Small Group Sessions

This module will introduce you to small group learning as a teaching method and includes a discussion of the rationale for small group learning, planning and facilitating for effective small group learning as well as a review of common facilitation challenges in small group learning and strategies to address them.

By the end of this module you should recognize the benefits of small group learning and have increased confidence in your ability to plan and facilitate small group learning activities.

To begin, let’s consider the question, “What is small group learning and how does it differ from other teaching formats?”

Small group learning is used in multiple contexts in medical and biomedical education. Small groups may serve as companion or supplemental groups to traditional lecture formats, help learning in the lab, represent clinical teaching units such as the “ward team”, or represent the main learning unit of a course or curriculum.

Small group size may vary depending in the context of learning and consideration of the optimal size and composition is important. However, the exact size of a small group is much less critical than what happens in a small group in terms of teaching and learning.

Small group learning is characterized by learning that is active, collaborative, and self-directed. Small group learning emphasizes a supportive and open learning environment. In effective small group learning experiences, students may discuss ideas, compare and contrast opinions, test hypotheses, practice skills, receive real time feedback and reflect on their learning needs and goals. Contrast this experience with, for example, the traditional medical or biomedical lecture in which learning is more passive, unidirectional, and instructor-directed. (Although we hope that you have discovered techniques to make lectures more active for learners in the module on lectures.)

Small group learning often requires more resources (facilitators, space, time) and effort to plan and execute. So why bother?

Thoughtfully planned and skillfully executed small group learning has the potential to create rich and meaningful learning experiences. Effective small group learning allows for the application of theoretical learning into real world contexts and contributes to mastery of higher order skills, which ultimately results in deeper and longer lasting learning. There are many opportunities for small group learning (both formal and informal) in medical and biomedical education. Improving your understanding of small group learning will allow you to make the most of these opportunities for your learners and yourself.

Hopefully this will convince you that the effort to plan and execute small group learning activities is well worth it for learners and teachers.

The key features of small group learning include:

Active learning

Collaborative learning

Self-directed learning

Supportive and open learning environment

(See module on Adult Learning Principles for a description of these)

As you read through this module, continue to reflect on your own experiences teaching or learning in small groups. What do you notice about these experiences that promote learning that is active, collaborative, and that encourages learners to take initiative for their own learning? How would you describe the learning environment?

Effective teaching and learning requires careful planning and forethought. By considering the following questions each time you plan a learning activity you’ll be more likely to focus your planning and cover all important aspects of teaching and learning in small groups.

What is it that I want to teach?

Who are my learners?

How will I teach the material?

How will I know that my learners have mastered the material?

We will address these questions in the following sections:

• Identify goals and objectives

• Consider your learners and group factors

• Develop educational activities

• Determine assessment tools

Identify goals and objectives (What is it that I want to teach?)

Identify goals and objectives for small group learning sessions within the entire curriculum. As mentioned in the overview, small group learning may supplement traditional lectures, help learning in the lab, represent a clinical teaching unit, or be the main learning unit of a course or curriculum. Determining your goals and objectives will guide the structure of your group, the learning activities you use, and your evaluation plan.

In contrast to other teaching methods, small group learning may address both content and process goals and objectives.

Consider the following example.

You are running a small group session that supplements a course on Research Methods. The content goal of the small group is to learn about different research designs and the appropriate use of each. A process goal is to improve learners’ collaboration, communication and presentation skills. The latter skills are all important for future researchers.

Consider your learners and group factors (Who are my learners?)

Ask yourself the following questions:

• What are my learners experience level or areas of expertise?

• What are their learning needs?

• What are their learning styles?

• What prior norms for learning in groups (e.g. collaborative and active vs authoritarian and passive) are my learners familiar with?

• Are their existing or prior relationships among group members and how might these effect learning?

Now consider group size and composition:

• How might group size impact small group learning? Is there an optimal group size for the content and your learners’ needs?

• What is the optimal composition of the group in terms of gender, experience level, communication/participation style, majority status on the group. How might different balances of the above impact participation and influence in the group?

• What physical setting might be most conducive for effective group learning?

