Small Group Learning Research Articles

Outcomes of an interprofessional peer facilitators program: Building a confident, competent, and collaboration ready healthcare workforce

Peer facilitation during interprofessional simulation-based learning enables students from diverse professions and backgrounds to enrich each other's learning in small groups. Peer facilitators are interprofessional role models and serve to maintain neutrality, listen actively, and respond to group dynamics supporting interprofessional education (IPE). This paper will report the outcomes of an interprofessional peer facilitation program as part of a larger IPE curriculum in a graduate program in the health professions. The authors conducted a mixed methods evaluation of peer facilitators' development measured through a peer facilitator knowledge and self-efficacy tool. Results of qualitative and quantitative data from four years of the program are discussed, documenting the outcomes serving as a peer facilitator has on entry-level health professions learners.

Using Needs Analysis to Foster Sustainability of Business English Courses: A Case Study of a University in the South of Chile

The purpose of this study is to conduct an in-depth needs analysis in order to create a sustainable business English course. Drawing critical insights from the development and implementation of a sustainable curriculum, a mixed-methods approach was carried out that involved data collected via a structured questionnaire administered to 117 university students of business administration and accounting. The findings indicated that a substantial majority of respondents perceived their level of English language proficiency to be low, with merely 25% evaluating their English skills as either “good” or “excellent”. Several language skills such as speaking, listening, and writing were recognized as communicative needs for effective business communication and studies, with over 86% interested in registering for the course. Regarding pedagogical needs, the emergence of preferences for face-to-face teaching, making the course mandatory, varying perspectives regarding the frequency and duration of courses, and inclination towards small group learning were established. For the sustainability of the business English course, this study suggests an integrated, responsive, and adaptive course that emphasizes interactive learning and curriculum alignment with global business trends.

What’s art got to do with it?—Transfer of learning in museum-based health professions education

Museum-based education for health professionals is a rich and expanding field in which educators engage health professions learners in arts-based activities intentionally designed to support transfer of learning from a museum to a clinical context. Museum-based education for health professionals promotes several key learning outcomes including: mastery of core skills such as observation, interpretation, and communication; cultivating personal insight; fostering appreciation for multiple perspectives; opening avenues to explore social advocacy; and promoting wellness. Following a museum-based activity, translational facilitators guide learners through a debriefing process which supports the discovery of real-world connections to clinical teaching, learning, and care delivery. Translational debriefing involves practices such as attending to psychological safety, using reflective listening and open-ended questions, practicing cultural humility, maintaining neutrality, and modeling curiosity. These translational opportunities can also help participants who are themselves health professions educators gain insights into their own teaching practices and provide new tools to incorporate, including bedside teaching strategies and innovative ways to facilitate small group learning.

Centering and marginalization in introductory university physics classrooms

IntroductionResearch-based instructional strategies in physics promote active participation in collaborative activities as a primary means for students to construct understanding. Discussions of physics content are also negotiations of social relations.MethodsVideo analysis of small-group collaborative learning activities in introductory physics classrooms at three different universities, using situated learning theory analyses that include a critical consciousness lens.ResultsStudents’ ability to actively participate in sensemaking may be limited by their peripheral or marginalized position. Some people seem to be centered (or marginalized) for reasons other than the strength of their physics reasoning, and some people’s contributions are elevated (or neglected) for reasons other than their scientific merit.DiscussionSome of the behavioral patterns that we observe typify racialized and gendered interactions that are common in broader U.S. society.

