ASKING ANSWERABLE QUESTIONS

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ASKING ANSWERABLE QUESTIONS

• Scott Richardson, M.D.
• Mark Wilson, M.D.

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Recent Questions

• Divide into groups of 2-3
• Recall gt 1 recent question about/from clinical
  practice or clinical teaching
• Write it down
• Return in 2 minutes

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Background Questions about the disorder!

• 2 Components
• Question root verb what causes..
• Condition
• .pancreatitis?

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Background Questions

• What
• How
• Where
  
• When
• Who
• Why

• Disorder
• Syndrome
• Finding
• Health State
• Concern

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Please..

• Take a card
• Be ready to write on card to make handout

?
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Foreground Questions

• About patient care
• 4 (3) components
• a. patient problem
• b. intervention
• c. comparison intervention
• d. clinical outcomes
  
  
  write on card (side A)

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Foreground Qs

• Background Qs

Clinical Experience
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HOW DOES IT FEEL...

• TO KNOW?
• TO NOT KNOW?

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AS TEACHERS

• Anticipate affective and cognitive responses to
  questions
• Recognize cognitive dissonance . . . use it
  wisely
• Celebrate knowing and learning
• Be Self-aware, not self-conscious
• Balance support and challenge

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DURING listen carefully spot knowledge gaps
teaching movements

• AFTER
• return to small groups
• select gt 1 gaps
• write foreground questions with 4/3 components
• return in 4 minutes

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Map Top 10

• Clinical findings
• etiology/harm
• differential diagnosis P (D)
• manifestations of disease
• diagnostic tests
• prognosis
• therapy
• prevention
• experience/meaning
• self-improvement, learning

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Write on Card (side B)...
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Teaching with Qs

• Recognize
• Select
• Coach
• Assess

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Listen Diagnose Compare Notice Use
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Recognize Qs

• LISTEN with both ears
• DIAGNOSE case learner
• COMPARE to inner model - how should go
• NOTICE learners cognitive dissonance, other
• USE map to locate Qs

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Select Qs

• What is illness?
• What is role?
• What are learning needs
• Of these, select
• most urgent
• most interesting
• most feasible to answer
• most likely to recur

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Coach Qs

• try this
• should I start Aldactone in this patient with
  CHF?

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Coach Qs

• Celebate Curiosity
• Buildup . . . dont tear down learners Q
• 2 stages
• add components
• Q behind Q
• Model

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Learning Stages

• Unconsciously incompetent
• consciously incompetent
• consciously competent
• unconsciously competent

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Teaching EBM can be

• 1. Patient centered
• 2. Learner centered
• 3. Active interactive
• 4. Part of being
• clinicians

• 5. Match take
• advantage of
• clinical setting and
• circumstances
• 6. well-prepared
• 7. multi-staged

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AskingQuestions

• For practice
• For teaching
• For daily life

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Take It Home

• Believe questions RULE!
• Know anatomy of both background foreground
• Use a map of where questions come from
• Recognize Qs - hearem coming
• Select 1/few
• Teachem THERE!

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Why Bother?

• Relevant to clinical needs
• relevant to learning needs
• plan search strategies
• recognize answers

• Reawaken curiosity
• in referral, communication
• in teaching, comprehension
• fun!

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Teach EBM

• Modeling
• teach by example
• Incorporating
• teach with evidence
• Coaching
• teach EBM skills per se

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Large Groups CHALLENGES

• paradox of attention
• items move too fast
• same task too long
• self-consciousness terror!
• Teacher, learner
• other e.g. beepers

• Physical space
• passivity expectations
• model information transfer

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Large Group Methods

• Buzz groups -gt specific assignments
• demonstrations role play
• pace changes

• Interaction
• A.V. is support, not show
• multi-media
• adjust to group