Small Group Teaching

Vinod Patel Bernadette O’Hare

Aim.• To discuss small group teaching: Pros and

Cons• Consider new approaches that develop

from the group

Objectives.

• To agree the particular strengths of Small Group Teaching

• To identify difficulties with Small Group Teaching

Format of the session.

• Brief Introduction• Strengths and Weaknesses analysis• Tools of teaching OTJ• Logbook Exercise• Concluding Discussion

Small Group teaching in GP• Build on prior experience and knowledge• Clearly related to learning needs of the participants• Active learning• Focussed on problems• Immediately applicable• Action-Reflection cycles• Acquisition of technical skills

De Villiers et al 2003

Medical Students: Small Group • Effective Small Group Tutors• Positive group atmosphere• Active participation and interaction• Keeping to goals• Clinical relevant• Promotion of clinical thinking and problem

solving

Steinert 2004

Experiences of Small Group Teaching

• Positive • Negative

Experiences of Small Group Teaching: St George’s

Positive• Enjoyable, interactive,• Makes you think, involved• Own pace• Links with other parts of

course• Builds on prior learning• Teamwork emphasis• More heads• Cannot opt out• Deep discussion• Group socialisation

Negative• Terror of being asked question• Mini-lecture• Monologue• Domination by a few • Did not deal with my issues• Poor preparation• Tutor had to drag out answers• Too long• Tutor poorly prepared

Peter McCrorie 2006 ASME booklet

Increasing levels of performanceby taking a break

0 5 10 15 20 25 30 35 40 45 50 55 60

Period of teaching (minutes)

Leve

l of p

erfo

rman

ce

RestLearning gainedthrough rest period

Source: Bligh (1998)

| | | | | | | | | | | | |

Learning lostthrough rest period

Small Group Teaching

Point 2 Point 3 Point 4 Point 5Point 1 Point 6

“Rest”“Rest” “Rest”“Rest”“Rest” “Rest”

What size and How Shall we sit!

What size and How Shall we sit!

Role of the Tutor:• Instructor• Devil’s Advocate• Probe answers, even wrong answers• Chair the interactive discussion• Be the information source• Facilitator: guide, ensure objectives and

“curriculum” delivered, ensure progress

Richmond’s Strategic Interventions

• Start, finish, outline task, summarise, set further activities

• Maintain flow of content• Manage group dynamics• Facilitate goal achievement and check

understanding• Manage the environment: time, equipment,

heating!)Richmond DE 1984

Small Group Rules• Punctuality• Finish on Time• Do not talk over each other, avoid interruption• Values each other contribution• Respect viewpoints• Turn up prepared• Join in• Keep personal issues outside• Maintain confidentiality if needed• Mobile phone ?!

Peter McCrorie 2006 ASME booklet

Small Group Dynamics• Forming• Norming• Storming• Performing• Adjourning-moving on

The Kolb CycleIn Small Group Teaching

Planning and Preparing

Reflection

Concluding

Action

The Kolb CycleIn Small Group Teaching

Planning and Preparing

Reflection

Concluding

Action

Background work

Actions in the group what happened

New Learning

New Skills

Challenging Learners• Dominant• Know it all• Centre of Attention• Aggressive/Argumentative• Offensive• Politically incorrect• Flirtatious• Joke a minute• Garrulous• Disengaged

• Bored• Let’s other people do

work• Lazy• Shy• Delicate, tearful• Over dependant• Late• Frequently ill• Mentally disturbed

Peter McCrorie 2006 ASME booklet

Small Group Learning Summary

• Can be very productive• Special Skills: Facilitation• Active Learning and Reflection ideally• Range of activities: discussion, role play,

videos, quiz, etc etc• Keep to the intended outcomes (if

essential)

Some Definitions:• Professional Supervision: Regular

extended one to one meetings between experienced clinicians, to discuss specific cases

• Informal Supervision: opportunistic exchanges, short, spontaneous

• Managerial Supervision: Direct supervising manager and supervisee

John Launer ASME 2006)

Some Definitions:• Remedial Supervision: Regulatory authority

has concerns about someone’s performance• Mentoring: Guidance and support offered by a

more experienced colleague• Coaching: Supervision aimed at unlocking

someone’s potential (maximise performance)• Educational Supervision: organised clinical

supervision taking place in context of recognised training

John Launer ASME 2006)

Mentoring• Usually guidance and support by a more

senior colleague• Also peer mentoring and co-mentoring• Formal or informal• Voluntary and confidential

Launer’s Seven C Approach• Conversation:• Curiosity:• Contexts:• Complexity:• Creativity:• Caution:• Care:

Launer 2002)

Launer’s Seven C Approach• Conversation: talking through versus direct advice• Curiosity: explore, detail, specificity• Contexts: in the shoes of the other person• Complexity: looking at the whole, avoid “quick fix”, do

not lose the individual• Creativity: innovation, imagination, thinking laterally• Caution: circumspection, do nor over stretch the

relationship, realistic expectations• Care: Attentiveness and positive regard

Launer 2002)

What makes a good teaching session?

• Small groups• Interesting signs / classical case• Focussed area for teaching• Observed examination with feedback• Combined with theory and case

discussion

Langrish J, Informal Oxford Student Survey 2003