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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 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?

'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.  Access: Coaching questois to facilitate clinical decision making and clinical reasoning with students.

 

The Superguide (Health Education & Training Institute, 2011, p. 47) refers to other guided questions that encourage independent thinking and problem solving, such as:

  1. What approach are you taking in this situation and why?
  2. Can you explain the steps of the task/treatment/intervention and why they are completed in this way?
  3. What outcomes do you want and how can they be achieved?
  4. What is your action plan if this approach does not work?
  5. What values, attitudes, knowledge and/or skills are being challenged in this situation?
  6. How would you approach the situation next time?

(Irwin, 2008, as cited in Health Education & Training Institute, 2011)


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