Walk-Around Team Facilitation During Team-Based/Case-Based Learning (Dr. Buescher)

    Have you ever noticed faculty members uncomfortably walking around during team-based learning experiences?  It is new to so many of us, it is difficult to figure out how to best invest our energy.    Take a page from Dr. Buescher’s playbook on this one...  

     During one team-based learning experience early last fall, we noticed Dr. Buescher working with a group that was already showing signs of not working well together.    He walked up to the group, and asked, “What are you doing?”  

     After receiving a non-committal answer, he asked, “What should you be doing?”    

     To this they repeated the team assignment, but it was obvious they didn’t know where to start.  

     Dr. Buescher, using a great teach-by-questions approach, asked, “Okay, so what do you need to figure out first?”   To this prompt, one of the group came up with a plausible first step.    He encouraged them and they took off.    He circled back to that group several times early in the TBL experience, and was there as they were synthesizing their final answers.  

     His goal did not seem to be to answer the questions for them—and he didn’t—it looked like he was encouraging them to employ a kind of clinical logic to the problem at hand.  He did provide answers when they were required, but his big contribution was in prompting the students to ask the right questions for themselves, in getting them to approach things with a clinician’s logic.     

     When he was not engaged with that group, he was doing the same kinds of things with other groups…   Not answering questions, but asking them:  “What should you be trying to determine here?”   “What is the first step towards generating a diagnosis?”    In this way he helped many groups move ahead as they reasoned through cases.

What’s the value of this approach?   This was early in the M2 year, and the team he focused on was new to each other (By the way, they never quite jelled, but that is another story).   By focusing the team on determining the right questions to ask, and by encouraging a pattern of clinical reasoning, he facilitated a very productive team experience.    The gold in these exercises happens right there in the group.   Yes, the debriefs are valuable, but the process…   learning to ask the right questions and track what you know and what you then need to know…   that is the gold.    

     Wondering how to contribute in team-based experiences as a facilitator?    You cannot go wrong if you help groups determine which questions to ask.   And, if you are wondering if your jumping in will help or hurt, just know: it will almost certainly help.   Especially if you focus on the process—on building the clinical reasoning—on asking the right questions.