Faculty perceptions on barriers affecting small group teaching in undergraduate medical education

Wincy E. Wilson; Vidya G. S.; Priyanka Singh; Ramya M. P.; Chandrakala C.; Srividya V.

doi:10.18203/2394-6040.ijcmph20262258

Authors

Wincy E. Wilson Department of Community Medicine, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
Vidya G. S. Department of Community Medicine, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
Priyanka Singh Department of Physiology, Co-convenor of Medical Education Unit, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
Ramya M. P. Department of Community Medicine, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
Chandrakala C. Department of Community Medicine, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
Srividya V. Department of Community Medicine, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20262258

Keywords:

Competency-based medical education, Faculty perception, Small group teaching, Undergraduate medical education

Abstract

Background: Small group teaching (SGT) is a central instructional strategy within competency-based medical education (CBME) by NMC, formally implemented in undergraduate medical education in India in 2019. SGT promotes active learning, critical thinking, collaboration, and self-directed learning. However, despite curricular emphasis, effective implementation remains inconsistent across institutions due to behavioral, curricular, and contextual challenges. Hence, the present study was conducted to assess faculty perceptions on barriers affecting small group teaching in undergraduate medical education.

Methods: A cross-sectional mixed-methods study was conducted among 100 teaching faculty members and postgraduate tutors involved in undergraduate teaching at a tertiary care medical college, Bengaluru. A validated self-administered questionnaire assessed perceived barriers across four domains: student-related, faculty-related, curriculum-related, and infrastructure-related. Responses were recorded on a five-point Likert scale. Quantitative data were analyzed using descriptive statistics and expressed as frequencies, percentages, and mean Likert scores. Qualitative responses were analyzed using thematic analysis.

Results: Student-related barriers were perceived as the most significant challenge (76%). Infrastructure-related barriers showed moderate agreement (57%), followed by curriculum-related barriers (56.1%). Faculty-related barriers were the least perceived (50.9%). Student unpreparedness (79.8%) was the most frequently reported barrier. Perceptions were largely consistent across designation, years of teaching experience, and CBME training status. Thematic analysis demonstrated that student-related concerns constituted 46% of qualitative responses.

Conclusions: Faculty perceive student preparedness and motivation as the primary barriers affecting SGT. Addressing these modifiable factors through structured orientation, curricular alignment, and institutional support is essential to strengthening CBME implementation.

References

Harden RM, Crosby JR, Davis MH. Outcome-based education: Part 1- an introduction to outcome-based education. Med Teach. 1999;21(1):7-14.

National Medical Commission. Competency-Based Undergraduate Curriculum for the Indian Medical Graduate. New Delhi: NMC; 2019.

Meo SA. Basic steps in establishing effective small group teaching sessions in medical schools. Pak J Med Sci. 2013;29(4):1071-6.

Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs: Prentice Hall; 1984.

Biggs J. Enhancing teaching through constructive alignment. High Educ. 1996;32(3):347-64.

Freeman S, Eddy SL, McDonough M, Smith MK, Okoroafor N, Jordt H, et al. Active learning increases student performance in science, engineering, and mathematics. Proc Natl Acad Sci USA. 2014;111(23):8410-5.

Schmidt HG, Rotgans JI, Yew EHJ. The process of problem-based learning: What works and why. Med Educ. 2011;45(8):792-806.

Steinert Y. Faculty development: From workshops to communities of practice. Med Teach. 2010;32(5):425-8.

Dolmans DHJM, Schmidt HG. What drives the student in problem-based learning? Med Educ. 1994;28(5):372-80.

Miller GE. The assessment of clinical skills/competence/performance. Acad Med. 1990;65(9 Suppl):S63-7.

Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: Transforming education to strengthen health systems. Lancet. 2010;376(9756):1923-58.

Crouch CH, Mazur E. Peer instruction: Ten years of experience and results. Am J Phys. 2001;69(9):970-7.

Koles PG, Stolfi A, Borges NJ, Nelson S, Parmelee DX. The impact of team-based learning on medical students’ academic performance. Acad Med. 2010;85(11):1739-45.

Michaelsen LK, Knight AB, Fink LD. Team-based learning: A transformative use of small groups. J Educ Psychol. 2008;100(1):1-12.

Singh K, Mahajan R, Gupta P, Singh T. Comparison of lecture-based teaching and small group discussion in medical education. Int J Appl Basic Med Res. 2012;2(1):24-7.

Topping KJ. Trends in peer learning. Educ Psychol. 2005;25(6):631-45.

Khan IA, Shabbir N, Ahmed A. Implementation challenges of small group teaching in undergraduate medical education. J Coll Phys Surg Pak. 2018;28(3):210-3.

Al-Mously N, Salem R, Al-Hamdan N. The impact of small group teaching on students’ learning outcomes in medical education. Med Teach. 2014;36(Suppl 1):S14-7.

Veloski J, Boex JR, Grasberger MJ, Evans A, Wolfson DB. Systematic review of the literature on assessment-driven learning. Med Teach. 2006;28(2):117-28.

Palmer EJ, Devitt PG. Assessment of higher order cognitive skills in undergraduate education. BMC Med Educ. 2007;7:49.

Steinert Y, Mann K, Centeno A, Dolmans D, Spencer J, Gelula M, et al. A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education: BEME Guide No. 8. Med Teach. 2006;28(6):497-526.

Dath D, Iobst W. The importance of faculty development in CBME implementation: a mixed-methods study. Med Teach. 2010;32(8):683-9.