There are no absolute answers to these questions, although carefully considering these issues may anticipate and prevent problems and enhance small group learning considerably.

Develop educational activities (How will I teach the material?)

Now it is time to identify educational activities to meet the goals and objectives of the course and which take into account the experience and needs of learners.

Aim for activities that promote:

• Individual accountability and a high level of collaboration

• An exchange of diverse perspectives

• Critical thinking and problem solving

• Perspective transformation (in which learners are challenged to explore assumptions and existing beliefs, aided by reflection and alternate perspectives)

Using a variety of active learning strategies will ensure that small group learning is interesting and effective.

Let’s refer back to the previous example of the course on research methods. The following exercise will help learners in the group meet the goals of learning about research design and improving collaboration, communication and presentation skills.

The group is given a research question and are tasked with identifying 2-3 possible research designs to answer the research question. The group must describe the pros and cons of each potential design. Each group member is then assigned a role with a specific task or level of expertise associated with it (such as principle investigator, statistician, graduate student, research coordinator). Each member presents the pros and cons from the perspective of their role. The group must agree on a final research design.

Consider assessment type and tools (How will I know that my learners have mastered the material?)

(The assessment modules will explore this topic in more detail.)

Assessment of learners in the context of small group learning should be based on the goals and objectives of the session/course and address the question: How will I know that my learners have mastered the material or process related goals? Depending upon the course or curriculum, assessment may be:

• Formative- monitor learning by providing ongoing feedback to improve learning

And/or

• Summative- evaluate learning often by using some standard or benchmark at the end of a course

Summative assessments are typically “high stakes” and involve written or oral/observed examinations.

Formative assessment is often more informal or “low stakes” and focused on addressing learners’ needs in real time and assisting them in improving. Small group learning to improve specific skills creates a unique opportunity for formative assessment

Finally let’s consider the role of the facilitator in small group learning the “teacher’s” role is as a facilitator of learning as opposed to a transmitter of knowledge.

In small group learning the “teacher’s” role is as a facilitator of learning as opposed to a transmitter of knowledge.

In this role the facilitator is responsible for:

• Creating a supportive and open learning environment
• Coaching learners to identify learning styles, needs and goals
• Planning sessions and activities to meet learning goals
• Monitoring and facilitating group process to enhance learning
• Role modeling active, self-directed, collaborative learning

Characteristics of effective facilitators:

• Flexible
• Non-judgmental
• Supportive
• Enthusiastic
• Keeps group on time and on task
• Monitors and facilitates group process
• Shares power and leadership

You may be asking yourself, how does one accomplish this and cultivate these characteristics?

The following is a sample planning guide that a facilitator might use to promote active, collaborative, self-directed learning and create a supportive learning environment. Ideas for reflection on the planning guide are in italics.

Planning guide:

Small group session: Research Methods course, first session:

Begin first session with introductions:

Exercise 1: Introductions

Invite learners to take a few minutes to talk with a partner, encourage them to talk with someone they do not know and have them gather the following information about them: where they are from, what is their educational or work background, what is their interest in taking the course, how does it fit with their educational/career plans, do they have prior experience or expertise in the content area, how would they describe their group participation style, what are they most excited about for this course, what are they hoping to learn?

Facilitator process plans: Introduce self. Introduce exercise, provide time frame for exercise (6 minutes for paired introductions, 20 minutes for sharing in group). Gently remind learners a few minutes into the exercise to make sure each has a turn to speak.

Include self in the activity with a partner. After each learner has had a chance to ask and answer questions, invite each participant to introduce their partner to the group? Name connections between learners as they arise, point out emerging resources in terms of participant experience, highlight shared and differing learning goals and participation styles.

**Reflect for a moment on this exercise, what has the facilitator accomplished in the first session using this active learning exercise?

