The objective of this educational guide is to outline the major facets of effective small group learning, particularly applied to medicine. These are discussion skills, methods, the roles and responsibilities of tutors and students, the dynamics of groups and the effects of individuals. It is argued that the bases of effective small group learning are discussion skills such as listening, questioning and responding. These skills are the platform for the methods of facilitating discussion and thinking. The facilitating methods strengthen the generic methods, such as tutorials, seminars and electronic tutorials. However, the success of these methods is dependent in part upon the roles and responsibilities taken by students and tutors and the consequent group dynamic. The group dynamic can be adversely affected by individuals. Evaluation of the processes of small group learning can provide diagnoses of the behaviour of difficult individuals. More importantly, studies of the processes can help to develop more effective small group learning.