Games in Teaching

Good facilitation starts long before you walk into the room. Never underestimate the preparation phase.

• Game selection: Assess the needs of the group first. What problem are you trying to solve? New group needing connection? Tired group needing energy? Use that answer to select the right game type.
• Time: Be realistic about how long the game plus debrief will take. The debrief is not optional — it is where the learning happens. Always budget more time than you think you need.
• Space: Some games need room to move. Some need chairs arranged in a circle. Check the room in advance. A game that requires standing and moving does not work in a room full of fixed-desk seminar seating.
• Resources: Print materials, pens, cards, balls — whatever the game needs. Running out of materials mid-game destroys the momentum.
• Group size: The ideal group size for most games is somewhere between 5 and 12 people. Larger groups usually need to be split into subgroups.
• Accessibility: Think about anyone with a physical disability, hearing difficulty, or other access need. Design the game so no one is excluded. Exclusion is both unkind and counterproductive.
• Practice run: If it is a new game, do a quick mental run-through or even a short physical rehearsal beforehand. The first time you run a game is rarely the smoothest.

The activity itself needs to be facilitated — not just launched and left.

• Give clear instructions: For simple games, verbal instructions are usually fine. For anything complex, consider written instructions or a short demonstration. Always check understanding before you start.
• Welcome clarifying questions: Allow participants to ask questions before starting, not during. Questions mid-game break the flow.
• Allocating roles: If the game needs roles (patient, doctor, observer), assign them systematically. A clear way to avoid arguments: "Get into threes, decide who is A, B, and C — then I will tell you what each role is." This avoids the awkward negotiation phase entirely.
• Appoint a reporter or scribe where needed: Rotate this role across sessions. Avoid reinforcing stereotypes about who writes and who presents.
• Remind the group of ground rules: Especially important if the game involves giving feedback to others.
• Facilitator participation: Join in. When you play alongside your group, you set the tone, demonstrate the standard, and signal that this is genuinely worthwhile.
• Give a time warning: Let participants know when there are two or three minutes left. This helps them wrap up naturally rather than stopping abruptly.

Never skip or rush the debrief. It is the single most important part of any game-based learning activity.

The game creates the experience. The debrief creates the learning. Without it, participants have had an enjoyable ten minutes — but little lasting insight. With it, they leave with specific insights, clear intentions, and real behaviour change.

Structure your debrief in four stages:

After every session, spend five minutes reflecting on your own performance as a facilitator. This is not self-criticism — it is continuous improvement.

• Did the game achieve what you hoped it would?
• Were your instructions clear enough? Did anyone look confused?
• Did you allow enough time — especially for the debrief?
• How did you handle the energy in the room? Did you read the group well?
• Were there any moments of exclusion — anyone left out or uncomfortable?
• Would you use this game again? What would you change?
• Which facilitation skills might you want to develop further — active listening, handling conflict, giving feedback?

The first session sets the culture for the entire year. A warm, participatory opening tells trainees: this is a safe group, your voice matters here, and HDR is not going to be lectures at you every Tuesday afternoon.

Recommended sequence:

1. Name icebreaker (5 min) — something simple: each person says their name, where they are based, and one non-medical fact about themselves. Sounds basic. Works every time.
2. Ground rules game (10 min) — rather than the TPD announcing rules from the front, ask small groups of three to write two or three things they need from this group to feel safe and valued. Share, compile, display. These become the group's own ground rules — and people keep them because they made them.
3. Expectations grid (10 min) — a four-quadrant flipchart: "What I expect from the teaching / from myself / from my peers / and one thing I am a little nervous about." Post-it notes are brilliant for this. Revisit at the end of the year.

Clinical topics at HDR can easily become passive lectures. Games transform them into active learning. The principle is: turn what could be a slide into an activity.

