Small Group Discussions

Aruna Chhikara; Jorden Cummings; Andrea Nykipilo; and Ashraf Salem

Description of Strategy

There are a variety of ways that instructors can create more interactive learning environments. One strategy is to use small group discussions during a class session to expand on material presented in other formats. This strategy requires active participation on the part of the learners to work together in a small group to explore, investigate, make connections, engage in discussion, and reach conclusions. Small-group discussion tends to be informal, brief, and can be used multiple times throughout a class session. By using this strategy, discussion stimulates deep thinking and learners are expected to articulate their ideas within their group. In a large group, it is sometimes difficult for all students to take part, especially those who may be shy or feel the pressure of speaking in public. Working together creates the opportunity for students to maximize their own and each other’s learning (Johnson et al., 2014) and takes advantage of peer-to-peer instruction. Small group discussion is a method that instructors can use to include all students and facilitate them to actively engage with the course material.

What does small group learning look like in action? Watch this video to hear the instructor and student perspective on the use of this strategy in the classroom:

Effective Group Work in the College Classroom (Chasteen, 2013).

Why Use it?

“Cooperative learning is the instructional use of small groups so that students work together to maximize their own and each other’s learning” (Johnson et al., 2015, p. 87). In their meta-analysis, Johnson et al. (2014) looked at over 168 studies which compared the relative efficacy of cooperative, competitive, and individualistic learning methods on the achievement of students 18 years or older. The results of these studies indicated that cooperative learning methods, such as small group discussion, promoted higher individual achievement than did competitive or individualistic learning methods. In addition, they summarized that this higher individual achievement resulted in higher integration into university life and lower attrition, increased student participation and engagement in learning, promoted greater personal interaction among students, increased self-esteem and led to more positive attitudes towards learning. According to Johnson and Johnson (1989; as cited in Johnson et al., 2014), these positive outcomes resulting from cooperative learning strategies are reciprocally related and “are central to a high-quality university experience and to creating a university learning community” (p. 103). As such, “it is important to use instructional methods that maximize student achievement” (Johnson et al., 2014, p. 96).

How to Apply It

Small group discussion is a very adaptable format, useful for many different subjects, class sizes and professional applications. “Teaching using small group discussions can produce a wide variety of positive educational outcomes. These outcomes, however, only occur when instructors create conditions which motivate students to prepare for and engage in give-and-take discussions” (Michaelsen, 1997, p. 1). It is important for instructors to maximize student learning through careful management of all phases of the group discussion activity, from planning to summarizing.

Preparing to use Small Group Discussion in your Teaching

  • Ensure that content needed for the discussion has been taught or that the students are prepared for the discussion through pre-assigned reading.
  • Create a comfortable, relaxed environment. This could include arranging furniture configurations and discussing group norms so everyone is comfortable to participate.
  • Outline expectations for participation and reinforce the importance of discussion in your course. If you use discussion regularly, you may consider incorporating participation as a marked component of the course.
  • Provide structure to the discussion by selecting questions or tasks that encourage collaboration among group members and build on prior knowledge.
  • Communicate the expected product of the discussion and set time limits.
  • Ensure that your activity aligns with the group discussion format as well as the goals and learning objectives of your session/course.
  • Consider group size and composition. An ideal group size for small discussions is 2-6 people (Brame & Biel, 2015), depending on the activity you have planned. You may want to consider pre-assigning group members to ensure a mix of professions, skills, or experience, which could lead to richer, more varied discussion. For more formal or ongoing groups, group members can assign roles, for example scribe, reporter etc.

During Group Discussion

  • Actively monitor discussions by circulating and checking in with groups.
  • Facilitate, guide, and assist but do not take over the discussion from the participants.
  • Provide clarification and feedback as needed.

After Group Discussion

  • Allow time after the small group discussions for each group to report and for students in other groups to ask questions and comment.
  • Summarize the main points of the small group discussions and integrate them into the closure of the lecture.
  • Refer to these main ideas in subsequent sessions and make connections to the overall topics being taught within the course.

