Dealing with dysfunctional tutorial groups

Background: The popularization of problem-based learning has introduced management of small groups as a critical skill for medical faculty. Some faculty have found themselves ill dysfunctional groups without the skills necessary to correct the learning climate. Purpose: This study was conducted to generate strategies faculty can use to deal with difficult tutorial groups. Methods: Twenty-three experienced tutors were arranged into 5 groups, then rotated through 5 training stations. Each station consisted of 5 students trained to behave according to a dysfunctional scenario. Tutor groups assessed the problem of each station group, planned an intervention, and intervened via one of the group's tutors. Results: Assessments of the difficulties in each group varied according to the particular station group scenario being observed interventions were tailored to the specific assessments tending from less invasive (i.e., asking questions while the case is being discussed to influence the direction of discussion) to more invasive (e.g., stopping discussion and invoking ground rules) to address the identified problems. Conclusions: We concluded that (1) establishing ground rules is important to the successful development of groups, (2) tutors and groups should deal with conflict directly as it arises, and (3) tutors should intervene strategically to foster positive group development. A model for strategic intervention is offered.