Measuring group function in problem-based learning: development of a reflection tool

BackgroundProblem-based learning (PBL) is a pedagogy involving self-directed learning in small groups around case problems. Group function is important to PBL outcomes, but there is currently poor scaffolding around key self-reflective practices that necessarily precedes students’ and tutors’ attempts to improve group function. This study aims to create a structured, literature-based and stakeholder-informed tool to help anchor reflective practices on group function. This article reports on the development process and perceived utility of this tool.MethodsTool development unfolded in four steps: 1) a literature review was conducted to identify existent evaluation tools for group function in PBL, 2) literature findings informed the development of this new tool, 3) a group of PBL experts were consulted for engagement with and feedback of the tool, 4) four focus groups of stakeholders (medical students and tutors with lived PBL experiences) commented on the tool’s constructs, language, and perceived utility. The tool underwent two rounds of revisions, informed by the feedback from experts and stakeholders.ResultsNineteen scales relating to group function assessment were identified in the literature, lending 18 constructs that mapped into four dimensions: Learning Climate, Facilitation and Process, Engagement and Interactivity, and Evaluation and Group Improvement. Feedback from experts informed the addition of missing items. Focus group discussions allowed further fine-tuning of the organization and language of the tool. The final tool contains 17 descriptive items under the four dimensions. Users are asked to rate each dimension holistically on a 7-point Likert scale and provide open comments.Researchers, faculty, and students highlighted three functions the tool could perform: (1) create space, structure, and language for feedback processes, (2) act as a reference, resource, or memory aid, and (3) serve as a written record for longitudinal benchmarking. They commented that the tool may be particularly helpful for inexperienced and poor-functioning groups, and indicated some practical implementation considerations.ConclusionA four-dimension tool to assist group function reflection in PBL was produced. Its constructs were well supported by literature and experts. Faculty and student stakeholders acknowledged the utility of this tool in addressing an acknowledged gap in group function reflection in PBL.

The effect of the Educational Scholar Program as a longitudinal faculty development program on the capability of educators as scholars

IntroductionThe Educational Scholar Program (ESP) is designed and implemented as a longitudinal and institution-based faculty development program. The present study aimed to assess the effect of the ESP on educators’ capabilities to undertake SoTL activities associated with their scholar role.MethodsThis study was conducted from 2017 to 2022. The participants (n = 64) were educators in six schools of Shahid Sadoughi University of Medical Sciences. The ESP was a faculty development program that consisted of training and project-based stages. The educators experienced small-group learning, self-directed learning, and reflective assignments in the training stage. In the second stage, the educators completed a SoTL (Scholarship of Teaching and Learning) project. Learner-related outcomes based on Kirkpatrick model was assessed. The reaction of educators (satisfaction, active participation in the ESP, and the perception of mentoring sessions) was assessed by three questionnaires (Reaction level). The educators’ learning was evaluated by modified essay questions and their project reports (Learning and Behavior levels). Outputs of the ESP including journal publications, abstracts presented at meetings or congresses, grant funding, awards in educational festivals, promotions, projects with ongoing implementation following the ESP, and conducting further SoTL projects after ESP were assessed quantitatively over two years after participating in the ESP (Results level). Data were summarized by descriptive statistics (mean, percentage, SD, 95% Confidence Interval (CI)). Cut-off scores of the instruments was calculated with a standard setting method which introduced by Cohen-Schotanus and Van DerVleuten. Data analyzed by One-sample t-test.ResultsSixty-four of 72 (89%) educators completed the ESP. The mean (CI) satisfaction score of educators was 42 (CI: 26.92–58.28), the active participation was 92 (CI: 80.24-103.76). The scores of the mentoring assessment from the perspective of the educators were reported at 90 (CI: 78.24- 101.76). The mean (95%CI) learning scores in the essay examination were 88 (CI: 70.36- 105.64), and project assessment were 90 (CI: 78.24- 101.76). The results showed the educators’ scores in reaction and learning significantly higher than the cut-off scores. (P < 0.05). Most projects were conducted in curriculum development and assessment/evaluation domains. The number of projects with ongoing implementation over the two years following the ESP and the acquisition of grants was higher than other outputs in the results level.ConclusionThe ESP, as an institute-based longitudinal program, enhanced the learner-related outcomes (in four levels of reaction, learning, behavior, and results). The creation of practical learning and supportive mechanisms influenced on the results. The outcomes of ESP indicated that the educators prepared to conduct SoTL activities in their educational community.

