Asking Questions

Your ability to ask good questions of the student is key to your ability to be an effective preceptor. There are a variety of to asking questions.

Questions can help you:

  • Diagnose a student's current knowledge base
  • Engage the student and help sustain his/her interest
  • Stimulate, expand, and refine the student's thinking
  • Assign responsibility for learning with the student

Watch the following video clip, paying particular attention to the preceptor's response to the student.

What do you think about this preceptor's response to the student?

In this case, the preceptor did not give the student enough time to respond to the question. This can easily occur, particular in the office setting where there is a constant pressure of time constraints. If at all possible, allow the student more than 3 seconds to respond to your question. There may be an awkward moment of silence. However, this moment is just as awkward for the student as it is for you, and it is likely that the student will "step in" with a response if he/she knows you will actually be waiting for it.

One way to think of the types of questions you are using is to separate them into a taxonomy of "lower order" and "higher order" questions. Each are helpful in eliciting certain kinds of information or addressing a certain "level" of learning. This can be illustrated by looking at the following flow diagram of cognitive learning. This flow incorporates a continuum, from the most basic level of 'knowledge,' to the most advanced level of 'evaluation."

Six Levels of Cognitive Learning

remembering material

grasping the meaning of material

using material in new situations

breaking material down into its parts

putting parts together in a new way

judging the value of material

Lower Order Questions

Lower order questions are best at addressing the lower levels of cognitive learning (knowledge and comprehension). They tend to be closed-ended questions where a short, concrete response is being solicited from the student.

  • What are the names of the 12 cranial nerves and their associated functions?
  • What is the right dosage and route of administration of this medication?
  • What are the key physical findings of rheumatoid arthritis?

Higher Order Questions

Higher order questions are best at addressing the higher levels of cognitive learning (application, analysis, synthesis, and evaluation). They may include closed-ended questions, but they also may include open-ended questions that invite reflection, synthesis, and problem solving.

  • What are some of the contributors to Mrs. Jones' recent heart attack?
  • What is your proposed management plan for this patient?
  • At the present time, what is the most appropriate approach to treat this patient's diabetes?

Teaching Hints

The following list outlines a number of helpful hints when questioning your students.
  • Whenever possible, ask rather than tell
  • Ask one question at a time, as concisely as possible
  • Adjust the difficulty of your questions to the student's abilities, working towards increasingly higher levels of thinking
  • Include questions that help students explore their attitudes and feelings
  • Ask questions about process as well as outcome
  • Model the kinds of questions you want students to ask themselves
  • Avoid playing "Guess what I'm thinking"
  • If you question students in the presence of patients, be sensitive to the patient's needs

Module 3: Interacting with Your Medical Student