Working and learning together in small groups is a key component of the PCC program.  Small group work represents both a setting for learning medicine and an opportunity to develop the skills needed to work as a member of a team. 
Planning Time During Group Meetings  

The agenda for each group meeting is determined by where you are in working through a case.  There are, however, 2 requirements:

• The focus for your first two years is on the acquisition of basic science information within the context of social medicine and the clinical case study.  Therefore, students must devote time to discussing basic science as well as clinical science issues relevant to the case. (Remember the levels of organization.)

• Developing productive working relationships depends, in part, on giving and receiving feedback.  Therefore, you must reserve time at the end of each group session for evaluation of that day’s meeting (i.e. "wrap up").

Student Roles During Group Meetings 

As you work through the case, three special roles will be needed: doctor, patient and scribe.  During the quarter, each student should serve at least once in each role.

The scribe records the group’s discussion on the board.  This role is essential to the group process and also represents a skill that each student should develop - being able to record and reflect the group discussion.  Generally, the scribe records ideas in 3 separate categories: data, hypotheses, and learning issues.  Other information being discussed may also be written.  One student must serve as scribe during each group meeting.  During the quarter, each student should serve as a scribe.  Some groups have also found it helpful to have an additional student keep a written record of all, which has allowed the scribe more flexibility in participating.

At case closure, when final learning issues have been delineated, the scribe of the case should submit the learning issues as directed by the Instructor of Record.

The patient (or reader) holds the case materials and answers the doctor’s questions.  One student should serve as patient during each group meeting as necessary and should be selected one meeting PRIOR to the case opening.  When feasible the patient will be provided with pertinent information about a case at this time.  In this way, the student can review material and answer questions more readily.  It is important that the student serving as patient be reminded that this information is not to be shared with other students prior to case opening!

The doctor asks questions of the patient to elicit important information about the case.  One student should serve as the doctor for each session.  Other students can feed into the doctor with suggestions.  Facilitators will expect a rationale to be given when a lab test is requested.  As with the student in the role of the patient, the “doctor” should be assigned one session PRIOR to the opening of the case.  Thus, the doctor will be able to review questions and procedures in eliciting a patient history.

Assigning the role of physician to one student allows each student to develop interviewing skills.  This is an opportunity for the student in this role to follow the interviewing guidelines learned in the clinical science lab.  In addition, the student in this role of physician should summarize his or her findings about the patient at the end of the session.  If a student serves as a physician for the entire case, a final case summary from the student is also appropriate.  Thus, ALL these roles should be taken seriously; they are all part of the learning process in medical education.

Wrap Up

After students go through the session and have developed learning issues, there is a wrap up.  This is an important part of the meeting because it allows students and facilitators to make comments on the day’s session. 

         The wrap up proceeds as follows:

• Each student takes a turn and each one should comment.

• Facilitators conclude the wrap-up session with comments.

This serves as an excellent time to make comments on the process, the focus, and how the group is doing. Be truthful but be supportive as well!

 Professional Behavior in Group

Productive small group work relies on the professional behavior of all participants.  Please review the following guidelines and plan to apply them in your group:

• Be punctual

• Be prepared

• Participate in both talking and listening

• Be courteous.  Be open to other viewpoints; criticize ideas, NOT people.

Peer support is an important component of professional behavior.  Peer support can assist groups to mature and become more effective.

The Contract

The PCC is structured to provide students with an education that will help them beyond medical school.  The faculty will support the students; in turn, students need to take the responsibility to follow a contract for the small group:

• Be actively involved in the group discussions and attend all sessions

• Come prepared

• Learning issues that are turned in should truly reflect your group study

Learning Resources

As a part of the sharing and discussion during the small group process, specific learning resources will be identified.  Anchor texts for referral during the sessions are located in the 2 drawer file cabinets in each small group meeting room. Additional required texts and published materials are available in the Learning Resource Center (LRC).

LRC staff are available to guide students to resources upon request.

Other learning resources for students include: selected faculty, usually accessed by students during the Resource/Problem Set Block in their schedules; radiologic films; web resources; journal articles; powerpoint slides; etc.

 LRC Resource Sessions

The purpose of the LRC Resource Sessions for PCC students is to provide them with a framework for efficient and effective identification and use of information resources.  This is an important aspect of the PCC in support of the basic tenets of problem-based learning that are emphasized in this program.

Although students will initially differ in their level of resource knowledge and skills, we expect they will become competent in the following areas, in order to accomplish the goals set forth in the PCC:

• develop the ability to identify areas in which more information is needed

• develop the skills to find, evaluate, and assimilate pertinent information efficiently

• develop the clinical and interpersonal skills necessary to practice as an osteopathic primary care physician

• develop life-long learning skills to stay current in your field

These sessions will be offered throughout Year 1 and 2 of the program with session times and locations arranged upon request.

Specific Facilitator Duties - In Summary

Introduce self and assist group with introductions.

Include a short overview of the small group process at OU-COM for the PCC.  Student orientation will include an explanation/demonstration of the small group process as well.

• Assist students in their various roles as scribe, patient and doctor.

•  Distribute case material at appropriate times.

•  Manage the group time to allow for the wrap-up at the end of each group session.

•  Assist the group to stay on track in the formation of learning issues.

•  Keep notes on the identified learning issues throughout the case.  These notes will be helpful in identifying content gaps.

•  Stimulate group discussion in a non-directive manner.

•  Assess student participation and performance.