Sample of Activities to Encourage Discussions in Small Groups

(adapted from Gonzalez, 2015)

Think, Pair, Share
Ask students a question. First, they think and answer on their own, then discuss their answers with a partner for a period of time. Following this, the pairs present their ideas to the class. Record the ideas on the screen or white board and ask other students to build on the discussion.

Snowball Discussion
Students begin in pairs, responding to a discussion question with a single partner. After each person has had a chance to share their ideas, the pair joins another pair, creating a group of four. Pairs share their ideas with the pair they just joined. Next, groups of four join together to form groups of eight, and so on, until the whole class is joined up in one large discussion.

Gallery Walk or Chat Stations
Stations are set up around the classroom. Small groups of students visit stations together performing a task or responding to a prompt, which will result in discussion. Mind Mapping or

Concept Mapping
Start with a broad question or problem. Have students generate responses by writing ideas on post-it notes and placing them in on a wall or whiteboard. Students can then group all the ideas into categories and discuss why the ideas fit within them and how the categories relate to one another.

Learning Environments

Tsao (2015) notes that use of discussion is relatively unknown and underutilized in medical education, although it can be a highly effective learning strategy. Physically, small group discussions work best in situations where students can be divided into groups of about six (up to a maximum of 12 students) (Tsao, 2015). Surveys of medical students indicate that they prefer smaller subgroups (e.g., 5 students) and environments where they can teach one another (Kooloos, Klaassen, Vereijken, Van Kuppeveld, Bolhuis, & Vorstenboch, 2011). As will be discussed, this peer teaching is one of the reasons small group discussions are so effective. However, there are more considerations for learning environment than just the physical space or size of groups. When considering what learning environments to use small group discussion in, it is important for an instructor to consider two features: their intentions for the learning opportunity and their ability to be prepared for it.

Small group discussions are a useful approach when an instructor wants to promote critical thinking skills and/or retention of learning material. Indeed, in one qualitative analysis of strategies for high achievement in undergraduate medical education, learning in small groups was reported as one key strategy (Abdulghani et al., 2014). As Tsao (2015) further observes, this critical thinking “compels group participants up ‘Bloom’s Categories of Thinking’” (p. 332). Empirical research has shown that small group discussions can be particularly helpful for retention of learning material via elaboration. Elaboration is defined here as developing “meaningful new relations between prior knowledge or between prior knowledge and new information” (van Blankenstein, Dolmans, van der Vleuten, & Schmidt, 2013, p. 730). Elaboration leads to cognitive networks (of knowledge) that are more strongly interconnected (i.e., held more deeply than networks with less interconnection) (van Blankenstein et al., 2013). One of the best ways to do this elaboration is via explanation of material to others (e.g., by teaching and explaining to others in small group discussions). In two studies, van Blankenstein and colleagues have demonstrated that elaboration via small group discussion is helpful for students with prior knowledge of the topic and that giving explanations to others is positively correlated with retention of knowledge 1-month later (Blankenstein, Dolmans, van der Vleuten, & Schmidt, 2011; Blankenstein et al, 2013).

As mentioned, it is also important for the instructor and students to be prepared for small group discussion. Placing explicit expectations on students for how they will prepare for the small group discussion encourages their preparation and ensures a more efficient discussion (Tsao, 2015). In fact, Blankenstein et al. (2013) demonstrated that elaboration is actually harmful to the learning of students without prior knowledge of the topic (i.e., who are unprepared). Tsao recommends setting up the learning environment with six ground rules, and then utilizing a structured 8-step process that becomes expected for learners (and provides guidance for them to prepare). These are represented in the following two tables.

  1. Group participants must attend regularly and come prepared to discuss the assigned material.
  2. Everyone is expected to participate and interact. Though session-to-session variations are expectable, all group participants are expected to engage in active listening and respectful speaking.
  3. A friendly, accepting group climate is important to any learning environment. A nonthreatening environment that fosters curiosity will make learning rewarding, perhaps even exciting.
  4. Learning through discussion (LTD) is a cooperative learning process. Unduly competitive behaviors are discouraged in this methodology. They detract from the goal of mastering the material and diminish group cohesion.
  5. Learning is the chief goal of LTD. As such, the pre-assigned material must be adequately and efficiently worked through.
  6. Evaluation of the group process and individual contributions to the discussion are integral to group operation. It is only through this process that the group as a whole improves.

