The Use of Teacher Questions in Medical Education

“Questions are the teacher's single most influential teachers act” Taba 1966

Reasons to use questions Questions are motivating, they keep students on task Questions focus the learner’s attention on what is to be learned Questions especially thought questions illicit deeper thinking processes

Goals of Questions To focus the learner on one area of subject matter To evaluate the learner’s understanding of the subject matter To give the learner the opportunity to practice and clarify his/her knowledge of the subject matter To stimulate higher level thinking about the subject matter though discussion

Good questions don’t just happen they are planned Questions that stimulate thought require prior thought

Types of Questions Recitation _ answers reflect a knowledge or understanding of the facts of the subject matter. typically a questions that have 1 best answer Discussion _ answers used to develop higher level thinking about the subject matter by Analyzing the situation Look for cause and effect Find relationships between he element and total organizational scheme

Examples Recitation questions Discussion questions What is the dose of XYZ anesthetic premedication for children undergoing sedation? Discussion questions Should all children undergoing sedation be given premedication?

De-briefing questions Debriefing is the activity that allows the learner to compare the activity of the simulation with that of the real world or compare it with the ideal of the real world Therefore debriefing is analysis comparison application of knowledge thinking though similar scenarios

Question formation prior to debriefing Choose type of question to be used, based on your instructional goals ( evaluation of knowledge , repetition of facts , discussion ) Choose the cognitive level of the questions Do you want to evaluate or rehearse correct answers in preparation for examination? Do you want the learner to learn form past experiences ? Do you want he learner to devise new ways to think and act i9n future situations ? Construct one and only one question for each goals Consider the wording and the syntax of the question Practice the question and the possible answers

Preparation of the Question in the debriefing session Decide on the cognitive level of the questions and answers to be used If you want the learner to answer at a higher cognitive level , you must ask the question t cognitive level that is above the learners norm Define the question clearly and one at a time Avoid strings of multiple questions Vague questions make the student guess what it is that you are looking for rather than use the time constructively to formulate a higher level answer Practice the questions and the possible answers

Decide on the cognitive level of the questions and answers to be used If you want the learner to answer at a higher cognitive level , you must ask the question at cognitive level that is above the learner’s current norm

It is not sufficient for teacher for ask good questions, the questions also must elicit good responses form the students

Questioning techniques that elicit good answers Keep the all learners on task during the question and answer session by not appointing a respondent before the question is asked Phrase each question clearly Do not string questions together Provide for wait time Provide positive feedback Consider non questions alternatives

Keep all learners on task Ask questions of both volunteers and non volunteers in the classroom D not string questions together Use clear and unambiguous questions If you are not clear of the question itself the learners will not be clear of the answer

Wait time Wait time is perhaps the most important element of questioning techniques There are 2 types of wait time Wait time 1 - the time between the teacher’s spoken question and the response of the learner Wait time 2 - the time between the learner’s response and the next comment by the teacher

The use of wait time to prompt learner responses Allow for wait time #1 greater than 5 seconds for the learner to respond before adding any additional comments Allow the learner to respond fully Allow for wait time #2 to allow any other learner response or elaboration

Wait time is critical to good questioning technique A wait time of > 5 seconds will increase the length of the student responses 3 – 7 fold increase the incidence of student generated questions (you will ask few questions ) Decrease failure to respond to questions (you will ask few questions ) increase student achievement on written tests , particularly on items that are cognitively more complex ( Yearny and Porter ) Increase student exchanges and thus change this social dynamics of the session

Habits that interfere with Wait time exalting the students to “ think about this “ Verbatim recitation of the student answer other students learn that they need not listen to each other , you will restate the prior answer for them “ yes …but”, “don’t you think that” comments Students halt their line of thought and try to guess what it is that you are looking for

Process the learner‘s response Listen fully to the students response. Do not be thinking of the next questions that you will be asking ( If you have formed your questions prior to the session this is not necessary) Provide adequate feedback , especially if recitation question Sustain the question if discussion question

Sustaining Discussion Use the initial question to which you yourself do not truly know the answer Pose one and only one question Allow adequate wait time Allow for other learners to response Reflect and restate the learners answer s/he has spoken Do not immediately give your answer

Non question alternatives Statements state the thoughts that occur to you in relations to what the students have said . This is especially effective in the discussion of affective knowledge ( e.g. team work during a crisis, interpersonal issues between staff ) Student questions reformulate the students own question or ask for other questions Silence say nothing but maintain a deliberate silence until the speaker resumes or another student enters in

Post questions session Analyze your use of questions Evaluate the learner’s responses Refine and reconstruct your questions for the coming session