1. BEYOND GROUP DISCUSSION SKILLS: How do I Organize a Small Group Learning Session Effectively? Janice L. Benson, MD U of Chicago/NorthShore University Health System Alicia Vazquez, MD Cook County-Loyola-Provident Family Residency Program The Cook County Family Medicine Faculty Development Program Supported in part by HRSA grant # D55HP20647

2.  Overview-3 mins  Reflection Exercise in Pairs-10 mins  Lecture-15 mins  Large Group Discussion-10 mins  Summary-5 mins Agenda

3.  Reflect on exciting small group learning experiences  List 3-5 components of planning effective small group learning  Give 5 examples of content/material that can be presented in small groups  Discuss dilemmas/challenges in organizing small group learning sessions Objectives

4.  Cook County Family Medicine Faculty Development Program  In existence since 1984  Funded by HRSA for 23 of 27 years  Latest cycle 2010-2015  Over 150 graduates  40% grads teach in medically underserved communities  40 % grads are underrepresented minorities Who We Are

5.  Cook County FM Faculty Development Program  Teaching skills continuous focus  Curriculum design as required product for fellows  “Design Studio” is predominant small group learning strategy for fellows  Residents & Fellows learn to plan & lead small group discussions  Other teaching strategies: short lectures and large group discussions Who We Are

6.  Clinical supervision (precepting)  1 Teacher:1 Learner  Lectures  1 Teacher: many Learners  Small groups  1 Teacher: some Learners Basic Formats of live teaching sessions

7.  Behavioral theory  Objectives & Evaluation  Cognitive & constructivist  Reflective skills are key  Knowledge is deepened & elaborated into schema  Social learning theory  Role modeling by teachers & peers are socializing  Team work practiced Learning theories inform the planning of small group sessions

8.  Single group discussion vs. Seminar series  Workshop vs. “Design Studio”  Single meeting vs. “Team-based learning” Small Group Learning Sessions Single session vs. Continuity series?

9. Small Group Exercise Reflect on your best small group learning experience. What did you love about that experience? What were the attributes and behaviors of the facilitator that helped make this a great experience? What kinds of learning experiences work well in small groups?

10.  “The Healer’s Art” (Ramen)  Seminar of faculty with medical students year-long  Students do retain human-orientation & learn more professionalism  Problem-Based Learning (Dolman)  Facilitators need skills-questioning  “Checking-in” with learners  Cases with more structure require less content expertise  Team-Based Learning (Parmalee)  Depth of knowledge  Problem solving skills  Team communication  Leadership skills  Leading small groups on psychosocial issues help faculty too! (Kumagai)  Reflective approaches  Enhanced interpersonal relationships w students, peers, patients  Source of fulfillment and renewal Small Group Sessions What is the research on effectiveness?

11.  Discussion-focused- “open –ended” in intent  Ethics cases  Psychosocial issues  Cross-cultural experiences  Case discussion and application  Product-focused -’closed-ended’ in intent  “Design-studio” (Schon)  “Team-based learning” (Parmelee) Types of Small Group Sessions

12.  Purpose  Active learning  Information retained longer  Instructor role=Facilitator  Clarify information  Involve participants Small Group Sessions-Discussion

13.  Technique  Student centered  Redirect, reframe or require discussion  Open & closed-ended questions  Written questions for participants and facilitators  Need consent if video-taping discussion Small Group Sessions-Discussion

14.  Construct clear objectives  Why are you doing the session?  What do you plan to accomplish?  Semi-structured-  Construct 2-4 guide questions  Pre-determine group composition  Learning materials and room set-up  Timed-agenda Components of Small Group Sessions Discussion

15.  Construct clear objectives  Why are you doing session?  What do you plan to accomplish Semi-structured-  Skill-based learning applied to own product  Learning materials and room set-up  Product accomplished in session  Coaching and modeling  Guided practice with faculty and peer feedback Components of Small Group Sessions Product Type

16. COACH STUDENT Old way : —Coach Demonstrates, Student Listens —Student Imitates, Coach criticizes COACH STUDENT New Way: —Student designs, “Know-how” —Student describes design Reflection-in-action —Coach/student reflect on description of design Reflection-on-action after Donald A. Schön’s work, “Educating the Reflective Practitioner” “Design Studio” after Donald A. Schön’s work, “Educating the Reflective Practitioner”

17.  Semi-structured workshops  Structure –ground rules, didactic, brainstorming  Protected time  “In the room together”  Learners=Fellows (faculty, fellows, senior residents)  Teachers=Faculty Development Faculty  Resources=hotspot link, laptop computers “Design Studio” Elements

18.  Artistic stance to learning in studio  Learner works on curriculum design project  Guilt-free, low-pressure orientation-”Let’s get the work done”  Not directly competitive  Entrainment  All learners and teachers “In the room together”  Scaffolding  Coaches immediately available to supply new ideas, skills, or resources  “Work-shopping”  Group feedback intermittently  Goal-no homework! Design Studio

19. Overall very well received Example Quotes  “Design Studio is invaluable time to be productive, brainstorm with others, and get immediate feedback on curriculum ideas”  “Having the faculty makes you think through and come up with questions” Participants’ Feedback

20. More Example Quotes  “Initially going over different methods and then actually pursuing them gives a new perspective”  “Direct advice from facilitators”  “The time! The space to have questions”  “Helpful in that we got to focus on our own work and find problem areas in which we could ask for help” Participants’ Feedback

21. Small Group Reflection exercises “Best Teacher”, ‘best lecturer” attributes Role plays Used to practice skills, e.g. precepting Small group ‘Fish bowl” exercise Demonstrate group discussion processes “Design Studio”- Work in session Create interactive sessions and curriculum product Other didactic forms Review FP Essentials and Journal Club content How We Use Small Group Sessions

22.  Remember small group sessions require thoughtful preparation and organization  Semi-structured  Require clear objectives  Guide questions  Written materials to guide facilitators  Room preparation & technology ready Summary

23.  What have been the dilemmas or challenges encountered in facilitating small group work?  Organizing the small group sessions?  Conducting the small group sessions? Large Group Discussion

24.  Good luck with your next small group session! THANK YOU Summary