Table 1. Tsao’s Six Ground Rules for Small Group Discussion. (Tsao, 2015, p. 333)

It should be noted that a number of assumptions underly Tsao’s approach to “learning through discussion” (LTD). First is the idea that the learning environment should be conductive to groups that can be used regularly and maintain relatively the same group composition from session to session. Thus, in Tsao’s conceptualization, LTD is best accomplished when used regularly. Another assumption is that learners have been assigned information to review prior to the discussion and that they will use the structured approach (see Table 2) to prepare. Tsao assumes that each time a group meets they need a leader, and that turn taking should be used to set up the learning environment to meet this expectation. Last, as shown in Table 2, Tsao’s approach requires 60-minutes per discussion.

Step Label (Time) Details
1. Checking In (2-4 min)
  • Group members introduce themselves if it is the first meeting
  • Group members report how they are doing and how they feel about the upcoming discussion
  • Aims at reducing need to “deal with” feelings during discussion
2. Vocabulary (3-4 min)
  • Group looks up words, defines terms, refreshes everyone’s member on concepts
  • Group share results with each other
3. Statement of Author’s Main Message (5-6 min)
  • Obtain overall understanding of assigned material that was to be read prior to group
4. Discussion of Major Themes or Subtopics (10-12 min)
  • Break down materials into important themes or subtopics
  • Recommended group limit to 3 subtopics for sake of time
5. Comparing the Material to Other Works (15-16 min)
  • Relate learning from this material to ideas and concepts already acquired
  • Aimed at reducing “fragmentary instruction” over time in education
6. Application of Material to Self (10-12 min)
  • Group participants share a personal application from the material
  • Designed to enhance acquired and enduring knowledge by linking it to personal significance
7. Evaluation of Author’s Presentation (7-8 min)
  • Group appraises author’s theory, logic, and conclusions
  • Invites expression of opinions and how to do constructive criticism
8. Evaluation of Group & Individual Contributions (7-8 min)
  • Consider group’s overall functioning
  • Ask who and what was constructive/inhibited the conversation

Table 2. Tsao’s Eight Step LTD Process (Tsao, 2015, p. 332-333)

In summary, small group discussions (or LTD) are best used in a learning environment where instructors are aiming for deeper elaboration of the learning material and the development of critical thinking skills about that materials. Moreover, this learning environment needs to be appropriately prepared for these small group discussions, in order to maximize the learning capabilities of this approach.

SWOT Analysis of the Strategy

When considering the use of small group discussion as a teaching strategy in the classroom, a SWOT analysis of the strategy, where strengths, weaknesses, opportunities, and threats are discussed, can be helpful. The SWOT analysis will identify areas of strength that could be drawn upon for opportunity in using the strategy as well as considering how to eliminate any weaknesses to create more opportunities. This analysis can help an instructor determine the appropriateness of an educational strategy as well as what challenges may be faced in implementation.


To highlight the strengths of small group discussion contexts, they enhance students’ overall learning experience in several ways. For example, small group discussions can address gaps in students’ knowledge, allow students to discover and engage with a range of perspectives, exchange ideas and backgrounds in an interactive way, assist students in clarifying their attitudes and speak to an idea about the subject matter as they test their own ideas and attitudes against those of others, and help students develop a sense of academic willingness to share ideas. Small group discussions also help students to make sound clinical decisions and practice clinical skills, and promote students’ reflection and feedback.


On the other hand, small group discussions have some weaknesses. For example, facilitators or staff have to be well organized to ensure there is variation in learning methods, variation across the class meetings in terms of activities and locations within the class, and how to change the dynamics of the class and learning when there is just a handful of pupils. Lack of diversity within the small number of students provides less opportunity to mix and learn from the members of a larger group (McCrorie, 2014), which is also a weakness.

A major drawback of this teaching methodology is the large amount of faculty time required for preparation, organization, and set-up. Another potential problem is the dependence on the faculty member’s small group facilitation skills. An ineffective facilitator can lead to a poor learning climate and outcome. Poor facilitation can also lead to a lack of participation from group members (e.g., students are not engaged in the process or students are not prepared for the session). The student who does not participate and the student who dominates are two of the most common problems encountered by small group facilitators.

