Small Group TeachingSmall Group Teaching

John T. Benjamin MD

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UNC Department of Pediatrics

The Teaching CenterThe Teaching Center

Small group vs. clinical Small group vs. clinical teaching vs. large group teaching vs. large group

teachingteaching

• Arbitrary differences

• Emphasis somewhat different but basic tenets the same for all kinds of teaching

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Examples of Small Group Examples of Small Group TeachingTeaching

(My Personal Activities)(My Personal Activities)

• Teach Attending• Inpatient Rounds• Morning Report (chief residents lead)• Pre-clinic talks for continuity clinic• Some noon conferences: at beginning of

hour. (merge large group and small group)• This course• ICM with 2nd year students• Others?

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First Step: Pre-planningFirst Step: Pre-planning

• If asked to do small group teaching:

» Be aware of existing goals and objectives of the educational coordinator.

» If none exist, develop your own goals/objectives.

» Create any materials you might need to get started with the group.

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Approaching the Small GroupApproaching the Small Group

1. Orientation day 1

2. General Approach to the Small Group

3. Be interactive-use different teaching techniques

4. Summarize as go along

5. Review what has been said at end of each session and beginning of next.

6. Don’t forget to give individual feedback

7. Evaluate what you have done

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1. Orientation – Day 11. Orientation – Day 1

• Ask for learners goals and objectives• Determine needs of learners and what they

would value the most out of session.• Set expectations- writeups/presentations/etc• Mention feedback and the intention to give

feedback to each learner; when to be given.• Determine if there are to be absences during

the course and when.

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2. General Approaches to 2. General Approaches to ConsiderConsider

• Start out with fun exercise: px/case/etc• Ask the right question: balance between

“pimping” and being interactive.• Start with open-ended question and wait for

at least 3 seconds for answer.• Be enthusiastic/ interested in learners’

feedback• Utilize different teaching techniques

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3. Be Interactive3. Be Interactive

• Empty Vessel comparison: no way to teach and no way to learn. Teaching is not telling.

• Involve the students – make them ask themselves questions and answer their own questions.

• Need to ask the right questions

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Teaching techniques that could Teaching techniques that could be used in small groupbe used in small group

• Role Playing (Drs. Byerley/Liles- clinical

teaching; Feedback exercise; today)• Buzz Groups (Dr. Hamrick- curriculum)• Case Discussion (Let learner present)• Mini-Presentation (3 minute student pres)• Brainstorming (Dr. Liles- large group)

(www.pediatricsinpractice.org)

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Examples of other techniquesExamples of other techniques

• Using auditory senses (eg cough)

• Themes for the day• Scavenger hunt for

physical findings.• Demonstrations• Notebook/flash card• Teach at bedside• 3 minute reports

• Phone call role plays

• Learner shares 1 thing learned that day from patient or from rounds.

• Sign out exercise• Unknown pictures• Summarize at the

end of rounds (inpatient) or after seeing each patient (outpatient)

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4. Summarize as Go Along4. Summarize as Go Along

• Start session with unknown or something fun

• Then go to content. About half way through a half hour talk either summarize yourself or get learner to do it.

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5. Summarize at end of Session5. Summarize at end of Session

• Repeat, repeat, repeat

• Summarize everything covered in 3 sentences. Ask: So what have we learned today?» Eg Continuity Clinic talks – needed to

review again every 3 months.

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6. Give Feedback6. Give Feedback

• Make clear on day 1 when feedback is to be given.

• Then label it as feedback as doing it.

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Feedback – 5 minutes a weekFeedback – 5 minutes a week

• Organized in advance and predictable – not just when things go wrong. Private setting.

• Start by saying: This is our feedback session. • Then ask: “How do you think things are

going?” and then listen carefully.• Sandwich not always necessary• Be explicit and give examples• Ask for it to be bidirectional

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Conclude FeedbackConclude Feedback

• By summarizing and giving a plan of action if needed.

• If problem, identify specific time to meet again in 3-4 days.

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Feedback vs. EvaluationFeedback vs. Evaluation

• These two terms are not equivalent.

• Evaluation is what is done at the end of the experience with the learner. Feedback should be happening as go along.

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7. Document Evaluations of 7. Document Evaluations of Your Teaching!Your Teaching!

• www.med.unc.edu/oed/toolbox/welcome• This website contains evaluation forms for

peers, students (learners) and self-assessments. Just click on the pdf files

• Remember, for your Teaching Portfolio, you will need evidence of your teaching effectiveness!

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Challenges to teaching small Challenges to teaching small groupsgroups

• Not all learners motivated- or engaged• Different levels of learners at same time• How bring the quiet student into the

discussions • Dealing with the dominating or difficult

student• You as teacher haven’t done good job with

needs assessment (this not always easy)

• Others?

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Exercises for Small GroupExercises for Small Group

• Teaching same level and different level learners. How approach differently?

» Exercise #1: Same level learner

» Exercise #2: Different level learners

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Exercise #1- small groupExercise #1- small group

• Teach 3rd year medical students about colic:» How do you follow outline (needs assessment

intro/discussion/conclusion/review?)

» How do you determine your effectiveness?

» 1 faculty member/ 1 “teacher” / 2-3 students per group.

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Exercise #2- small groupExercise #2- small group

• Teach different levels of learners about colic on rounds. (3rd year students/ intern/ upper level resident)

• 1 faculty member/ 1 teacher / 1 3rd year / 1 intern/ 1 upper level per group.

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Conclusion:Conclusion:Small Group TeachingSmall Group Teaching

• Must prepare (needs assessment, set agenda day 1 and at beginning of each session; ask right question – be interactive; summarize as go along, review, give feedback, get evaluations of what you have done).

• Bias: most fun part of teaching in academic medicine

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