Improving surgical skills with feedback: directly-observed versus video-recorded practice

ObjectiveThis study aimed to compare two methods of feedback: verbal face-to-face feedback after direct observation (F2F-feedback) versus electronic-written feedback after observation of recorded-VDO of student’s performance (VDO-feedback), in terms of effectiveness in improving skill, effects on motivation and satisfaction.BackgroundMedical schools are responsible for teaching and ensuring proficiency of basic surgical skills. Feedback is effective in developing psychomotor skills; by providing information of learner’s current performance, how to improve, and enhancing motivation.Materials and methodFifty-eight medical students (3rd– 4th year) were trained to perform vertical mattress suture in small groups. Then, during 6-week period of self-directed practice, students were randomized into group1 VDO-feedback (male:female = 21:8) and group 2 F2F-feedback (male:female = 20:9). Feedbacks were provided once every 2 weeks (Week2, Week4). End-of-rotation OSCE was at Week6, and retention tested was at Week8. Performance checklist (Cronbach’s Alpha 0.72) was used to assess skill at 4 timepoints; pre- and post- small group learning, OSCE, and retention phase. Questionnaire was used to assess motivation, learning strategies and satisfaction (Cronbach’s Alpha 0.83).ResultAfter in-class learning, further significant improvement of skills could be gained by both F2F- and VDO- feedbacks (p < 0.0001). Both could similarly retain skill for at least 4 weeks later without additional practice. Self-efficacy, test anxiety, and cognitive strategies scores were significantly increased in both groups (p < 0.05). Extrinsic motivation was increased in VDO-feedback group. No difference in satisfaction between groups was observed.Discussion and conclusionVDO-feedback could be alternative to F2F-feedbacks for basic surgical skill training when limitation for simultaneous meeting of teacher and students occurs.Trial registrationThis study has been registered to Thai Clinical Trial Registry (WHO International Clinical Trial Registry Platform) on 11/07/2023 (TCTR20230711005).

A Pilot Study of Art Museum-Based Small Group Learning for Pre-Health Students.

Health professions educators are increasingly recognizing the fundamental role the arts and humanities play in professional identity formation; however, few reports exist of programs designed specifically for pre-health professional students. We designed and delivered four, 2.5-h sessions for pre-health professions students at a local museum in partnership with museum educators. Participants were invited to respond to a follow-up survey asking about their perceived insights from and importance of the session. We used descriptive statistics and thematic content analysis for quantitative and qualitative data, respectively. Ten of the participants responded to the survey (n=10/23, response rate=43%) and all supported the integration of such an experience in their pre-health curriculum. The qualitative analysis of responses to the open-ended item about any insights gained from participation in the program revealed three themes: cultivation of the health professional, personal growth, and awareness and appreciation of multiple perspectives. Participants who responded to our survey drew meaningful connections to the relevance of these sessions to their development as future professionals.

Meta-strategic Learning of Structure Strategies in Reading Comprehension of Expository Texts

Meta-strategic learning refers to a mediated construction of knowledge regarding when, why and how to apply a group of strategies for accomplishing cognitive tasks. This study examined the effect of meta-strategic learning of structure strategies on reading comprehension of expository texts by secondary school students under whole-class instruction conditions. The effect of a meta-strategic intervention program was compared to that of a strategic program, which focused on a direct (unmediated) instruction of how to apply each structure strategy separately, and to a control group. Moreover, we explored the role of students’ engagement in class discussions and tasks in meta-strategic learning. Three structure strategies using texts from three school domains were taught during 9 double lessons. Programs’ effectiveness was examined by near- and far-transference reading comprehension tasks, and a strategic knowledge questionnaire given before and after intervention. Findings indicated that both programs were similarly effective in enhancing students’ reading comprehension skills and strategic knowledge. The unique benefits of meta-strategic learning were apparent particularly for high-engaged students in far-transference tasks and for all students in overt application of strategic elements during task completion. More research is required to explore further benefits for meta-strategic learning in small groups and over the long-term.