Similarly, poor group dynamics can result from too much competition among group members, or if one student dominates the session. Providing adequate structure for the small group is important as well as faculty development programs for training effective facilitators.

Figure (1) : SWOT Analysis of Small Group Discussion Teaching Strategy


Interactive learning through small group discussions is a good opportunity to interact with the learners directly and work towards a specific goal with achievable outcomes. The instructor and the students are in direct communication and understand each other’s mind through negotiating understandings and differences, and cultivating shared meanings. This is in fact a student-centered learning approach that enables students to take up the responsibilities of carrying out activities, planning learning, interactions with teachers and peers, and researching and assessing learning. The small group is already motivated for learning as the purpose of forming a small group and the topic of discussion are already clear. There is a constant submission and feedback and the topic gets comprehended in an almost ideal situation. The peers interact among themselves constantly and build a good rapport among themselves as well as with the teacher. So, interactive learning is one of the best methods for metacognition of the subject matter and not much efforts are needed to prepare for the final exams or the approaching assignments.

Small group discussion helps in embedding the key points to the permanent memory of the learner. In lecture based direct teaching, student’s engagement is low, while in small group discussions social interaction is at its maximum. Students reflect upon their understandings, viewpoints and experiences with ease in the interactive learning set up. During small group discussions, the learners get an opportunity to share their personal capabilities and novel ideas and get good feedback from teacher in an open minded and positive environment and develop the skills of sensitive listening and a watchful attentiveness. Such platforms are the best ones to create a loved and cared feeling among students. That’s the time when students get opportunity to open up and share their weaknesses with the teacher and the peers. Some shy students are best involved in the learning process by interacting in small groups and they find their problems and apprehensions resolved. That creates a feeling of new confidence among the students and a cohesive group is created while interactive learning through small group discussions happens. Small group learning is good even for culturally diverse members as it is easy to get acquainted with and know well each other in a short period of time.

Small group discussion also provides a good opportunity to work on student’s opinions and a teacher can estimate how they could improve their self-directed learning skills. Hence, innovative learning formats could be developed to address both perceived and unperceived education needs in a supportive environment that is both enjoyable and competitive” (Hande, 2014, p. 338). Keeping in view the broader prospects of the study carried out in premedical settings, teachers can make best use of virtual and physical resources while teaching in small groups in clinical settings. For healthcare professionals, it is actually a crucial skill required to work in small groups to meet the challenges of the contemporary health care environment. A very good opportunity for health care professionals is to show their leadership quality in small group and then grow up into a leader on the level of society. The small group learnings are the grooming places for students. It also provides willingness to the learners to rethink and question one’s views and positions. Students may try to find ways of weaving together their different contributions and insights, recognizing their interests and agendas (Mick & Alexander, 2013). Immediate and detailed formative feedback from the peers and the teacher make the group productive, vibrant and motivated more than when the discussion started.


One threat to this teaching and learning strategy is that everyone has their own temperament, way of working, and the timings of working (Jackson et al., 2014). Sometimes the group is not in alignment and it becomes difficult to work in a collaborative manner. Another threat is that if all get aligned with each other as far as time constraints are concerned, they may not have same views about a specific topic that they are required to work upon. That becomes a big hurdle in the smooth completion of the work and reaching to a productive and efficient outcome. Experience of a senior group member may be different from the expected outcomes of the work to be done because of some administrative or technical reason. There may come a roadblock which could be difficult for instructor to deal with. Sometimes such situations create a tension among the group members and then it is the teacher’s role to ease out those tensions in a positive environment. An instructor in health care profession is not merely a teacher, but he/she is a leader who can deal psychologically with the learner’s mind. Sometimes dominant students try to drag the discussions as per their views while passive and lazy students prefer to keep mum. Also, some teachers are over talkative and give the student’s groups less time to reflect upon.

There are sometimes institutional threats too. The curricula are designed so rigidly that students might not be able to feel the sense of ownership to the learnings and new findings in small groups.

One of the less talked of threats is the local institutional politics.

