Small Group and Large Group

What is a ‘small group’?

A typical view of a ‘small group’ is around eight to 12 learners facilitated by a teacher. ‘The purist view of small group teaching is that it must be learner-centred, with all students joining in free discussion of a particular topic’ (McCrorie, 2006, p. 5).

In clinical teaching, however, groups may be smaller than this, sometimes even a pair of students or trainees working with a healthcare team. In other cases, as higher education programmes take larger numbers, ‘small groups’ may comprise as many as 25 or 30 students. Small groups can also operate within a much larger setting, such as a lecture, workshop or conference. Small group teaching is necessarily more demanding of staff and room resources and time than lectures; however, well-designed small group teaching has clear benefits for student learning in terms of retention of information, critical thinking and consolidation of learning from different parts of a programme (McCrorie, 2006, pp. 1–4).

As McCrorie notes, however, ‘group size is probably less important that what the group actually does’ (2006, p. 5). So what characterises a ‘small group’ is not so much its size, but the teaching and learning context and the way in which the teacher works with and facilitates the learning process. Small groups provide opportunities for learning that are difficult to establish in large group settings. They are particularly useful to enable learners to take part in discussion, active participation, feedback and reflection, and to consolidate learning, clarify understanding, and explore ideas and concepts. Depending on the purpose and nature of the group, small group teaching can also help to develop ‘transferable’ skills, such as study skills, communication skills, teamwork, problem solving and personal development. 

Small group events have an emphasis on learning (as opposed to teaching), a specific task or focus and involve active participation by group members. One of the characteristics that differentiates small group teaching from large group teaching is that there is a greater attention to group processes as well as to achievement of tasks. Some of the aspects that help to make small group teaching effective in the clinical environment include both task- and process-related aspects and draw from adult learning theory:

• building on and relating activities to learners’ prior knowledge and experience
• relating to the perceived learning needs of the participants
• involving active learning and participation
• enabling group interaction within a positive group atmosphere
• adherence to group goals
• cases that promote critical thinking and problem solving
• being clinically relevant and applicable to practice
• facilitating the integration of knowledge and skill
• cycles of action–reflection
• allowing the acquisition of technical skills
• effective tutors

(de Villiers et al., 2003; Steinert, 2004).

Small group teaching and learning in context

Small group teaching and learning in context

Small group teaching does not take place in a vacuum. The diagram below shows how teaching and learning methods interrelate with learning outcomes/objectives, assessment, and evaluation and quality assurance. The teacher has a role in ensuring that each session forms part of the whole curriculum by creating opportunities (through selecting appropriate teaching and learning methods and creating a stimulating learning environment) for learners to achieve the stated objectives and thus be capable of passing assessments.

Thinking point

• What do you think are some of the most appropriate activities and learning/teaching methods that will facilitate both achievement of set task as well as group processes? 

The role of the teacher

The role of the teacher

There are three main activities that small group teachers have to manage simultaneously:

• managing the group
• managing activities
• managing the learning.

In many small group teaching situations, the role of the teacher is that of facilitator of learning: leading discussions, asking open-ended questions, guiding process and task, and enabling active participation of learners and engagement with ideas. However, small groups function and behave in various ways and have different purposes. Teachers therefore need to be able to adopt a range of roles and skills to suit specific situations, often during the same teaching session.

Other roles that may be adopted include that of:

• the instructor, who imparts information to students
• the neutral chair
• the consultant, from whom learners can ask questions
• the devil’s advocate
• the commentator
• the wanderer, such as in a larger workshop
• the absent friend (McCrorie, 2006). 

Some of the problems associated with leading effective small groups are summarised by Jacques (2003):

• the teacher gives a lecture rather than conducting a dialogue
• the teacher talks too much
• students cannot be encouraged to talk except with difficulty; they will not talk to each other but will only respond to questions from the tutor
• students do not prepare for the sessions
• one student dominates or blocks the discussion
• the students want to be given the solutions to problems rather than discuss them.

