There were a wide range of responses regarding facilitator skills and roles, both from the student and the facilitator perspective. The level of experience impacted on facilitator perceptions of their ability to undertake certain facilitation duties and tasks. On self-evaluation, most facilitators believed that they could adequately manage the group process, although some found it difficult not to share their expertise. Students were, however, more severe in their criticism of facilitator abilities, where there were clearly differences in perceived level of facilitator skill and commitment. These results suggest a need for more explicit instructions to both staff and students regarding expectations of facilitators in the programme.
While some negative student comments pertained to facilitator performance in the group process (e.g. interfering with the group process), others related to facilitators not being in touch with programme details (e.g. timetables, assessment procedures). Since 2001 was the first year of PBL implementation, with many aspects evolving, it is understandable that some facilitators were not always aware of the latest developments. Facilitator meetings with curriculum organisers arranged prior to the start of the theme and at least once during the 6 weeks, served to inform facilitators of the scope of the learning objectives and problems to be addressed. The question arises whether this intervention, as well as other reports presented to Faculty Board, provided sufficient information regarding curriculum implementation. Of interest, and an issue for debate, would be the consideration of the dual responsibility of facilitators and curriculum developers in this regard (i.e. of becoming informed and of being informed). Since facilitators are being paid during the early stages of PBL implementation, while the traditional curriculum is being phased out, should they then not make every effort to keep abreast of Curriculum 2001 developments? Only 50% of facilitators (< 30% of the more experienced) had contacted MEDev with a query, suggesting a degree of apathy. Almost half of the facilitators were prompted to facilitate for financial reasons, which may question their recorded intrinsic motivation (i.e. felt it was their responsibility, believed in the PBL philosophy) (Table 2).
Content expert vs. non-expert facilitator
An important and not unexpected outcome of this survey was the issue of tutoring (i.e. providing content expertise). There is considerable literature on the content expert vs. the non-expert in PBL, the results of which are contradictory in terms of the impact on student learning [10–12]. While facilitators in the present survey understood that they were not to share their content expertise, many were unable to restrain themselves. Tutors new to PBL have been reported elsewhere to experience the same difficulty, which carries with it the danger of directing the tutorial process [13–16]. Silver and Wilkerson, following their study on tutors' self-rating of their expertise and performance, believe that dominant tutors may impede students' ability to prioritise learning goals, ask and answer critical questions and synthesize their learning . Content experts also found it more difficult to maintain the facilitator role, but that if they did, they were more satisfied with PBL as an educational process . Perhaps the marginal preference of facilitators in the present study to facilitate in the new programme vs. lecture in the old one indicates an underlying uneasiness with their changing role in student learning. Despite most facilitators enjoying their sessions and believing that PBL promoted student learning, only 57.6% would prefer to facilitate (vs. teach). This may, in part, reflect Oliffe's comments that PBL facilitation provides little nourishment for the traditional teaching ego . Maudsley has summarised the changing role of the facilitator/tutor most eloquently: "The tutor's challenge is to forego the tightrope of effectiveness by balancing intervention in the group process between an informal, empathetic style and sparing use of personal content expertise" (p. 660). It might then take more than a 3-day training workshop to develop an appropriate ethos in staff in terms of embracing the new pedagogy. While almost 88% of facilitators felt that it their responsibility to participate, only 67% did so because they believed in PBL. This figure is only slightly higher than for those who were facilitating for promotional purposes. Again, such a response might indicate that some facilitators were not sufficiently intrinsically motivated by curriculum change, the reasons for which may be numerous (e.g. perhaps not seen as a faculty priority; work overload; not sufficiently informed). Clearly, it is in a faculty's interest that staff members willingly accept curriculum reform and volunteer as facilitators, theme co-ordinators, clinical skills tutors, etc. without extrinsic motivating factors such as remuneration. The difficulty arises, however, in the face of a human resource shortage, with many having clinical duties, post-graduate students and teaching commitments in the traditional programme. The phasing out of one programme and the implementation of another, particularly if the latter is of shorter duration, places considerable demands on staff. Incentives such as merit notches and promotion might therefore be necessary to encourage participation during this difficult interim period. Ideally, these measures should be in place prior to programme implementation. Faculty might consider suspending student registration for a year, to release some staff to assist with planning and to develop the human resource capacity to undertake the first year of implementation.