The facilitator has:

• set a precedent for group participation and has encouraged connections to develop between group members
• assessed what experiences and expertise each group member brings to the collective experience
• role modeled reflective questioning
• invited learned to self assess current level of learner and goals in the context of real life educational and career goals
• established that they are part of the group (by participating in the exercise) and not the leader of the group
• promotes active learning through a paired discussion among group members
• raised the issue of learning style and group process by inviting group members to comment how they prefer to participate in groups
• begun to highlight the diversity of the group
• exercised her role of task and time keeper by reminding participants to use their time to accomplish the exercise

Exercise 2: Establish guidelines/norms for group function

Review course goals and objectives (or solicit them when appropriate). Begin a discussion on group norms by asking the question, “How do we want to work together?” It may help to pose some more reflective questions such as, “Consider a time when you were working in a group that was motivating, productive and enjoyable. What were important features of how group members worked together that you think contributed to this positive experience?”

Facilitator process plans: Invite each person to comment by going around the group.

Transcribe the ideas of the group for everyone to see. Only write down things that everyone agrees on. Participate in the discussion by clarifying and delving deeper when necessary. Offer important guidelines that may not have been mentioned but do not force them on the group. Help the group to see what their collective experience brings to this exercise.

Final guidelines for group work might resemble this:

• Observe confidentiality
• Respect all members and ideas
• Avoid judging or fixing
• Speak from your own experience
• Allow for silence
• Allow for full participation of all members
• Bring 100% of self and effort to sessions

**Reflect for a moment on this active learning exercise, what has the facilitator accomplished?

Invited the group to begin to create a shared understanding of their work together

• Set a precedent for certain behaviors and norms-this will be helpful if the facilitator needs to address process issues in the future
• Begun to create a safe and supportive learning environment
• Set a precedent for group participation
• Solicits a variety of ideas and encourages the group to discuss them and agree
• Established individual and group accountability

Hopefully the above example has given you a sense of what “facilitating learning” might look like. These sample exercises encourage active learning and promote collaboration, self-directed learning, and establish the building blocks for a supportive learning environment.

The following are other behaviors and skills of effective facilitators:

• Bridges discussion to conceptual framework as well as “real world” inferences or implications
• Uses reflective open ended questioning, active listening and silence
• Summarizes at close of session (or invites group members to do so, this serves an added purpose of assessing what the learners have learned from the session)
• Elicits next steps for learning
• Periodically checks in around group process. Asks the group to consider how they are functioning, what is working well and not so well.

Leading small groups can be a challenging experience. As discussed earlier, facilitators must monitor group process and intervene when the group gets derailed which may happen for a variety of reasons.

Here are some examples of factors that may negatively impact group function and some strategies for addressing them.

Participation: The quiet or low participator

Low participation: participant may be more introspective and requires/prefers time to process ideas or it may be that others do not provide space for a balance of participation in a group.

• Create specific activities for reflection/processing and group sharing (examples Think/Pair/Share, Think/Write/Share)
• Invite input from all participants in a nonthreatening way and in a way that provides warning and time for low participators to prepare to speak.

Sample language for addressing this issue:

“I want to make sure that all perspectives are considered. Let’s summarize what we have so far and then invite others to share their thoughts? Sally, I am particularly interested in your ideas given your past experience working in industry. Can you share your thoughts when we finish summarizing what we have so far?”

Influence: The domineering participant

The domineering participant: this participant may monopolize small group discussions to promote a specific agenda. This may be motivated by passion for the subject, competitiveness, or a desire for validation.

• Support and invite minority opinions and encourage clarification and discussion
• Refer back to group guidelines that encourage balanced participation and valuing of all perspectives
• Respectfully and non judgmentally point out the issue:

Sample language for addressing issue:

“Bill, I appreciate that you feel very strongly about this point. I want to make sure everyone feels comfortable and shares their ideas before moving on. Can you hold onto your thoughts for now while we hear from others?”

Feelings -Group climate and handling emotion

Group climate and emotion can have a profound impact on group function and learning. When challenges arise and they are not addressed this can negatively impact group function moving forward.

• Recognize and acknowledge changes/tensions in group climate
• Name the issue
• Reinforce and support desirable behavior
• Model non judgmental language
• Directly address maladaptive conflict, competition, avoidance

Sample language for addressing issue:

“We have done a lot of good work and seem to agree on a few important items, I wonder though if we have fully addressed all of the issues, in particular the more contentious ones. Is there another way we could think about these issues?”