Effective tutors are essential to ensuring that small groups work well. Any teaching event will be more successful if the teacher:

• is enthusiastic
• has organised the session well
• has a feeling for the subject
• can conceptualise the topic
• has empathy with the learners
• understands how people learn
• has skills in teaching and managing learning
• is alert to context and ‘classroom’ events
• is teaching with their preferred teaching style

• has a wide range of skills in their teaching repertoire, including ‘questioning, listening, reinforcing, reacting, summarising and leadership’ (McCrorie, 2006, p. 8). 

Making the shift from teacher as expert to facilitator is sometimes seen as diminishing a teacher’s power and authority, but this should not be the case. Facilitating learning is empowering for both the learner and the teacher and frees the teacher from many of the burdens that having to be an ‘expert’ might entail. It would traditionally have been seen as a weakness for a teacher to say ‘I don’t know, let’s find out’ or ‘I don’t know, do any of you students know the answer?’ and clearly clinical teachers need to know more about many topics than their students or trainees, but medical science is changing so rapidly that no one can know everything. Implementing an evidence-based approach to clinical learning and to medical practice involves finding out about the latest research. You can use these techniques and this approach to facilitate your own and your students’/trainees’ learning.

Types of small group event

Types of small group event

There are a number of models for small group teaching, designed around specific tasks and with a specific purpose in mind. When planning the type of small group teaching that might be most appropriate for your session, think about the learners who will be involved, the resources available (teachers, facilitators, ‘experts’, patients, rooms, equipment), the learners’ needs and the learning outcomes that are to be achieved.  

Small group teaching can be structured around:

• topics or themes - e.g. evidence-based practice, asthma, chronic lung conditions
• clinical cases (actual patients or case notes) - e.g. Mrs X presents with…
• clinical or community-based problems - e.g. problem-based learning, a child with a wheeze
• situations - e.g. critical incident or significant event analysis
• tasks or skills - e.g. X-ray meetings, clinical audit, examination of cardio-vascular system.

The format of small group teaching events needs to encourage and facilitate participation by group members. Sometimes, there is little or no choice about the sort of event that a teacher has to facilitate, as these are pre-planned as part of a programme. Knowing some of the advantages and disadvantages and aims of each of these can be helpful in terms of your own preparation and expectations.

The next section considers some of the most common formats and types of small group teaching event. Lectures and clinical skills teaching are covered in two other modules in this series: Improve your lecturing and Teaching clinical skills (please note this module will be available soon). 

Seminars and tutorials are two of the most traditional models for learning in groups in higher education. The words can be used interchangeably but the main aim of both is to encourage group discussion. Teachers tend to have a more directive role in these types of small group teaching event, although it can be useful to rotate the leadership role around the participants.

A ‘seminar’ normally describes a group discussion led formally or informally by the tutor, focusing on issues arising from subject matter. The number of students is normally between eight and 20. In the traditional model, one student will be asked to present a critical analysis or other preparation to introduce the discussion. Often seminars are used at postgraduate level, providing a forum for presenting research findings to a constructively critical group of academics and peers.

The word ‘tutorial’ tends to be used for smaller group teaching events where more time is spent with individual students and their development, using certain aspects of subject matter to stimulate debate. In one-to-one tutorials the tutor may look at assignments prepared by the learner or discuss career options or other professional development topics. Tutorials can also be delivered online. Tutorials can be very successful if a clinical or other ‘trigger’ is used to stimulate discussion and debate. Triggers might include videos, photographs, results of tests or investigations or, in problem-based learning (PBL) and case-based learning (see below), a short paper-based scenario or set of case notes and test results.

Clinical tutorials should focus on the solving of patient problems rather than delivering factual information. You will need to plan the teaching, with clear aims and objectives. Ensure that students/trainees know that they will be expected to participate, and set tasks for them to perform in preparation for the tutorial. Remember to act as a facilitator and encourage interaction between the participants. You should avoid conducting tutorials in which you or your students/trainees present topics. If, for example, you wish to have a tutorial dealing with hypertension, then the case notes and investigations of a patient with hypertension should be the focus.

