1. Small Group Teaching John T. Benjamin MD The Teaching Center UNC Department of Pediatrics The Teaching Center

2. Small group vs. clinical teaching vs. large group teaching Arbitrary differences Emphasis somewhat different but basic tenets the same for all kinds of teaching The Teaching Center

3. Examples of Small Group Teaching (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 2 nd year students Others? The Teaching Center

4. First 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. The Teaching Center

5. Approaching 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 The Teaching Center

6. 1. 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. The Teaching Center

7. 2. General Approaches to Consider 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 The Teaching Center

8. 3. 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 The Teaching Center

9. Teaching techniques that could be 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) The Teaching Center

10. Examples 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) The Teaching Center

11. 4. 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. The Teaching Center

12. 5. 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. The Teaching Center

13. 6. Give Feedback Make clear on day 1 when feedback is to be given. Then label it as feedback as doing it. The Teaching Center

14. Feedback – 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 The Teaching Center

15. Conclude Feedback By summarizing and giving a plan of action if needed. If problem, identify specific time to meet again in 3-4 days. The Teaching Center

16. Feedback 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. The Teaching Center

17. 7. Document Evaluations of 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! The Teaching Center

18. Challenges to teaching small groups 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? The Teaching Center

19. Exercises for Small Group Teaching same level and different level learners. How approach differently? »Exercise #1: Same level learner »Exercise #2: Different level learners The Teaching Center

20. Exercise #1- small group Teach 3 rd 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. The Teaching Center

21. Exercise #2- small group Teach different levels of learners about colic on rounds. (3 rd year students/ intern/ upper level resident) 1 faculty member/ 1 teacher / 1 3 rd year / 1 intern/ 1 upper level per group. The Teaching Center

22. Conclusion: Small 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 The Teaching Center