Leading small groups can be a challenging experience. As discussed earlier, facilitators must monitor group process and intervene when the group gets derailed which may happen for a variety of reasons.

Here are some examples of factors that may negatively impact group function and some strategies for addressing them.

Participation: The quiet or low participator

Low participation: participant may be more introspective and requires/prefers time to process ideas or it may be that others do not provide space for a balance of participation in a group.

• Create specific activities for reflection/processing and group sharing (examples Think/Pair/Share, Think/Write/Share)
• Invite input from all participants in a nonthreatening way and in a way that provides warning and time for low participators to prepare to speak.

Sample language for addressing this issue:

“I want to make sure that all perspectives are considered. Let’s summarize what we have so far and then invite others to share their thoughts? Sally, I am particularly interested in your ideas given your past experience working in industry. Can you share your thoughts when we finish summarizing what we have so far?”

Influence: The domineering participant

The domineering participant: this participant may monopolize small group discussions to promote a specific agenda. This may be motivated by passion for the subject, competitiveness, or a desire for validation.

• Support and invite minority opinions and encourage clarification and discussion
• Refer back to group guidelines that encourage balanced participation and valuing of all perspectives
• Respectfully and non judgmentally point out the issue:

Sample language for addressing issue:

“Bill, I appreciate that you feel very strongly about this point. I want to make sure everyone feels comfortable and shares their ideas before moving on. Can you hold onto your thoughts for now while we hear from others?”

Feelings -Group climate and handling emotion

Group climate and emotion can have a profound impact on group function and learning. When challenges arise and they are not addressed this can negatively impact group function moving forward.

• Recognize and acknowledge changes/tensions in group climate
• Name the issue
• Reinforce and support desirable behavior
• Model non judgmental language
• Directly address maladaptive conflict, competition, avoidance

Sample language for addressing issue:

“We have done a lot of good work and seem to agree on a few important items, I wonder though if we have fully addressed all of the issues, in particular the more contentious ones. Is there another way we could think about these issues?”

Leading small groups can be a challenging experience. As discussed earlier, facilitators must monitor group process and intervene when the group gets derailed which may happen for a variety of reasons.

Here are some examples of factors that may negatively impact group function and some strategies for addressing them.

Participation: The quiet or low participator

Low participation: participant may be more introspective and requires/prefers time to process ideas or it may be that others do not provide space for a balance of participation in a group.

• Create specific activities for reflection/processing and group sharing (examples Think/Pair/Share, Think/Write/Share)
• Invite input from all participants in a nonthreatening way and in a way that provides warning and time for low participators to prepare to speak.

Sample language for addressing this issue:

“I want to make sure that all perspectives are considered. Let’s summarize what we have so far and then invite others to share their thoughts? Sally, I am particularly interested in your ideas given your past experience working in industry. Can you share your thoughts when we finish summarizing what we have so far?”

Influence: The domineering participant

The domineering participant: this participant may monopolize small group discussions to promote a specific agenda. This may be motivated by passion for the subject, competitiveness, or a desire for validation.

• Support and invite minority opinions and encourage clarification and discussion
• Refer back to group guidelines that encourage balanced participation and valuing of all perspectives
• Respectfully and non judgmentally point out the issue:

Sample language for addressing issue:

“Bill, I appreciate that you feel very strongly about this point. I want to make sure everyone feels comfortable and shares their ideas before moving on. Can you hold onto your thoughts for now while we hear from others?”

Feelings -Group climate and handling emotion

Group climate and emotion can have a profound impact on group function and learning. When challenges arise and they are not addressed this can negatively impact group function moving forward.

• Recognize and acknowledge changes/tensions in group climate
• Name the issue
• Reinforce and support desirable behavior
• Model non judgmental language
• Directly address maladaptive conflict, competition, avoidance

Sample language for addressing issue:

“We have done a lot of good work and seem to agree on a few important items, I wonder though if we have fully addressed all of the issues, in particular the more contentious ones. Is there another way we could think about these issues?”