See ‘Facilitating learning: small group teaching methods’ in Explore this topic, for further discussion and ‘hints and tips’ for delivering seminars and tutorials.

Workshops are educational seminars or meetings where there is interaction and exchange of information; sometimes they are designed to generate information or position papers. They may be offered on a residential basis over several days to introduce a course and core topics, or at the end to reinforce and integrate learning. They are particularly useful as part of blended or distance learning programmes to bring participants together face to face or to deliver learning where there is a need for resources, people and equipment to which students do not normally have access. A range of activities can be used, including role-play triggers, video, case studies and patient encounters to set the scene and stimulate discussion and debate.

Journal clubs are meetings of staff where everyone is asked to present their comments on recent papers in the medical (or other) literature. This works well, provided the topic is of direct relevance to participants, everyone comes prepared and there is time for discussion and clarification. It should not turn into a series of mini-lectures.

Syndicate groups are where participants are asked to prepare (individually or in pairs) on a pre-selected topic around a theme (for example, on different conditions/diseases around a theme of chronic obstructive airway disease) and report back at the syndicate group. Again this needs to be well facilitated, everyone needs to have prepared and be willing to contribute, and time needs to be set aside for discussion.

Action learning sets (ALSs) are frequently used in postgraduate staff development and training. They comprise a group of six to eight people who come together around shared and negotiated tasks, problems or ‘issues’. Some ALSs are task-focused, others are set up to support and facilitate personal and professional development and allow individuals to bring work-related ‘issues’ to the group, which helps the person to reflect, find solutions and discuss options. There is a set structure to an ALS, with clear ground rules around time and participation. The group usually facilitates itself, although some sets are facilitated and more task-focused.

Small group activities

Small group activities

Jacques (2003) suggests that teachers have a range of choices available to them when working with groups. The sequence of activities is a strong determinant of learning, as is the way that teachers handle group processes and dynamics: sensitivity being one of the most important skills. Jacques also suggests that ‘imaginative management in the setting of tasks and the organizing of purposeful activities for sub-groups… can create a firm foundation for qualities such as openness, networking and proactive communication – important ingredients in the process of personal and organisational change.

The attached Teachers’ toolbox item summarises a selection of activities. Some require more active facilitation by the teacher, while others require the teacher to take a back seat and allow the group process to determine events and outputs.

Large group teaching

Lecturing is often seen as the main method for enabling large groups to learn effectively. The  module provides many examples of techniques and methods you can use to facilitate learning in small groups. You will see later in this module that many small group techniques can be used within a lecture theatre, in workshop situations or in conferences and symposia.

Elton’s (1977) model classified all teaching and learning systems techniques into three broad groups:

• mass instruction
• individualised instruction
• small group learning.

In the table below we have adapted his ideas to consider large and small group teaching/learning and individual instruction. This classification can be used to indicate the role of the teacher and the types of instructional material that might be useful in each of the contexts.

Class of techniques	Examples	Role of teacher, instructor, trainer
Large groups	Conventional lectures and expository lessons, workshops, conferences, symposia, lab classes, distance and online learning conferencing, teleconferencing, television and DVD/video, films	Traditional expository role; controller of instruction process. Some interaction possible, needs careful planning and specific interventions from the teacher/facilitator
Individualised instruction	Directed study (reading books, handouts, discovery learning), open learning, distance learning, programmed learning, mediated self-instruction, computer/web based learning, e- learning, one-to-one teaching, work shadowing, sitting by Nelly, mentoring	Producer/manager of learning resources, tutor and guide
Small group learning	Tutorials, seminars, group exercises and projects, games and simulations, role play, self-help groups, discussions	Organiser and facilitator

(Ellington and Race, 1993)

Winston (2008) suggests that beginning lecturers or presenters need to ‘realize that the nature of an audience changes with its size. With fewer than 20 people, discussion is possible. With more than 50, a performance is expected, and an audience can turn vicious if it does not get one. Start your career teaching to small classes.’ In this module we will look at techniques to break a very large group into smaller groups, and other ways in which you can avoid the (thankfully rare) ‘viciousness’ to which he alludes.