About PBSGL

What is PBSGL?

The Practice Based Small Group Learning (PBSGL) initiative began in 1986 in the Foundation for Medical Practice Education (FMPE) at the McMaster University in Canada.
Across the world there are now over 5000 GP and PN members that enjoy being involved in PBSGL groups, as a way of maintaining their CPD and closing the gap between current practice and "best practice".
NES has supported PBSGL since 2006, for General Practitioners and Practice Nurses and in 2009 PBSGL became a part of GP CPD provision provided by NES.

How does it work?

GPs / PNs from a single or several practices voluntarily work in small groups of 5-12 with one person as facilitator, meeting on a regular basis. They discuss real patient problems, and the evidence to solve these cases.
Each meeting lasts 1-2 hours
The problems, the evidence, patient leaflets and websites are all combined in specially-prepared "modules" - which are available to all groups.
It is an enjoyable, relaxed and effective way to learn.
There is an enormous choice of modules that groups can study, and groups can cover as many as they like.
Groups usually meet every 6-8 weeks - sometimes by webcam or video conference in remote and rural areas.
The modules cover a broad range of common conditions - as below.
The Scottish project modifies the modules to remove any "Canadianisms" - and this process is referred to as Tartanising ('T' on the list of modules). Half of the modules available to PBSGL members are Tartanised and the other half are developed by GPs in the UK.
New modules are produced at a rate of 12-14 per year.
The steering group also produces de novo UK modules which refer to SIGN and NICE guidelines, and are proving very popular with groups.

PBSGL benefits

PBSGL is well-placed to fulfil the requirements of Appraisal and Revalidation.
PBSGL also helps reduce professional isolation, and is particularly valued by those GPs and Practice Nurses who may live and work far from other educational resources. The chance to talk with colleagues about everyday clinical matters, in a facilitated educational environment, has led to successful groups lasting for many years.

Future plans

We plan to develop the project by:

continuing to develop our own UK-based educational materials,
involving other health practitioners,
supporting the spread of PBSGL to the rest of the UK, and
actively researching the process of PBSGL.

Publications/Research

From the first days of implementation of Practice Based Small Group Learning (PBSGL) in Scotland we have been committed to evaluating and researching its acceptability and effectiveness as a learning method in our context. Listed below are the titles, references and abstracts of papers that have resulted from this work, all of which have been published in peer-reviewed journals. The articles include:

A description and analysis of PBSGL as a learning method
Both a quantitative and a qualitative evaluation of the pilot phase of PBSGL in Scotland when there were only five groups
A description of the experiences of a PBSGL group using video conferencing to overcome the challenge of isolation
A theoretical article focussing on commitment to change
Three papers that resulted from the pilotting of PBSGL in groups of Practice Nurses and groups that included Practice Nurses and GPs

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Practice Based Small Group Learning

Ottawa international medical educators conference, Oral Presentation, (Kuala Lumpur)

Rial J. (March 2012)

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Practice Based Small Group Learning

Association for Medical Education in Europe conference, Oral presentation, (Lyon)

Rial J. (August 2012)

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A pilot using Practice Based Small Group Learning as a form of CPD for General Practice trainees as they transition to independent practice

Education for Primary Care, Main Article

Rial J. (May 2013)

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Supporting educational supervisor development at the interface: evaluation of a pilot of PBSGL for faculty development

Education for Primary Care 24, 3, 178-184

MacVicar R, Guthrie V, O'Rourke J, Sneddon A. (January 2013)

Abstract:

Practice based small group learning is an established approach for Continuing Professional Development for GPs in Scotland. This paper describes an extension of the PBSGL approach to support the learning and development of educational supervisors from both hospital and general practice, working together in peer-facilitated small groups to address topic-specific, evidence-based educational modules. Four groups met on three occasions each and qualitative data were gathered from interviews with the facilitators and the participants. This was supplemented with observational data of the group process and function. Both GPs and consultants enjoyed the format and were very positive about the experience of working together in this way. Both commitment to change educational practice and reported actual changes in practice were evident.

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Practice-based small group learning in GP Speciality Training

Education in Primary Care 23, 1, 27-33 (7)

Hesselgreaves, H and MacVicar, R. February (2012)

Abstract:

This research aimed to explore GP Specialty Trainees' (GPSTs') perspectives of the impact of PBSGL on curriculum needs, preparation for independent practice, and facilitator learning.

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Practice-based small group learning: what are the motivations to become and continue as a facilitator? A qualitative study.

Quality In Primary Care 19 1 5-12

Cunningham D, McCalister P and MacVicar R. (2011)

Introduction and method: Growth of participant numbers has required the recruitment and retention of trained peer facilitators who help PBSGL groups to learn. It was not known what the perceptions and experiences of PBSGL facilitators were; in particular what had motivated them to become and continue as a facilitator. Two focus groups of PBSGL facilitators were held; their discussions were audio-recorded and transcribed with permission. Data generated was coded, and themes constructed from these codes.

