Over the last 20 years, there has been considerable enthusiasm for approaches to teaching games and sports that use a game-centred approach (GCA). GCA is an umbrella term for pedagogical approaches and models that have game play and reflection on game play as central elements of the learning process. However, they should not be confused with the games concept approach used in Singapore and reported on in Chapter 3. The underlying philosophy of the GCA approaches described here is that students need to develop an understanding of how to play rather than an overriding focus on what to do when they do play and that this understanding is developed through their active participation in, exploration of, and reflection on, their play. The how element can be developed because GCAs have the capacity to examine a broad range of game-play elements, such as strategy and tactics and decision making, as well as movement skills, and to explore the relationships these elements have with performance. As a result of this learning through games via progressions from simple to more complex practice games and the use of questioning, students in classes characterized by GCAs can recognize that there is more to play than movement alone. This, in turn, provides them with the opportunity for greater learning, engagement and participation. The study presented in this chapter investigates how physical and health education (PHE) pre-service teachers may gain an understanding of how to effectively use GCAs (see Forrest 2009; Forrest, Wright and Pearson 2012). Conducted over a five-year period, it examined the development of GCA understanding in second- and third-year PHE pre-service teachers arising from their engagement in a formal course of study focused on GCAs. The study revealed a range of issues associated with pre-service teachers developing an understanding of GCAs. Prominent amongst these was the management of more open questions and discussions in a GCA lesson. This is an important area as it has direct links to the quality of student learning experiences in GCA lessons (Light 2013). However, data from this study strongly suggests that while the participants (pre-service PHE teachers) valued the role of appropriate questions and question structures, and understood the role these played in improved learning, they could not sustain this type of questioning. This chapter will use participant self-reflections as well as comments and exchanges from GCA lessons to demonstrate this and other issues relevant to the investigation.