In a multidisciplinary setting, making the learning in small groups a successful teaching strategy, it is advisable to give the same group of learners more chances to work with each other so that they understand each other better and work more effectively towards better patient care and health service delivery.

In order to keep improving and developing our teaching strategies (around the topics or themes, clinical cases, community-based problems, situations, or the tasks and skills based), we may use problem-based learning techniques, and self-evaluation (by students). We need to ensure that every student contributes towards the discussions and full student participation is a must for the successful group discussion and peer effect is very prominent on the small group interactive learning (Mills & Alexander, 2013; Webb, 1989)

The best thing about this learning technique is that it is always subject to change based on the interactions between students and teacher as it is inspiring and open to further discussions. Teachers can also effectively improve their teaching skills by frequently discussing the dynamics of their classroom with peers experiencing the same challenges (Hurst, Wallace, & Nixon, 2013).

Tales from the Field

Tale from the Field: Negative Experiences, But Insight for Next Time! Jorden Cummings, PhD., R.D.Psych.

I primarily teach graduate-level Psychotherapy courses to our students in the Clinical Psychology PhD program and Qualitative Research to a range of graduate students in Psychology and related disciplines. Our research team meetings in the lab also generally led by small group discussion as well. Unfortunately, I find my attempts at small group discussion often fall flat and students respond with silence, unless we are discussing difficult or contentious material. I realize now, reviewing this literature, that my small group discussions are falling flat because I haven’t prepared students ahead of time with my expectations or provided instructions for what to bring forward for small group discussions. With more practice in these skills, I think my small group discussions will be more successful in the future!

Tale from the Field: Threats to Group Discussions, Ashraf H Salem, MEd, MD First Year Medicine & Dentistry Small Group Facilitator

I was teaching Anatomy to First year Medicine and Dentistry, In fact I saw that small group discussion is promising interactive discussion that deepen the studied topics. But the presence of some resistant students not only endanger themselves but also carry a threat to the group. Some students who simply do not care, I tried to involve them in the discussion by asking some simple questions, open some brainstorming discussions. Sometimes it helps to be back on track sometimes I fail to involve them. I think the problem is in the curriculum design where small groups interact discussion must be highlighted with proper percentage of marks.

Tale from the Field: Positive Experiences, Andrea Nykipilo, RN FINE Level 1 Instructor and Course Lead

I instruct a 2-day multidisciplinary workshop called Family and Infant Neurodevelopmental Education (FINE) Level 1. This course for all NICU professionals is a combination of lecture, hands-on skills, and small group discussion. It is designed to combine different teaching modalities and shared experience between multidisciplinary participants is highly valued. All material has a focus on the baby’s experience.

The small group discussion serves multiple purposes in this context:

    • Participants can share ideas in an informal atmosphere
    • Learning is deepened from the didactic and hands-on portions of the course
    • Gets people moving around and using their brains in different ways to interact with the material
    • Allows participants to experience a variety of points of view and to guide the discussion in the direction they wish, depending on the group composition.

Small group discussion sessions throughout both days of this workshop remain an integral part of the learning and teaching. On evaluation, workshop participants rate this component very highly as one of their preferred parts of the course.

Student Tale from the Field: Mixed Experiences

“I find small groups largely unhelpful, depending on the student. If we all know each other … In a small group of strangers I fall silent and zone out. I’d rather listen to a professor or learning on my own. But if I know the people I am [more likely] to talk.”

In a study of medical students in India, students reported that small group discussion (related to case examples) was an effective method of learning. As noted by the authors 70% of students “opined the small group discussion was interactive, friendly, innovative, and build interaction between teacher and student. They also felt that small group discussion increased their thought process and helped them in better communication” (Annamalai, Manivel, & Palanisamy, 2015) These examples illustrated students’ mixed experiences with small group: Some students will enjoy them and some students will not.

Image Attributions “Team work, work colleagues, working together” Photo by Annie Spratt on “Work in Progress Coworking, Las Vegas United States” photo by John Schnobrich on No title. Photo by Saad Sherif on “Students Learning Together” Photo by Alexis Brown on

Additional Resources-Small Group Discussion in the Online Environment

Facilitating Structured Discussions on Zoom (Kacz, 2020)


Abdulghani, H. M., Al-Drees, A. A., Khalol, M. S., Ahmad, F., Ponnamperuma, G. G., & Amin, Z. (2014). What factors determine academic achivement in high achieving undergraduate medical students? A qualitative study. Medical Teacher, 36, Sup1, S43-48.

