Teaching & Learning


How to grow and stay small: a strategy for scaling up while enhancing inclusivity

Dr Steven Buckingham, Division of Medicine, explains a novel approach to small-group teaching in Applied Medical Sciences, which focuses on the student, not the module content.

T&L image

16 April 2019

We had developed the Applied Medical Sciences course in 2014 as a flipped course i.e. consisting of online content students would complete before covering in more depth in classes.

We had small student numbers with a high ratio of teaching fellows. We designed the course as a coherent, systematic teaching system that allowed the teaching fellows to concentrate on delivering very personalized tutorials.  

As student intake increased without a corresponding increase in teaching staff, it became impossible to deliver the same kind of tutorials. I therefore redesigned the teaching in 2017 to allow small-group teaching to continue with the same level of staffing.

This involved changing from a two-step design of online learning and tutorials, to a three-step design, which introduced in large-group teaching in workshops, and a different approach to small-group teaching.


Changing the design of the course to accommodate growing student numbers

Our teaching involves around 80 first year undergraduate students, who are supported by eight teaching fellows. Students from three separate programmes join us, as they share the teaching content in their first year:

  • Applied Medical Sciences
  • Cancer and Medical Sciences 
  • Nutrition and Medical Sciences. 

Our original flipped course contained two main components:

  1. Online learning at home
  2. Tutorial teaching on campus.

The new system has three main components instead of two. There is no increase in the number of contact teaching hours, but the distribution of these hours has changed.

1. Online content

This is the same as for standard flipped learning.

2. Workshops: large-group teaching

The entire cohort is taught by one teaching fellow in a weekly three-hour workshop (with three modules running concurrently, students spend nine hours a week in workshops). 

The aim is to test, practice and consolidate the online learning. 

They consist largely of simple questions testing the material and students work on these questions in teams of three or four. Votes are taken on the answers and the teaching fellow explains any misconceptions.  

Once fluency in these basic concepts, facts and operations is obtained, the students then work on a more open-ended question or problem. 

The teaching fellow circulates around the room, joining in conversation and providing help or guidance when needed.

3. Small-group teaching  

Each teaching fellow is allocated two groups of students, with approx. eight students per group, meeting weekly.

The aim is for the teaching fellow to guide the students’ intellectual development. It is forbidden to deliver course content or to explain material being taught in the course.  

The content of these sessions can vary greatly from one session to another. Examples of sessions can include:

Socratic query

The students are asked at the beginning of the session whether they think the NHS should fund acupuncture. There is usually a strong consensus that it should not.

The Teaching Fellow then probes the reasons for, and assumptions behind, the students’ stance, using established Socratic techniques. 

The form of the interaction makes it clear that it is not about being right, but about analysing and refining an argumentational position.

Coursework planning

Students are invited to discuss how their plans for their coursework can be demonstrated to meet the marking criteria. Then they are challenged to define their own, personal criteria for success.

This encourages students to interpret marking criteria as a guide to personal fulfilment rather than a diagnostic standard. It is a stepping-stone to weaning them off trying to please authorities and onto setting their own goals.

Problem-based learning

Students are presented with an ill-posed problem (i.e. one with no clear correct answer and with many potentially irrelevant clues). Using established problem-based learning methods, students evaluate their own learning needs and develop a strategy for solving the problem.

Peer evaluation

Student groups swap their coursework drafts and evaluate them for each other. This makes them aware of the process of feedback and instills a sense of ‘assessment for learning’. It also has the desired side-effect of encouraging self criticism (“Hey, we didn’t do that in our poster, did we?”).

The teaching fellow remains with the groups all through the year, if not the entire degree. This provides the students with consistency, stability and an opportunity to develop important teacher-student and peer-peer relationships.

The consistency in the group also allows an environment to develop in which every member feels valued and stimulated in critical thinking.


Supporting teaching fellows to adopt a new style of teaching

Using small-group teaching that is separate from the module, is a novel approach and not something our teaching fellows had done before.

To support them, we created scripts for the small-group sessions. These were not strictly required, but the teaching fellows needed reassuring as they were leaving their comfort zone of teaching content they considered themselves experts in.  

We met weekly to discuss what was going to be done in that week’s small group and to share concerns and feedback.  

A survey of our teaching fellows showed that they were happy with the system and that it had helped them improve as a teacher. 

The flipped/blended learning approach we use in the first year of study enables us to maintain small group teaching despite potentially problematic increases in student numbers. It’s clear that our diverse student cohort benefits from and enjoys the variety of teaching styles and the close student/staff relationship that this approach cultivates.” Andrew Williams, Senior Teaching Fellow, Division of Medicine


Adapting to the changing face of higher education

The way students are learning is changing and we need to adapt.  

By focussing teaching fellow time on the students as people rather than as deliverers or brokers of content, we provide something that no online course could give.  

It helps with inclusivity because a small group is a good environment to find your voice, while the hard bit about learning is done in the anonymity of a large workshop.


Benefits for our students and an in increase in Student Evaluation Questionnaire (SEQ) scores

The existing teaching system could not deliver small-group teaching given the increase in the student numbers and the level of teaching staff. 

Now, despite the growth in our department, students can still benefit from this more personalised contact with someone who is a member of research staff and a teacher.

SEQ scores increased from 65% to over 72% and students felt that the small-group teaching particularly benefited their development.  

Feedback from a selection of 1st year students

“I think the tutorials were especially effective. The fact that we do all the preparation by ourselves (at our own pace) means that we can spend all the contact hours in an interactive way - great method!”
"Small group teaching gave us a safe space to project our ideas and it allowed us to sharpen our debating skills."

"Leading the sessions allowed us to be independent in our learning."

"The concept of a small group learning environment allowed me to resolve my queries about the given coursework and certain topics in the module in a very convenient and engaging manner. It also allowed me to enhance my critical thinking skills and debating skills."


Top tips to emulate this in your programme

  1. Script the small group sessions in advance, and share experiences with each other.
  2. Make sure you never give in to the temptation to deliver module content in the small groups.
  3. Keep in focus the aim of using the small groups to get the students to become researchers.
  4. Expect problems with some groups (politics, problems with free loaders etc) and when you encounter them, work them through with the students. Assure them that these are the very problems they will face in the working world, and that they are getting a rare opportunity to learn how to succeed through these issues.