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PBSGL - an effective learning method, and it helps reduce professional isolation

Primary Care Educator News, Volume 2 No 4 Aug 2010. Dr P McCalister

A summary of PBSGL methods and history.

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PBSGL in GPST in Scotland

Hannah Hesselgreaves & Ronald MacVicar. Glasgow, AMEE 2010

This research aimed to explore GP Specialty Trainees' (GPSTs) perspectives of the impact of PBSGL on curriculum needs, preparation for independent practice, and facilitator learning. One-to-one interviews were conducted with sixteen GPSTs from a range of Scottish deaneries and stages in training and analysed using qualitative techniques.

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The Thistle and the Maple Leaf: International Collaboration to enhance CPD Ronald MacVicar & Heather Armson, Malaga, AMEE 2009

Summary of work: A collaborative partnership between the Foundation for Medical Practice Education in Canada and NES has involved an adaptation of PBSGL to meet the needs of Scottish General Practitioners (GPs). Collaboration has included facilitator training, "tartanisation" of learning materials and plans for collaborative research. Implementation strategies, expected and unforeseen challenges and adaptations required to facilitate the 'fit' of an existing programme to a different medical environment will be presented.

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Practice Based Small Group Learning

BMJ Careers. 20 February 2010, GP 62

McCalister P

Peter McCalister talks you through an effective learning method that helps reduce professional isolation.

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Practice Based Small Group Learning: how health professionals view their intention to change and the process of implementing change in practice

Medical Teacher DOI:10.3109/01421590902842425

Kanisin-Overton G., McCalister P., Kelly D., MacVicar R.

Abstract:

Commitment-to-change (CTC) strategies used as part of Continuing Professional Development (CPD) programmes have been found to influence changes in the clinical practice of health professionals. However, there is an unquestioned usage of the term 'commitment'...

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The Practice-based Small Group Learning programme: experiences of learners in multi-professional groups

Journal of Interprofessional Care. 2009 May;23(3):262-72.

Kanisin-Overton G, McCalister P, Kelly D, MacVicar R.

Abstract:

This study describes the experiences of General Practitioners (GPs) and Practice Nurses (PNs) as they came together and engaged in the Practice-based Small Group Learning (PBSGL) programme.

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The practice-based small group learning approach: Making evidence-based practice come alive for learners

Nurse Education Today. 29 (2009) 671-675

Overton GK, Kelly D, McCalister P, Jones J, Macvicar R.

Abstract:

This paper reports the study of a pilot learning programme for the Continuing Professional Development of Practice Nurses (PNs) in Scotland.

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Requesting a commitment to change: conditions that produce behavioral or attitudinal commitment

Journal for Continuing Education in the Health Professions 2008 Spring;28(2):60-6.

Overton GK, Macvicar R.

Abstract:

There is a lack of clarity in the conceptualization of commitment underlying the commitment to change (CTC) procedure used by organizers of continuing education in the health professions. This article highlights the two distinct conceptualizations of commitment that have emerged in the literature outside health care education and practice.

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Small group Learning and videoconferencing: are they compatible?

Education for Primary Care. 18(2) (pp192-195), 2007

O'Rourke J.

This paper published in the "Teaching exchange" part of Education for Primary Care describes the experiences of using videoconference as a medium for participants to "meet" in the pilot phase of PBSGL in the Highlands of Scotland.

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Applying evidence in practice through small group learning: A qualitative exploration of success

Quality in Primary Care, Volume 15, Number 2, April 2007 , pp. 93-98(6)

Kelly, Diane R.; Cunningham, David E.; McCalister, Peter; Cassidy, Joe; MacVicar, Ronald

Aim: The aim of this study was to explore the perceptions and experiences of PBSG participants to gain an understanding of how PBSG learning achieves its success.

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Applying evidence in practice through small group learning: A Scottish pilot of a Canadian programme

Education for Primary Care. 17(5)(pp 465-472), 2006. Date of Publication: Sep 2006.

MacVicar R., Cunningham D., Cassidy J., McCalister P., O'Rourke J.G., Kelly D.R.

Abstract:

There is a lack of consensus about how to translate research findings into practice. The gap between evidence-based practice and clinical practice is perhaps most apparent in general medical practice. This study examines the effectiveness of practice-based small group (PBSG) learning in addressing this gap and in participants' understanding of the effectiveness of small group functioning.

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Canada's Practice Based Small Group Learning Project: an innovative approach to continuing professional development

Education for Primary Care. 14(4)(pp 431-439), 2003. Date of Publication: Nov 2003.

MacVicar R.

Abstract:
This paper describes and analyses the Practice Based Small Group Learning Programme (PBSG).

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