Annamalai, N., Manivel, R., & Palanisamy, R. (2015) Small group discussion: Students perspectives. International Journal of Applied & Basic Medical Research, 5, PMC4552057.

Brame, C. J., & Biel, R. (2015). Setting up and facilitating group work: Using cooperative learning groups effectively. Retrieved October 18, 2020 from: sub-pages/setting-up-and-facilitating-group-work-using-cooperative-learning-groups-effectively/

Chasteen, S. (2013, December 31). Effective group work in the college classroom [Video]. YouTube:

Gonzalez, J. (2015, October 15). The big list of class discussion strategies. Cult of Pedagogy. Available at:

Hande, S. (2014). Strengths, weaknesses, opportunities, and threats of blended learning: Students’ perceptions. Annals of Medical Health Science Research, 4(3), 336-339.

Harvard Kennedy School (n.d.). Using small groups to engage students and deepen learning in new HKS classrooms. Available at:’s%20Office/Guide%20to%20 Small-Group%20Learning.pdf

Hurst, B., Wallace, R., Nixon, S. B. (2013). The impact of social interaction on student learning. Reading Horizons: A Journal of Literacy and Language Arts, 52(4), Retrieved from

Jackson, D., … & Davidson, P. M. (2014). Small group learning: Graduate health students’ views of challenges and benefits. Contemporary Nurse, 48(1), 117-128.

Johnson, D. W., & Johnson, R. (1989). Cooperation and competition: Theory and research. Edina, MN: Interaction.

Johnson, D. W., Johnson, R. T., & Smith, K. A. (2014). Cooperative learning: Improving university instruction by basing practice on validated theory. Journal on Excellence in College Teaching, 25(3&4), 85-118.

Kooloos, J. G. M., Klaassen, T., Vereijken, M., van Kuppeveld, S., Bolhuis, S., & Vorstenbosch, M. (2011). Collaborative group work: Effects of group size and assignment structure on learning gain, student satisfaction and perceived participation. Medical Teacher, 33, 983-988.

McCrorie, P., (2014). Teaching and leading small groups. In Understanding Medical Education: Evidence, Theory and Practice, 2nd Edition, (pp. 123-36). London, UK: Wiley Blackwell.

Michaelsen, L. (1997). Three keys to using learning groups effectively. Essays on Teaching Excellence, 9(5), no page. Available at:

Mind Tools Content Team. (n.d.). SWOT analysis: How to develop a strategy for success. Available at:

Mills, D., & Alexander, P. (2013). Small group teaching: A toolkit for learning. The Higher Education Academy. Available at: manager/documents/hea/private/resources/small_group_teaching_1_1568036632.pdf

Tsao, C. L. P. (2015). Using learning through discussion in medical education settings. Academic Psychiatry, 39, 332-334.

University of Michigan Center for Reseaarch on Learning and Teaching. (n.d.). Guidelines for using groups effectively. Available at:

van Blankenstein, F. M., Dolmans, D. H., J. M., van der Vleuten, C. P. M., & Schmidt, H. G. (2013). Relevant prior knowledge moderates the effect of elaboration during small group discussion on academic achievement. Instructional Science, 41, 729-744.

van Blankenstein, F. M., & Dolmans, D. H. J. M., van der Vleuten, C. P. M., & Schmidt, H. G. (2011). Which cognitive processes support learning during small-group discussion? The role of providing explanations and listening to others. Instructional Science, 39, 189-204.

Washington University in St. Louis Center for Teaching and Learning. (n.d.). Discussion strategies. Available at: methods/discussions/discussion-strategies/

Webb, N. M. (1989). Peer interaction and learning in small groups. International Journal of Educational Research, 13(1), 21-39.



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Instructional Strategies in Health Professions Education Copyright © 2020 by Aruna Chhikara; Jorden Cummings; Andrea Nykipilo; and Ashraf Salem is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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