group facilitator, it is your responsibility to elicit these students’ ideas so that all group members can benefit.

• Minimize your role as the expert. Behaving as the expert may cause student anxiety or resentment and possibly inhibit students from participating in the discussion. Establish the rule that the group leader’s ideas are also subject to examination and challenge.

• Minimize a high profile role in the group. It may be easier for many to impart knowledge than it is to facilitate a group discussion, but refrain from lecturing. It is important to extract yourself from the interaction as much as possible and allow the focus to be on the learners.

• Reduce the amount of information you provide. Allow the students to explore ideas, even if the ideas are inaccurate views. There is often more learned from pursuing the wrong path than the right one. Only when the element of time is crucial, should you end that discussion.

• Avoid using value judgements. This may inhibit the group members’ willingness to volunteer their thoughts and views. Allow other group members to refute statements, but your criticism may be viewed as wounding put-downs.