Design and Delivery of Small Group Pharmacology Exercises Facilitated Synchronously to Multiple Groups

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<b>Abstract ID 15865</b> <b>Poster Board 391</b> As pharmacology curricula have transitioned from lecture to active learning in small group, new challenges have arisen including ensuring appropriate student preparation and facilitating multiple small groups simultaneously with a limited number of session facilitators. Through continuous quality improvement and seeking student and faculty feedback, we have developed a structure for small group exercises that introduces, reinforces, and connects pharmacological concepts and drug classes. The small group sessions are designed on two premises: that the value of the small group comes from the discussion within the groups among the students and that the facilitator’s role is simply to reinforce and expand after that discussion. Student preparation is essential for successful discussions. In order to increase the likelihood of students completing pre-work, we design pre-work that is targeted specifically to that session. The pre-work generally takes the form of a short pre-recorded video accompanied by slides but may also include quick-check questions to help guide and reinforce content. We have found that students prefer recordings to assigned readings and that they prefer a targeted review video rather than referring them back to a topic covered in a prior course. The session begins with “warm-up” questions that are answered with polling software by each student and discussed with the entire class. The session facilitator is able to quickly clarify any concepts that are unclear before the students start on the session exercises. The warm-up questions also allow for students to enter into the small group discussion having refreshed drugs and concepts that are fundamental to the session and whose understanding is necessary for application in the cases and questions. In our pharmacology sessions it is common to have a single facilitator for 36 groups of students across 4 classrooms. This presents three specific challenges: ensuring full discussions rather than a race to answer, helping groups that get stuck, and identifying the areas that need further explanation. The depth of discussion often varies across the groups and can be gauged by spot checking groups and by reviewing answers that each group is required to submit. These answers can be used to adjust the questions in the following year and occasionally can result in multiple choice questions that are designed from the incorrect answers submitted. To decrease the time that groups are stuck and not making progress, we add “stuck questions”. These are guiding questions that reflect the way a facilitator would steer a group back on track. Because each group is submitting answers in real time, the facilitator has the opportunity to review the answers and identity areas where there is confusion. During the full-class case review, the facilitator can clarify discrepant answers, expand on the information in the case, and connect concepts across sessions and courses. Students are generally satisfied with the design and delivery of these sessions. In session and end-of-course evaluations, students often identify pharmacology small groups as a best practice. At the end of the pre-clerkship phase, 84% of students rated their pharmacology education as good/excellent. On the AAMC Graduation Questionnaire, 89% of students rated their pharmacology preparation for clinical clerkships as good/excellent. Observations from facilitators are that students are actively engaged with their groups and that the sessions are effective.