On this page you will find:
(Click on the accordion titles below to explore the content areas)
-
Questioning techniques to advance learning on clinical placements
Questioning techniques to advance learning on clinical placements
When possible, rather than ‘telling students what to do’ when confronted by a clinical problem, a supervisor should attempt to help the student solve the problem by asking them specific questions. This helps develop clinical reasoning skills and professional competence and confidence. In the video below, Wendy, a clinical education liaison manager from the School of Health and Rehabilitation Sciences at the University of Queensland, explores how questionning techniques evolve over a student placement:
-
Advanced Questioning
Advanced Questioning
Advanced questioning refers to the skill of asking questions, requiring the student to think and respond in increasingly more challenging (deeper) ways.
1. Bloom’s Taxonomy (1956, cited in Health Education & Training Institute, 2011, p 33) provides practical examples of the progressive sequencing of cognitive demands.
Highest Level of Thinking
Creating e.g. What would happen if ….?
Evaluating e.g. Is there a better solution to....?
Analysing e.g. How was this similar to .…?
Applying e.g. How are you going to do this in practice?
Understanding e.g. What do you think?
Remembering e.g. What happened after?
A comprehensive table of questions to develop each category of thinking can be found in Appendix A of the Learning Guide (Health Education & Training Institute, 2011, p 73).
2. Probing questions are used to help learners think through their responses more thoroughly. Examples include:
- Can you be more specific?
- In what ways is that relevant?
3. Metacognition i.e. encouraging the student to “think about how/why they think” incorporates self-regulation and self-monitoring:
- What makes you think that?
- Why did you make that decision? What were the influences?
The Superguide refers to other guided questions that encourage independent thinking and problem solving, such as:
- What approach are you taking in this situation and why?
- Can you explain the steps of the task/treatment/intervention and why they are completed in this way?
- What outcomes do you want and how can they be achieved?
- What is your action plan if this approach does not work?
- What values, attitudes, knowledge and/or skills are being challenged in this situation?
- How would you approach the situation next time?
-
Coaching questions to facilitate clinical decision-making and clinical reasoning with students
To facilitate clinical decision-making and clinical reasoning skills, student supervisors should consider the questions that they ask themselves. These questions have value as a teaching and scaffolding tool as they can provide concrete examples of the thinking steps that underpin clinical reasoning. This can assist students to make the 'jump' from data gathering to making clinical decisions on diagnosis and treatment.
'Delaney, Golding and Bialocerkowski (2013) in 'Teaching for thinking in clinical education: Making explicit the thinking involved in allied health clinical reasoning' developed a series of questions that can be used by student supervisors to enable students to think and reason like expert health professionals. Students can also use these questions as a self-reflection activity to increase clinical reasoning skills.
Clinical role - Questions students can address to determine their clinical role
- Why am I here?
- What is the purpose of my role for this person?
- What can I provide?
- What are the limitations of my role?
- What is the purpose of the referral?
- What do doctors think the prognosis will be?
- After my intervention, will there still be ongoing issues for the patient? • Who do I need to refer to?
Knowledge: Questions students can address to isolate relevant clinical knowledge
- What is the profile of the patient?
- What do I need to know for this patient?
- What information do I need before I start?
- How does this relate to what I already know?
- What is the priority?
- What things about this patient problem will impact on my assessment?
Teaching for thinking in clinical education
- What information should I gather through my subjective and objective examination?
- What are the problems that need to be assessed?
- What has been done prior?
- What has been effective?
- Do I have enough social information?
- What have other members of the health team found?
- What tools do I have available to me?
- Which assessment or diagnostic tool is going to provide me with the best information?
- What anatomic structures are involved?
- What are the connections between the presenting problem, history and patterns?
Patient perspective: Questions students can address to integrate the patient narrative and context with their clinical knowledge
- Who is the patient? What are their concerns, medical conditions, social situations, culture and home environment?
- Why did the patient present at the hospital?
- Are there any other issues with vision/hearing/strength/balance/ co-ordination/cognition/pain that impact the patient’s safety/ability to manage at home? What level of function did they have? Where are they now? Where do they want or need to get to?
- Is the patient/carer aware of my intervention?
- What would be the best outcome from the patient’s perspective? What actions do I need to take to achieve this outcome?
- Do I feel I have a full picture of the patient’s lifestyle?
- What level of questioning can this patient tolerate?
References:
- Delany, C., Golding, C., & Bialocerkowski, A. (2013). Teaching for thinking in clinical education: Making explicit the thinking involved in allied health clinical reasoning. Focus on Health Professional Education, 14(2), 44–56. https://search.informit.org/doi/10.3316/ielapa.344079003268797Christiansen, C., & Baum, C. (1997). Enabling function and well-being (2nd ed.). Thorofare: Slack
