I have had a few students that never are involved in class discussions. I finally decided to do a "whole class" question/answer role play. I am the client and my students are the technicians asking questions. I go around the room and everyone of the students has to come up with a question relating to the topic...I try and include real life senerio situations they can relate to. It seems to get the students who have been really quiet a better understanding of what the real world will be like and if they don't communicate with their classmates and instructors in college, they will struggle at a clinic!! I make that a HUGE point!