“METAPAD” (METAbolic PAthways Decoded) – a gaming innovation to ease the complexity of metabolic pathways by promoting self-directed, active, participatory learning in small groups

BackgroundIn medical education, the conventional didactic lectures make the learning process tedious and cause disinterest among students. To overcome this, an effective experiential learning integrated with game-based approach that intends to make the learning process fun filled, interesting and enhance the active participation of students to understand complex topics in a simple and optimum manner should be adopted.ObjectivesThe purpose of this study is to assess the efficiency of a puzzle-based innovation, METAPAD (METAbolic PAthways Decoded) in understanding the complexity of biochemical pathways by enhancing the self-directed learning of students through active engagement in small groupsMethodsIn this mixed-method study, 103 first professional year medical students in small groups were enrolled for the METAPAD gaming puzzle-based learning activity. The puzzles were integrated with a relevant clinical case study. Decoding the puzzle after identification of the metabolic pathway involved in the case was conducted in level 1,2 and 3 with increasing complexity of puzzles at every level. Following the puzzle activity, A 21-item questionnaire was administered to evaluate the usefulness of the innovation and students’ perceptions towards different learning styles. Also, students’ feedback was obtained through personal interviews for qualitative analysis and thematic analysis was performed.ResultsOne hundred and three first year undergraduate medical students participated in the study. Most of the students perceived the METAPAD gaming puzzle to be an effective and innovative style of learning. There was not any significant association between age, gender and acceptance towards the METAPAD gaming puzzle. The predominant type of learning style among the students was multimodal (49.5%). Also, there was no great influence of the learning styles on the overall perception towards the METAPAD gaming puzzle. However, learners emphasized the need to focus more while solving the puzzles.ConclusionStudents perceive the METAPAD gaming puzzle as an actively engaging teaching-learning method that enhances their creativity, critical thinking and problem-solving abilities. It promotes self-directed learning of complex pathways in biochemistry which helps in remembering and recalling information and improves their learning skills.

Case-Based Learning: An Analysis of Student Groupwork and Instructional Design that Promotes Collaborative Discussion

The use of small-group collaborative case-based learning methodologies has been growing both in interest and implementation across veterinary college curriculums in recent years. The ability of this pedagogical approach to solidify and deepen learning outcomes is well-established in the broader education literature. However, to achieve this positive impact, students must interact in productive discussions that expand the scope of their understanding. The present study focused on analyzing the ways in which professional veterinary students interact as they work collaboratively through clinical cases, in the context of a Team-Based Learning–intensive curriculum. This data was used to draw connections between the questions posed in the clinical case activities and the resulting intragroup collaborative outcomes, which can assist veterinary educators in sparking more robust student discussions through facilitation and instructional design. Fourteen participants formed two student groups that worked on 49 case questions across five sessions, providing 98 episodes of collaboration for analysis. The findings of this study revealed how professional veterinary students negotiated perspectives to come to consensus on in-class case-based learning tasks, including eight primary types of statements they made and seven overall patterns of group collaboration. This study highlighted specific elements of instructional design that influenced student collaboration including: allowing for multiple perspectives, sparking disagreement, perceived difficulty, learning outcome level, and the level of consensus required by the question structure. We present specific recommendations for veterinary educators to consider while designing questions for veterinary student groups.

