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BACKGROUND: There has been considerable debate over the need for content expertise to lead a successful small-group discussion for medical students. Some authors feel process expertise related to the conduct of a small group is of more value than content expertise related to the case. At least one study has presented data that suggest content expertise can lead to teacher domination of the learning environment. In an earlier study, the present authors found that students learned more and were more satisfied with small-group instruction when the instruction was facilitated by a faculty member who was an expert in the content of the case. That study also identified no tendency for content experts to dominate the sessions (e.g., through lecturing or otherwise controlling the learning environment). The purpose of the present study was to explore the efficacy of a carefully designed and highly focused case problem to remove the influence of group facilitators' content expertise on students' learning outcomes. METHOD: The 211 students in the University of Michigan Medical School class of 1994 were randomly assigned to 28 groups in a microbiology and immunology course in the fall of 1991; each small group was led by a faculty facilitator. Complete data were available from 27 groups: 13 groups led by experts and 14 groups led by non-experts. Data collection included observers' codings of interactions between the students and the facilitators (interactional analysis), test scores, and students' ratings of the experience. RESULTS: Unlike in the previous study, group leaders who were content experts devoted significantly more time to teacher-directed activities than did non-content-expert leaders. However, overall, 62% of the time was devoted to student-initiated activity. The results of the multiple-choice tests that were related specifically to the goals of the case indicated there was no significant difference between the students' performances in the groups led by experts and those led by non-experts. With respect to students' satisfaction, all students gave consistently high ratings to the experience and there was no difference between groups led by expert and non-expert facilitators. CONCLUSION: The data from this study suggest that a facilitator's content expertise alone does not determine the amount of teacher-directed behavior in a group, the amount of students' learning, or students' satisfaction. The focus built into the case and the amount of facilitator's training directly related to the content of the case are also significant variables related to students' learning, teacher's behavior, and students' satisfaction.
Davis et al. (Mon,) studied this question.