Reducing the Angst of Group Projects

By Sharon Buchbinder, RN, PhD
Author of Introduction to Health Care Management, 3rd Edition

Does any of this sound familiar?

“I hate group projects! This is a waste of my time!”
“Why can’t you just give us individual assignments?”
“Suzy was lazy and didn’t pull her weight!”
“Johnny didn’t get his work in on time!”
“No one could agree on a plan. It was a nightmare!”
“Jane was bossy and wouldn’t listen to anyone else’s ideas.”
“I had to do all the work. No one followed my instructions!”

What is it about group projects and teamwork that makes students moan, faculty cringe, and course evaluations vibrate with anger? Unless our students have been living in caves, they have all been exposed to teamwork from a young age. Whether it is a sports team, troop project, class community service, bake sale, car wash, or neighborhood cleanup, at some point in all our lives we have all worked in groups. We know our students need the experience of working in teams because that is the nature of the practice of health care management. Despite students’ life experiences and faculty awareness that this is a competency that must be demonstrated, few students or faculty members relish the prospect of group assignments—especially in online courses. How can we reduce the angst of group projects?

With better communication.

To give you an example of what I have done to improve communication in my group work projects, here is the group assignment and steps I have taken to improve faculty and student interactions. We use Blackboard (BB) as our learning platform in eight (8) week sessions, so the pace is fast and there is little wriggle room for falling behind. Since this assignment has multiple steps that build successively upon the previous one, I post weekly TO DO lists in each module. That way students can see what is due that week and check things off the list as they complete their work. This helps keep them (and me!) on task.

The Assignment

Using a case study provided by the faculty, groups of 2-4 students (depending on class size) will determine quality control problems using an appropriate quality assessment technique as outlined in the text.

USE THE GROUP PROJECT TEMPLATE posted in BB to format your paper submission.

Your PowerPoint (PPT) presentation should follow the paper, but NOT be identical to it. You will be narrating it in VoiceThread (VT), so you should not include each and every word in your PPT. This is where you use bullet points to guide your presentation. READ the Presentation Critique Rubric! Your presentation should not exceed 10 slides and 15 minutes.

From the groups’ findings, the groups will:

  • Develop a performance improvement plan, including methods to incorporate or overcome local, contemporary, and corporate cultures;
  • Identify and overcome other barriers to implementation success;
  • Develop a maintenance and evaluation plan, including timeframes for assessment of the plan, to ensure currency with the ever-changing regulatory environment.
  • Deliver a scholarly 8-10 page group-credited paper; and,
  • Deliver an online PowerPoint presentation narrated by team members using VT.

Students must use the assigned group rooms in BB for communication. If you do not use them, there is no documentation that work occurred and the group will earn a zero (0) for the project. You must work together immediately to come to a selection of two possible cases and you must respond to the instructor’s email for a conference call. If you cannot be on the call due to scheduling conflicts, you must get the information from your team mates about the deliverables.

Each group is required to have a conference call with the instructor within the second week of the course to discuss the deliverables for this project. This conference call will be worth ten (10) points on this group assignment. Prior to the call, the group must have reviewed and narrowed down their case study selection to two cases. You must come prepared with a minimum of 10 questions for the instructor about the analysis and presentation which uses voice thread. Lack of preparation for this conference call will cost the team points. Do not waste everyone’s time and points. BE PREPARED.

The GROUP PROJECT PAPER will be graded with the GROUP PROJECT RUBRIC included in this syllabus and in Blackboard under RUBRICS.

The PRESENTATION will be graded with the GROUP PROJECT PRESENTATION RUBRIC included in this syllabus and in Blackboard.

Students will be responsible for grading each other’s performance as team members using the CONFIDENTIAL TEAM MATE RUBRIC which you will be responsible for submitting on time. Students who do not return teammate evaluations will earn a zero (0) for the Group Project.