Online case-based learning in medical education: a scoping review

BackgroundCase-Based Learning (CBL) in medical education is a teaching approach that engages students as learners through active learning in small, collaborative groups to solve cases from clinical patients. Due to the challenges afforded by the COVID-19 pandemic, small group learning such as CBL, transitioned quickly to include technology-enhanced learning to enable distance delivery, with little information on how to apply pedagogical frameworks and use learning theories to design and deliver online content.MethodsTo extend understanding of online CBL a scoping review protocol following the PRISMA-ScR framework explored the literature that describes the use of online CBL application in medical education and the outcomes, perceptions, and learning theories. A literature search was conducted in January 2022 followed by a subsequent review in October 2022. After peer review using the PRESS guidelines, the CASP appraisal tool was used to assess the rigor of each study design.ResultsThe scoping review identified literature published between 2010 and 2022 (n = 13 articles), on online CBL in the field of medical education with 11 observational studies describing student and facilitator perceptions and two randomized controlled studies. Positive perceptions of online learning included a flexible work-life balance, connection with learners, and improved accessibility. Negative experiences of online CBL included poor internet access, a distracting learning environment, and loss of communication. In the studies that collected student performance data, results showed equivalent or improved outcomes compared to the control. The CASP appraisal tool highlighted the deficiencies in most study designs, lack of framework or learning theory, and poor reproducibility of the methods to answer the research questions.ConclusionThis scoping review identified literature to describe the academic outcomes, and student and facilitator perceptions of online CBL in medical education. However, the CASP tool uncovered deficiencies in study descriptions and design leading to poor quality evidence in this area. The authors provide recommendations for frameworks and learning theories for the future implementation of online CBL.

Faculty and Student Perceptions of Unauthorized Collaborations in the Preclinical Curriculum: Student or System Failure?

Unauthorized collaboration among medical students, including the unauthorized provision of assistance and sharing of curricular and assessment materials, is a reported problem. While many faculty view such sharing as academic dishonesty, students do not always perceive these behaviors as problematic. With the trend toward more small-group and team-based learning and the proliferation of resource-sharing and online study aids, collaboration and sharing may have become a student norm. This multi-institutional, qualitative study examined faculty and student perceptions of and student motivations for unauthorized collaboration. Using a constructivist approach, the authors conducted scenario-prompted semistructured interviews with faculty and students in the preclinical curriculum. Participants were asked to reflect on scenarios of unauthorized collaboration and discuss their perceptions of student motivation and the influence of personal or environmental factors. The authors performed inductive thematic analysis of the interview transcripts using open and axial coding followed by abstraction and synthesis of themes. Twenty-one faculty and 16 students across 3 institutions were interviewed in 2021. There was variation in perceptions among faculty and among students, but little variation between faculty and students. Both participant groups identified the same 3 areas of tension/themes: faculty/curriculum goals vs student goals, inherent character traits vs modifiable behavioral states, and student relationships with their peer group vs their relationships with the medical education system. Student behaviors were perceived to be influenced by their environment and motivated by the desire to help peers. Participants suggested cultivating trust between students and the education system, environmental interventions, and educating students about acceptable and unacceptable behaviors to prevent unauthorized collaboration. Given the various tensions and positive motivations behind unauthorized collaborations, institutions should consider explicitly preparing students to make thoughtful decisions when faced with competing priorities in addition to developing mitigation strategies that address the environment and its interactions with students.

Medical Educator as Game Master: What Dungeons & Dragons Can Teach Us About Small Group Learning.

Medical Educator as Game Master: What Dungeons & Dragons Can Teach Us About Small Group Learning.

IM Twenty-Four Steps Of Educational Innovation In Indonesia

This study aims to critically analyze educational innovation in Indonesia through twenty-four appropriate educational strategies. This type of research is library research. Collecting data by identifying discourse from books, papers or articles, journals, newspapers, the internet (web), or other information related to education. Data analysis used descriptive analysis, content analysis, and scientific critical analysis. The results of the study show that educational innovation in Indonesia can implement twenty-four educational strategies which include Personalization, Multi-Age Classes, Small Community Learning, Peer Group Learning, Small Group Learning Communities with other groups, Multidisciplinary Curriculum with Block Scheduling, Cooperative Learning, Cooperative Learning, Project Based Learning, Co-Teachers, Teaching Teams, Community Service Learning, Looping Partnerships, Business for Assessment, Resources, and Funding, Global Connections, Laptops, and Wireless Technology for Anywhere, Anytime Learning, Parental Involvement, Students Putting on Shows, Curriculum Life Skills (Non-Academic), Meaningful Career Counseling, Social/Emotional Counseling, Open Learning, Education to Serve Student Needs, Portfolio-Based Assessment and New Paradigm of School Buildings.

