Small Group Teaching Vinod Patel Bernadette O’Hare

1. Small Group Teaching Vinod Patel Bernadette O’Hare

2. Aim. • To discuss small group teaching: Pros and Cons • Consider new approaches that develop from the group

3. Objectives. • To agree the particular strengths of Small Group Teaching • To identify difficulties with Small Group Teaching

4. Format of the session. • Brief Introduction • Strengths and Weaknesses analysis • Tools of teaching OTJ • Logbook Exercise • Concluding Discussion

5. 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

6. 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

7. Positive Negative Experiences of Small Group Teaching

8. 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 Experiences of Small Group Teaching: St George’s Peter McCrorie 2006 ASME booklet

9. Rest Learning gained through rest period Learning lost through rest period Increasing levels of performanceby taking a break Level of performance | | | | | | | | | | | | | 0 5 10 15 20 25 30 35 40 45 50 55 60 Period of teaching(minutes) Source: Bligh (1998)

10. “Rest” “Rest” “Rest” “Rest” “Rest” “Rest” Point 1 Point 2 Point 3 Point 4 Point 5 Point 6 Small Group Teaching

11. What size and How Shall we sit!

12. What size and How Shall we sit!

13. 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

14. 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

15. 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 ?! Small Group Rules Peter McCrorie 2006 ASME booklet

16. Forming Norming Storming Performing Adjourning-moving on Small Group Dynamics

17. Planning and Preparing Concluding Action Reflection The Kolb CycleIn Small Group Teaching

18. Planning and Preparing Concluding Action Reflection The Kolb CycleIn Small Group Teaching New Skills Background work New Learning Actions in the group what happened

19. 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 Challenging Learners Peter McCrorie 2006 ASME booklet

20. 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)

21. 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)

22. 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)

23. Mentoring • Usually guidance and support by a more senior colleague • Also peer mentoring and co-mentoring • Formal or informal • Voluntary and confidential

24. Launer’s Seven C Approach • Conversation: • Curiosity: • Contexts: • Complexity: • Creativity: • Caution: • Care: Launer 2002)

25. 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)

26. 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 LangrishJ, Informal Oxford Student Survey 2003