Small group methods in medical teaching.

A teaching skill essential for all medical educators is small group competence. Lack of it can never have been more damaging: medical teachers have now to promote active learning, for which small group methods are optimal. The only kind of medical student now needed is an activated one, equipped for independent lifelong learning and teamwork; current educational innovation, such as problem based learning (Walton & Matthews 1989) depends on small group teaching. Small group work is a method for generating free communication between the group leader and the members, and among all the participants themselves. The group leader can make positive use of the differences in knowledge and attitudes among participants, made evident as they interact with each other. Small group work enables participants to gain a great deal from their fellows, in a type of communication which cannot take place in a lecture hall (Westberg & Jason 1996). Group methods have the particular merit that ± when properly used ± all participants have the opportunity to take part, and each can see for themselves the impact of their views on the other members of the group. Whenever anybody speaks the response evoked is immediately visible, whether it be assent, disagreement or disinterest. A group is also, most importantly so, a change system: those taking part in the dialogue are in̄uenced as they attend to the participants who speak, the facts being expressed, and the attitudes conveyed, and reconsider their own positions. The group leader (tutor, instructor, moderator, chairman, facilitator) is the crucial agent, not present merely to listen to the views being stated, but responsible for helping the group to identify any errors, misperceptions or biases of its members. This is achieved by encouraging them to communicate their ideas and to correct each others' errors of grasp as these gradually emerge. Only when participants themselves fail to do so is there need for the leader to step in to provide corrective feedback. Minimal intervention characterizes a competent group leader, but that in no way implies passivity or mere compliance on his or her part. Quite the contrary. The group leader is an expert at active listening, attentive always to the self-esteem of participants, and competent to conduct a group meeting by quite speci®c methods which result in an enhancing intellectual experience for all the members.