The Effect of The Power of Two Learning Strategies on Natural Science Material on the Thinking Ability of PGMI Students

Through the cooperative learning model, students will work together in their groups, then discuss some information, and disclose it to other groups. One type of cooperative learning, namely The Power Of Two Type. (The strength of both types) is learning in small groups by cultivating maximum cooperation through learning activities by friends themselves with two members in it to achieve basic competence. In this qualitative study, the literature review must be used consistently with methodological assumptions. This means that it must be used inductively so as to be able to answer the questions posed by the researcher.

Student-led Seminars as an Enforcement-learning Method for Human Anatomy – Dentistry Students’ Perspectives

Background: The “student led seminar (SLS)” is one in which students prepare and present selected topics through multi-source research with the assistance and guidance of the faculty. Teamwork is increasingly emphasized in health care, and team training is now considered to be essential in medical education. Small group learning promotes active learning and develops communication and teamwork skills. It also improves problem-solving skills, attitudes, and the development of interpersonal skills. Aim of the Study: The aim of this study was to evaluate the efficacy of SLSs as a teaching-learning method for Bachelor of Dental Surgery undergraduates through students’ perception. Methodology: This was a prospective, observational study conducted for 5 months among 1st year dentistry students. The students were divided in small groups and the topics for the seminar were allocated for presentation according to the roster. Each group was given 20 min for presentation, 10 min for question time and discussion. A hard copy of the slides presented was also collected. Feedback was taken on pretested questionnaire containing 11 Likert-based items on a five-point scale. Descriptive statistics were applied for each item question. Cronbach’s alpha test was applied to check the internal validity of the questionnaire. Satisfaction rate and index were calculated. Fischer’s exact test was applied to find the odds ratio of satisfaction rate between male verses female students and hosteller verses day scholar students for each item question separately. Student’s t-test was applied to determine the difference in the performance of students in the first and second internal assessments at P = 0.05 significance level. Results: Among the participants, 32 were female (mean age 19 ± 1.46) and 18 were male (mean age 20 ± 1.82) students. Ninety-five percent of students agreed that the seminars improved their self-confidence and enhanced their presentation skills, helped them acquire a deeper understanding of the topic, an opportunity to use resources (time, electronic gadgets, and media) responsibly, even outside the bounds of the lecture theatre. Overall, mean score on Likert scale was 3.9 ± 0.307. The satisfaction rate and index were the highest for question 3. The second term examination result showed statistically significant improvement over that of the 1st term. Conclusions: The student seminar is a potentially important resource of the teaching-learning method that has yet to be fully implemented and therefore needs to be incorporated into the medical curriculum on a regular basis.

An Investigation of Group Dynamics in Mixed Mode Classes among Undergraduates

Group work is highly important in higher education during assessment and evaluation. The stages of the learning activity are the same whether it is conducted face-to face or online. Students can develop new skills for continuous learning by working in groups. Students will be more accountable for acquiring knowledge in this way. Different strategies based on students' learning styles preferences can become effective instructional tools for improving critical thinking, communication, and implementation skills. The purpose of this research is to explore the implementation of a group dynamic approach in a small group. The research was determined using a qualitative survey. The model reflects the stages of forming, storming, norming, and performing on the group dynamics of 236 respondents of undergraduate students studying from three different faculties at University Teknologi Mara in Malaysia. The findings of this study show that these elements can be used to create a group dynamic that is suitable for small-group learning for university students. Since there has been a few study into group dynamics at the undergraduate level, it was beneficial to explore this concept in other categories of education such as master's and doctoral programmes and educators.

