Teaching a fishbowl tutorial: sink or swim?

The fishbowl method is a small group teaching technique in which a number of students engage in a discussion while observers form a circle around them. We use this method to teach medical interviewing skills, with students interviewing a simulated patient (SP) whilst being observed by their peers and a clinical tutor. However, there is little evidence to guide teachers on how best to structure a fishbowl tutorial.

Our aim was to develop guidelines for teaching medical interviewing skills in the context of a fishbowl tutorial by assessing preferred teaching approaches for all participants (students, tutors and SPs). Participant preferences for teaching in the fishbowl were established using questionnaires designed to seek participants' opinions on various aspects of fishbowl tutorials, integrating key areas of difficulty highlighted during SP and tutor training sessions.

Across most items there was a high degree of consistency in the preferences of tutors, students and SPs, which enabled us to develop a set of guidelines for running a fishbowl tutorial to be used for our teaching programme.

We found this process to be acceptable to all parties and relatively simple to perform. It helped us to define our preferred procedures for teaching medical interviewing skills using the fishbowl method. The process of gauging participant opinion to develop teaching guidelines is appropriate for use by other institutions to inform their teaching practices in the fishbowl technique, although the nature of the guidelines may differ across teaching settings. Further research is required to determine if the implementation of these guidelines improves student satisfaction with fishbowl tutorials.