• Run to the board: Write clinical questions on large cards. Split into teams. A question is revealed — the first team to agree on an answer and send one person to write it on the board wins the point. Generates discussion, friendly competition, and genuine recall. Relevant to any clinical topic.
• Criteria-forming game — the Aeroplane: Give teams a scenario where they must identify and rank the most important criteria for a decision (e.g., which patients to prioritise for referral). Different teams often produce different criteria — the discussion this generates is the learning.
• Lateral thinking puzzles: Use clinical puzzles that challenge trainees to think outside standard diagnostic frameworks. Excellent for sessions on clinical reasoning, cognitive bias, or diagnostic uncertainty.
• Just the facts: Seat the group in a circle. Each person contributes one fact about the topic. If they repeat or hesitate, they are out. The pace increases. Excellent for knowledge consolidation at the end of a clinical session.

Communication skills are best learned through experience, not through slides. Games and active exercises are therefore not optional extras in these sessions — they are the session.

• Group communication exercise (from downloads): A structured team task that reveals exactly how well — or how poorly — a group sends and receives information. The debrief maps directly onto consultation skills: what gets lost in transmission, what assumptions people make, and what happens when the sender and receiver are not sharing the same mental model.
• Active listening game: In pairs, Person A speaks for two minutes about something genuinely meaningful to them. Person B listens without speaking or reacting. Then B reflects back — not a word-for-word repeat, but the essence of what they heard. Switch roles. The debrief is almost always powerful: people realise how rarely they are truly listened to, and how different it feels when someone really is listening.
• Back-to-back drawing: In pairs, sitting back to back. One person describes a simple shape or arrangement. The other draws it without asking questions. Compare the result. Reveals how much we assume the receiver understands what we have not said. Maps beautifully onto the challenge of giving clinical information to patients.

Online teaching is here to stay in UK GP training. Virtual icebreakers and energisers need a different approach — but they absolutely still work.

• Cameras on, please — and say why: Do not just demand cameras on. Explain: "I find it much easier to have a human conversation when I can see people's faces. Would you all be happy to turn cameras on? Absolutely fine if you need to step away." This works far better than a cold instruction.
• Virtual icebreaker: One-word check-in via chat: Ask everyone to type one word describing how they feel right now — all at the same time, before anyone sends. Then everyone hits enter together. The resulting explosion of words is both informative and surprisingly warm.
• Breakout rooms for small-group games: Breakout rooms are the virtual equivalent of splitting into threes. Use them for short activities (two to three minutes), then bring the group back to share. The re-entry into the main room often generates natural energy.
• Shared polls as evaluation games: Tools like Mentimeter, Slido, or even a simple WhatsApp poll can recreate the human bar chart experience online. Display results live — it generates the same honest conversation without needing five physical chairs.
• Keep virtual games shorter: Online attention spans are shorter than in-person ones. A game that works beautifully for ten minutes in a room may need to be six minutes on Zoom. Err on the side of shorter and add time if the energy is high.

Most sessions end with a scramble for the exit. A short closing ritual — just five minutes — makes the learning stick and leaves trainees with a sense of completion rather than a sense of having been talked at until the clock ran out.

• One word I am taking away: Go around the circle. Each person says one word from the session that means something to them. Fast. No explanation needed. Creates a beautiful collective summary without any effort from the facilitator.
• The web game: Stand in a circle holding a ball of wool. The first person holds the end and passes the ball to someone while naming one thing they learned. That person holds their section and passes on. Eventually a web forms — visually representing the network of learning in the room. Cut the wool. Everyone takes their piece home.
• One public commitment: Each person says one thing they will do differently next week as a result of the session. Saying it publicly increases the chance of it happening. Brief. Powerful. Often the most memorable moment of the day.
• Back-writing (positive only): Tape a blank sheet to each person's back. Everyone walks around writing one genuine positive observation about each other — something they noticed or appreciated. Nobody sees what is written until everyone has finished. People take the sheets home. Trainers report this activity being talked about for weeks afterwards.