Facilitated Study Groups for Undergraduate Organic Chemistry: Experience from a Large Public Canadian University

Undergraduate organic chemistry courses have a reputation for being difficult among students in biological and physical sciences programs. Due to the extensive problem-solving, visualization, and depiction of chemical structures/reactions required, students may perceive learning such content as similar to learning a new language. Several interventions such as course-integrated tutorials or discussion sessions have aimed to assist students. Another effective approach that chemistry educators might consider is Supplemental Instruction (SI), a well-established program that emphasizes student-driven learning whereby student SI leaders facilitate discussions to help students arrive at solutions while also developing effective communication and study skills. A type of SI, Facilitated Study Groups (FSG), established by the Centre for Teaching and Learning at the University of Toronto Scarborough (UTSC) in 2009, were introduced regularly into organic chemistry courses in 2012. This program provides semester-long optional small-group peer learning sessions, each of which corresponds to a course lecture. The aim of this paper is to provide comprehensive coverage detailing the structure of the organic chemistry FSG program, peer facilitation strategies employed, quantitative/qualitative synthesis of student outcomes indicating program uptake. We consistently find significantly higher grades and significantly lower attrition rates for students who regularly attend FSG sessions in comparison to those who do not (n=16 semesters). Given the growing diversity of undergraduate classes in terms of approaches to learning, language, and cultural barriers (international students, English second-language learners, learning and psychosocial disabilities), our FSG sessions seek to foster inclusion amongst our heterogeneous pool of attendees. Here, we describe strategies that tailored FSG sessions to a diverse group of undergraduate students as suggested by a sizable percentage of the class availing themselves of this resource and by a narrative synthesis of end-of-term surveys. Together, we demonstrate successful adoption of an SI-based model for organic chemistry and present a practical framework that includes pedagogically informed session strategies and cost estimates to guide design of similar programs for post-secondary students at other institutions.

Teaching Students How to Think: A Longitudinal Qualitative Study of Preclerkship Clinical Reasoning Instruction

ABSTRACT Introduction An objective of undergraduate medical education is to teach students how to think like physicians through a process called clinical reasoning. Currently, clerkship directors often feel that students enter their clinical years with a marginal comprehension of clinical reasoning concepts; instruction in this area could be improved. Although there have been previous educational studies assessing curricular interventions to improve the instruction of clinical reasoning, it is not yet known what happens at an individual level between an instructor and a small group of students in the teaching of clinical reasoning. This research will identify how clinical reasoning is being taught in a longitudinal clinical reasoning course. Methods The Introduction to Clinical Reasoning course is a 15-month-long case-based course held in the preclinical curriculum of the USU. Individual sessions involve small-group learning with approximately seven students per group. Throughout the academic year of 2018-2019, 10 of these sessions were videotaped and transcribed. All participants provided informed consent. A thematic analysis was performed using a constant comparative approach. Transcripts were analyzed until thematic sufficiency was reached. Results Over 300 pages of text were analyzed; new themes ceased to be identified after the eighth session. Topics included obstetrics, general pediatric issues, jaundice, and chest pain; these sessions were taught either by attendings, fellows, or fourth-year medical students with attending supervision. The thematic analysis revealed themes associated with clinical reasoning processes, themes associated with knowledge organization, and a theme associated with clinical reasoning in the military. The clinical reasoning process themes included problem list construction and refinement, differential diagnosis, naming and defending a leading diagnosis, and clinical reasoning heuristics. The knowledge organization themes included illness script development and refinement and semantic competence. The final theme was military relevant care. Conclusions In individual teaching sessions, preceptors emphasized problem lists, differential diagnoses, and leading diagnoses in a course designed to strengthen diagnostic reasoning in preclerkship medical students. The use of illness scripts was more often implicitly used rather than explicitly stated, and students used these sessions to use and apply new vocabularies related to a clinical presentation. Instruction in clinical reasoning could be improved by encouraging faculty to provide further context to their thinking, by encouraging the comparing and contrasting of illness scripts, and by using a shared vocabulary for clinical reasoning. Limitations of this study include that it was done in the context of a clinical reasoning course and that it was done at a military medical school, which may limit generalizability. Future studies could determine if faculty development could improve the frequency of references to the clinical reasoning processes that could improve student readiness for clerkship.