Week 1. After randomly assigning students to groups, I post this ANNOUNCEMENT:

You will be participating in a group project that you must begin immediately in the group rooms I have provided for you. You have already been assigned to either Group 1, 2 or 3.  You and your team mates must meet in your groups in Blackboard, narrow the cases down to two (2) choices in the first week and have a conference call with me in the second week to discuss the project and the deliverables. On X (date), I will send you a Doodle invitation to the conference call. Doodle is a scheduling program that offers choices for you to indicate what dates and times you are available. This required conference call will be part of your group project grade, and is worth 10 points out of 100 possible points. You must come to this call prepared with questions for me. The project is due in Module 5, so time is of the essence.

Please take the time to look around and review the syllabus. Your team mates will be depending on you to do your share of the group work. If you have any major planned events (vacations, weddings, elective surgery, new job, intensive training, etc.) during this session, you may want to reconsider taking this course at this time.

Week 2: After establishing dates and times for the conference call, I email the students with the call in information. I also email them the template for the project paper to help them prepare their questions. Each group must create a set of questions for me and EMAIL them to me a minimum of 24 hours ahead of the call so I have time to prepare my responses. This saves everyone time on the call. I return the answers to the questions to each group by email within 24 hours after the call.

Week 3: Students should be posting in the group work area, assigning sections of the project, establishing group deadlines, and sharing contact information. I check to see if students are posting and interacting with each other effectively and moving the project along. In a large class, this is a time consuming task and you might miss something—or someone. Don’t worry. You will hear from the team mates…

Week 4: If someone is not pulling their weight, this is when I get emails and phone calls from team mates. Requiring students to work in Blackboard enables me a) to verify that they, indeed, have not been participating fully, and b) keep the team mates who reached out to me out of the conversation. My email goes like this: “Dear Janie—As you know the group project is due next week. I’ve been checking the Groups in Blackboard, and couldn’t help but notice that you have not been contributing fully to the discussions. Is there something going on in your life that is interfering with your participation? Please email or call me and let me know what’s going on. We want you to succeed!” I usually get apologetic emails in return and the missing student leaps back into the group with the assigned work products.

Week 5: Students should have uploaded their PowerPoints and narrated them using VoiceThread. In addition, they are required to submit Confidential Team Mate Evaluations. If a student does not submit this evaluation, they earn a ZERO for the Group Project, which is worth one-third of their grade. I review the presentations, provide feedback, and then I post an Announcement that looks like this:

Dear Class–

Your group project papers are graded and extensive feedback has been provided. Please read the feedback, as everyone has put time and effort in to provide it. I watched and commented privately on the slides in each presentation.

Some general comments on VoiceThread or any other recorded presentation:

  • DO make sure you are in a quiet space. When I hear conversations, dogs barking, or vacuums in the background, it distracts me from the substance of the presentation.
  • DO review your narration after you are done and correct it if you make mistakes.
  • DO read the title slide out loud.
  • DO use text sparingly. All you need is the key ideas for the slide, not tons of words that clutter the screen and tire the audience.
  • DO give your group members feedback on their slides. Everyone’s mind fills in the blank and skips words, that’s why we need a second reader.
  • DO give yourselves gold stars for a job well done! I enjoyed your presentations!

Week 6: Everyone takes a deep breath and works on their other assignments—including the Individual Project Case Study Presentation Critique.

Week 7: Students are required to submit their Individual Project Case Study Presentation Critique Rubric and a 600-800 word critique of the PPT addressing each criterion in the Critique Rubric indicating why they gave a particular score. Students must write their critiques from the perspective of a Quality Improvement/Patient Safety Professional and should evaluate another team’s (not their own) Quality Improvement Project PowerPoint and VoiceThread presentation.

Week 8: I collate the feedback for each team from each student, removing all student identifiers from the documents. So, for example, Team One has a document with all the comments from three or four other students, along with the rubrics that go with the comments. I repeat this process for each group. It is time consuming and tedious—but extremely valuable for the students.

