Facilitating Case Discussion: Barriers to Discussion

Facilitating case discussions is challenging, and there are a number of barriers to success. It is important to recognize that discussion diminishes when factual questions are asked rapidly in succession, a participant’s questions are immediately answered by the facilitator, short pauses occur after questions, or responses are judged and praised. Alternatively, the facilitator can promote discussion by 1) prolonging response time (silence after a facilitator question), 2) avoiding running commentary, judgments and/or editorializing by the facilitator; and 3) using a wide variety of questions beyond the factual level will promote rich discussions.

Sometimes it is necessary to redirect the discussion if it is being dominated by a single participant such as an opinionated faculty expert. Redirecting the challenging question to other members of the group by simply asking, What do others think? is often a successful management strategy. When the discussion is being dominated by a single participant—whether student, resident, or faculty—polling the other members of the group with questions like Does everyone agree with this? can be useful.