After reading the chapter on Clinical Teaching Strategies and Techniques and the article on Developing Questioning Skills I had to sit back and think. Clinical instructors get pulled in so many directions, they have to observe, intervene when needed, give feedback and support development of professional skills. Not only do they do this for an individual student, but rather multiple students at a time. In our clinic at OSU the ratio is 5/1, five students per one clinical instructor. Students really have to come to clinic with their game face on and be prepared for clinic. I found it interesting and was surprised when I read that the normal wait time for a question is One Second! To me that doesn’t allow much time for a student to digest the question to reply with an answer before the instructor spits out an answer. However I can see how and why this would happen in a busy clinical setting.
So how can we go from asking the wrong questions like asking questions on specific information to asking the right questions in order to promote learning? Simple follow the Principles of Questioning and allow students time to answer.
In the scenario of the lesion noted on the buccal mucosa, I would ask.
- How would you describe the lower lip?- Factual and thought-provoking question
- How does his health history tie into your findings?- Extracting question
- If this was in your mouth how would you address the lesion and what would you do?-Personalized question
- Under what circumstances would this need to be evaluated by the Pathologist?-Stimulate Critical Thinking and Encourage Lengthy and sustained answers
- What oral health recommendations would you recommend?- Simple question
- How can we communicate the severity/ lack of concern to the patient about our findings?- Partnership question
We need to make sure that we ask the approipate open ended questions to promote learning and give more than five seconds to receive a response. Some students are rapid firers when it comes to answering questions and others need to digest the question a bit before responding, and that’s okay. As instructors even though time is of essence, we need to extend the classroom knowledge into the clinical setting to make sure each student can relate the information. This goes back to the other week when we where describing what makes a Great Clinical Instructor and many of us said Patience!!! It all ties together.
I totally agree with you that the instructors are pulled in many directions in clinic. This is why the instructors need to be prepared themselves because it’s hard to ask proper questions on the fly when dealing with many students. Your class has it good. Our clinic student/instructor ratio was 10:1,
I love that it all ties together! I’m definitely one that needs to take a second to think about it. When another student or the instructor gives the answer, I wonder to myself if I could have gotten it on my own. I’m trying to challenge myself, so I need instructors that challenge me. Great questions!!
Your post is quite insightful. Yes it is difficult when you have many students to create the perfect questions for each scenario and each student. The questions you came up with were great! How do you think a student would respond to you if you asked these questions?
I think that it would make the students step back and think, but that’s what we want them too do! Like we talked about last week, critical thinking and problem solving are valuable skills to have. Once we get out into the real world we will need to be able to think these situations through ourselves and be able to explain them to our patient and doctor.
We both asked questions about a path consult. I specifically remember an instructor ask meabout linea alba (which was bilateral on my patient) and if it needed a path consult. I replied no. Then she went on to ask what type of lesions required a path consult. At first I didnt understand why she asked since linea alba was completely normal, then I realized she was testing my knowledge, constantly keeping my wheels sharp and turning. I thought this was especially good since we very rarley see precancerous lesions in the clinics. A little review never hurt anyone! Great post, as always, Mrs. Cain!
Great post! You bring up some great questions! They are all good open ended questions that make the student think and have to give a thorough answer. I also think that timing is always an issue when working with students in clinic and is something we need to be very aware of. This can be very difficult but we need to realize that this is a learning environment and for the student to become better taking time to ask these questions is very important.
I agree clinical instructors are pulled in many directions and have a lot of responsiblities. One second for students to answer is not enough time for them to answer a question. In my opinion it’s better for students to stop and think for a few seconds and respond with a more insightful answer than blurting out the first thing they can think of. In clinic I have had a few situations when a teacher wanted an answer from me in a second and when I took time to think about my answer she took it to mean I didn’t know. I hate when I’m asked to spit out answers that quickly. I prefer to use critical thinking in clinic and that takes more than just one second. I think we both agree the point is to not demand quick responses, especially if the faculty are using open-ended questions.