After reading all this, I’m guessing you are shaking your head and saying, “That’s a LOT of work.” Yes, it is. Much of it is front-loaded into the course in the form of announcements, conference calls, and To Do lists. Along the way, the faculty member must go into the groups and ensure the project is moving at a good (fast!) pace. Yes, it is labor intensive for faculty and for students. You must be involved, engaged, and available. There is no easy “Set It and Forget It” crockpot online teaching in this approach. However, unlike many of my previous methods with group work, the feedback from the students has been positive. With structured assignments and ongoing communication, you can reduce the angst of group projects.


Sharon Buchbinder is Professor and Program Coordinator for the MS in Healthcare Management at Stevenson University in the Graduate and Professional School and former chair of the Association of University Programs in Health Administration (AUPHA). She is also the author of three books from Jones & Bartlett: Introduction to Health Care Management, Cases in Health Care Management, and Career Opportunities in Health Care Management.


Here are some resources if you are interested in this topic:

Baker, D.P.,Day, R., & Salas, E. (2006). Teamwork as an essential component of high-reliability organizations. Health Services Research, 41(4 Part 2),1576-1598.

Buchbinder, S.B. Teamwork in online courses: How can we encourage effective participation? http://blogs.jblearning.com/health/2012/05/07/teamwork-in-online-courses-how-can-we-encourage-effective-participation/

Buchbinder, S. B., Alt, P. M., Eskow, K., Forbes, W., Hester, E., Struck, M., & Taylor, D. (2005). Creating learning prisms with an interdisciplinary case study workshop. Innovative Higher Education, 29(4), 257–274.

Buchbinder, S.B. & Thompson, J.M. (2016). Teamwork. In Buchbinder, Sharon B. & Shanks, N. (Eds). Introduction to Healthcare Management, 3rd Ed. Boston , MA: Jones & Bartlett, 2016, pp. 363-396.

Hoch, J. E., & Kozlowski, S. J. (2014). Leading virtual teams: Hierarchical leadership, structural supports, and shared team leadership. Journal of Applied Psychology, 99(3), 390-403. doi:10.1037/a0030264

Hospital Research and Educational Trust (HRET). TeamSTEPPS national implementation. http://www.teamsteppsportal.org/

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academies Press.

Kulesza, B. (2015). Leading global teams virtually. Strategic Finance, 97(4), 19-21.1), 6–13.

Leggat, S. G. (2007). Teaching and learning teamwork: Competency requirements for healthcare managers. The Journal of Health Administration Education, 24(2), 135–149.

Mitchell, P., Wynia, M., Golden, R., McNellis, B.,Okun, S., Webb, C.E., Rohrbach, V., & Von Kohorn, I. (2012) . Core principles & values of effective team-based health care. Institute of Medicine. Available at:  https://www.nationalahec.org/pdfs/VSRT-Team-Based-Care-Principles-values.pdf

Neily, J., Mills, P. D., Young-Xu, Y., Careney, B. T., West, P., Berger, D. H., et al. (2010). Association between implementation of a medical team training program and surgical mortality. Journal of the American Medical Association, 304(15), 1693–1700.

Pronovost, P. J., & Freischlag, J. A. (2010). Improving teamwork to reduce surgical mortality. Journal of the American Medical Association, 304(15), 1721–1722.

Quinlan, E., & Robertson, S. (2010). Mutual understanding in multi-disciplinary primary health care teams. Journal of Interprofessional Care, 24(5), 565–578.

Thompson, J. M. (2010). Collaboration in health care marketing and business development. In B. Freshman, L. Rubino, & Y. Reid Chassiakos (Eds.), Collaboration across the disciplines in health care. Sudbury, MA: Jones and Bartlett.

Weinberg, D.B., Cooney-Miner, D., Perloff, J.N., Babington, L., & Avgar, A.C. (2011). Building collaborative capacity: Promoting interdisciplinary teamwork in the absence of formal teams. Medical Care, 49(8), 716-723.

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