Novice facilitators: improving skills
Since the present survey was undertaken after only one year of the new programme, all facilitators, even if they had facilitated all six themes, could still be considered as novices in terms of their skills and role in PBL tutorials. Perhaps for some, the new programme challenged their epistemological beliefs and conceptions of teaching and learning , which they might (or might not have) espoused for as long as they had been teaching students. A new programme will undoubtedly place new demands on staff, impacting on their comfort zone, generating uncertainty, unease [10, 19] and even resistance [2, 4, 20]. Facilitator support, particularly in the early stages of PBL implementation, therefore becomes critical. Whilst Faculty organised meetings with facilitators during the themes, attendance was not always guaranteed due to other commitments (e.g. clinical duties, teaching in the old programme). Feedback to individual facilitators following student evaluation  as well as peer evaluation (e.g. presiding over a small group session) would be two ways in which facilitators could become confident in their facilitation skills. This feedback should be as early as possible, preferably before the next facilitation. This is, however, not always possible as it places additional demands on already busy curriculum organisers.
Facilitation expertise can be expanded by becoming a member of an informal, but preferably, a formal facilitator group. The former was created at the Nelson R. Mandela School of Medicine by facilitators who evidently found a need to share experiences, meeting over lunch-time to discuss areas of interest, problems, etc. An electronic interest group was also started for those who experience difficulty attending such meetings. For novice facilitators, peer assistance with issues such as dealing with quiet or disruptive students might offer more constructive support than can be provided by busy curriculum organisers. The latter should, however, not be used as an excuse by Faculty for not providing support. Since the small group tutorial and, by implication, facilitation, is a cornerstone of PBL, appropriate support structures (e.g. a staff development office) should be in place at implementation.
Strategies staff developers might consider to support facilitators could include co-facilitation, in which a novice facilitator attends sessions of a more experienced facilitator deemed to be "excellent" (by whom, as there is frequently a mismatch between perceptions of faculty and students?). Alternatively, videotaped sessions could provide a more permanent record of the process within groups , to be used during training sessions to highlight types of intervention and handling of difficulties.
Non-cognitive roles of facilitators: neglected considerations?
A much neglected but integral aspect of facilitation involves the non-cognitive roles of facilitators: as colleagues, role models and mentors. In a recent review article, Dolmans and colleagues summarise what they believe to be the three major trends in tutor research (content expertise; process variables; tutor characteristics in relation to differential content variables) and have suggested that in order to provide better insight into interpreting facilitator behaviour, future research should comprise qualitative studies regarding facilitators' conceptions of their role in student learning . In one of the few publications which considers the non-cognitive role of facilitators in the group process, Schmidt and Moust, despite advocating content expertise as a requirement, propose a model incorporating social congruence (a willingness of a tutor to develop an informal relationship with students and display a personal interest and a caring attitude) as an important variable affecting not only the manner in which the facilitator explains things to students, but also on group functioning .
The present study attempted to gauge facilitator perceptions of their relationship with students, apart from their role as a process expert. It is encouraging that ±64% of all facilitators (±71% of experienced facilitators) recognised that they should treat students as colleagues, suggesting that many facilitators may have made the transition from teacher/lecturer to facilitator/educator, have embraced the PBL philosophy and are able to acknowledge that they too, as non-content experts, are learners with the students.
Facilitators generally agreed that they should serve as role models for students, which is congruent with the literature regarding the importance of role models for developing professional and ethical behaviour in students . Facilitators were, however, less certain about their role as a mentor (only about 55% agreement). The variable perceptions of a mentor may have contributed to this uncertainty , although an example was provided in the survey (e.g. someone in whom students can confide). Since mentoring involves an active participation on the part of the facilitator (e.g. being available for consultation outside of the group; dealing with personal student issues). counselling skills might be a useful inclusion in facilitator training. In all probability, however, for educators still grappling to come to terms with the PBL philosophy, and understanding their new role in student learning and development, mentoring might be an overwhelming concept.