How do I learn to ask open-ended questions in problem-based learning (PBL) in medical education?

Learning to Ask Open-Ended Questions in Problem-Based Learning Facilitation

To effectively learn how to ask open-ended questions in problem-based learning facilitation, focus on developing questions that stimulate higher-order thinking, promote clinical reasoning, and encourage student participation without causing intimidation. 1

Understanding the Importance of Questioning in PBL

Open-ended questioning is a critical teaching strategy in medical education, particularly in problem-based learning settings. When executed effectively, questioning can enhance learner participation, concentration, and understanding of content. However, when used incorrectly, it can leave learners feeling singled out or even humiliated 1.

Strategies for Developing Open-Ended Questions

1. Focus on Higher-Order Thinking

• Aim to develop questions that promote critical thinking rather than simple recall
• Higher-order questions are more effective at developing clinical reasoning skills in students 2
• Move beyond basic knowledge questions to those requiring analysis, synthesis, and evaluation 3

2. Practice Question Formulation

• Begin questions with words like "how," "why," or "what if" rather than "who," "what," or "when"
• Transform closed questions into open ones (e.g., instead of "Is this treatment appropriate?" ask "How would you evaluate the appropriateness of this treatment?")
• Prepare key questions in advance of teaching sessions 1

3. Create a Safe Learning Environment

• Establish rapport with students before asking challenging questions
• Use non-threatening body language and tone
• Allow adequate wait time after asking questions (at least 3-5 seconds) 1

Implementing Questioning Techniques in PBL

The Model for Improvement Approach

Consider adapting the "Ask One Question" concept used successfully in clinical settings. This simple approach can be modified for educational purposes by asking students questions like "What aspect of this case would you like to explore further?" 4

Facilitating Clinical Reasoning

• Frame questions that help students make sense of complex, poorly delineated problems
• Focus on teaching students "how to think" rather than "what to think" about complex clinical scenarios 5
• Guide students through the inductive clinical reasoning process that is essential in healthcare problem-solving 5

Common Pitfalls to Avoid

• Asking predominantly low-level questions: Research shows clinical teachers tend to ask mainly low-level questions, which limits development of critical thinking 3
• Insufficient wait time: Rushing students to answer prevents deeper thinking
• Intimidating questioning styles: Avoid aggressive questioning that can humiliate or threaten students 1
• Answering your own questions: This prevents students from developing their reasoning skills

Developing Your Questioning Skills

• Record and analyze your teaching sessions to evaluate your questioning patterns
• Seek feedback from peers or educational specialists
• Participate in faculty development workshops focused on questioning techniques
• Practice deliberately formulating higher-order questions before teaching sessions
• Study examples of effective questioning from experienced PBL facilitators 2

By deliberately practicing these techniques, you can develop the ability to ask effective open-ended questions that enhance the problem-based learning experience and promote clinical reasoning skills in medical students.