Practice-based Small Group Learning for
Faculty Development
MacVicar R, Guthrie V, O’Rourke J, Sneddon A. NHS Education for Scotland
Centre for Health Science
Old Perth Road
Background: Practice based small group learning (PBSGL) is an
established approach for Continuing Professional Development (CPD)
for Family Physicians in Canada and General Practitioners (GPs) in
Scotland.1,2 PBSGL has been developed in Canada to involve faculty
development educational modules (PBSG ED)3 and evaluation involving
community based teachers reported commitment to change practice
after addressing a single educational module that was sustained after
three months.4 This study describes an extension of the PBSGL
approach in Scotland to support the learning and development of
educational supervisors from across the hospital and general practice
interface, working together in peer-facilitated small groups to address
topic-specific, evidence-based educational modules.
Methods: All GP and hospital educational supervisors in the North of
Scotland were invited to take part in a project, the specific aim of which
was to encourage evidence-based educational practice and to
encourage faculty development across traditional interfaces.
Participation was sought for four groups, each to meet on three
occasions to address PBSGL ED
modules. Two of the groups were
to be based in Aberdeen and two
in Inverness, each comprising four
hospital consultants and four GPs,
all of whom were educational
Supervisors. The aim was to ensure
that both undergraduate and
postgraduate educational roles
were represented. Qualitative
methods were employed in the
evaluation as suitable both for the
small sample size and because the
focus was to provide a descriptive
analysis of data, thereby eliciting
meaning and understanding. Data
were gathered from interviews with
the facilitators and the, supplemented by observational data of the
group process and function (including analysis of filmed footage). Data
were also gathered through focus group discussion with the facilitators
following completion of the pilot.
Hopes and Fears
“So it not only meets the need for stretching educators and
developing educators and so it is also about making and
strengthening connections with our secondary care
colleagues which is a real need and desire for us”
Structure and Format
“I liked the little chunks of dialogue and then reflection and
then the dialogue and further reflection and then going to
the evidence base and reading things because as a clinician
and not where my job is and primarily as an educationalist I
don’t know the evidence base for education. I know the
evidence base for my own specialty but I don’t know it for
education so that was very useful to read that and of course
that sort of stuff doesn’t tend to be in any of the medical
journals that I read and so it was for somebody who does a
lot of teaching, I think I realised how probably how little kind
of continuing teaching education that I do”
Change in Practice
“Well what had happened was the week that we met was the
Wednesday and something had happened with my registrar on
the Monday, so two days before and I had been chewing over in
my head what to do. I discussed it with a colleague and I was still
mulling it over and then I read all the stuff on Monday night and
then I read it again on Tuesday and it was the feedback, giving
feedback and in particular it said feedback should be timely, and
should be appropriate with some positive things in and you
should concentrate on the behaviour rather than the person, so it
explained properly how to give feedback and I then went and
gave relatively timely feedback and it was so useful, I’d recorded
it and I’m not sure I’d have been quite so sharp if hadn’t received
the information about giving feedback.”
Collaborative Working
“I suppose what I thought from the beginning this is great to
be having these meetings and understanding where we are
from. Until we do that there is lots of tensions, financial in
the NHS at the moment and education is something that
can get squeezed and there can be tensions built up
between general practice and our hospital colleagues and a
them and us situation. And it was such a release to be
somewhere where that wasn’t the case and I think that quite
encouraging cause the danger is that it goes that direction
and that would be such a disaster for us all I think.”
The questions addressed in the evaluation:
• Does PBSGL have the potential to improve individuals’ educational
• Does PBSGL have the potential to break down barriers between
primary and secondary care?
Results: A full cohort of educational supervisors was recruited to each
of the four groups (32 participants and four facilitators in total). Both
GPs and consultants enjoyed the format and were very positive about
the experience of working together in this way. Analysis of the
interviews, observations and focus group discussion revealed some rich
material that was categorised into four themes;
Hopes and fears for the project
Structure and format
Change in practice
Collaborative working
Conclusions: PBSGL as an approach to faculty development is
acceptable for UK educational faculty. As a tool to facilitate educational
supervisors from across the primary care/ secondary care interface to
learn together it seemed to be particularly useful. Both commitment to
change educational practice and reported actual change in practice
were reported
I’m involved in a lot of the educational activities, but I thought
this one was particularly good. I don’t know if it was because
there was a wider range of different specialists and generalists
and a wide range of different experience or seniority but
certainly I found it very enjoyable and useful and not
everything, CPD stuff ..that I could …I could say that about
R, Cunningham D, Cassidy J, McCalister P, O’Rourke J and Kelly D (2006) Applying Evidence in Practice through Small Group Learning:
A Scottish Pilot of a Canadian Programme. Education for Primary Care 17, 465-472.
2Armson H, Kinzie S, Hawes D, Roder S, Wakefield J and Elmslie T (2007) Translating learning into practice: Lessons from the practice-based small
group learning program. Canadian Family Physician 53: 1477-1485.
4Walsh AE, Armson H, Wakefield J, Leadbetter W and Roder S (2009) Using a Novel Small-Group Approach to Enhance Feedback Skills for
Community-Based Teachers. Teaching and Learning in Medicine 21(1): 45-51.
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© NHS Education for Scotland 2014. You can copy or reproduce the information in this document for use within NHSScotland and for non-commercial educational purposes. Use of this document for commercial purposes is permitted only with the written permission of NES
Published by NHS Education for Scotland: 10th April 2014