Using Questions to Enhance Rheumatology Education

Abstract

Meeting the increased demand for rheumatology care in the future will require changing the way rheumatology is taught. Enhancing rheumatology education may encourage more trainees to pursue rheumatology careers and improve knowledge about musculoskeletal conditions for primary care providers. However, the inherent uncertainty that surrounds the etiology, diagnosis, and treatment of many rheumatic diseases presents a unique challenge to rheumatology education and demands a distinct approach. By mastering the art of questioning, faculty can improve a learner's ability to understand and remember the material, apply knowledge in new settings, overcome cognitive biases, support an environment of inquiry, and develop metacognition, even under uncertainty. Trainees should also learn the craft of asking questions as a method of studying, a practice that stimulates curiosity, and a tool that will help them become life-long, self-directed learners. In this guide, we present the evidence behind the power of questions, provide a model for the best use of questions in various teaching venues, and recommend specific techniques for effective questioning. This article is protected by copyright. All rights reserved.

A Tutorial for Implementing Strategic Questioning in the Clinical Teaching Environment

“…The authors discuss formulating questions for the purposes of addressing low to high levels of cognition, ranging from recall of memorized facts to generating alternative hypotheses. Similarly, Hausmann and Schwartzstein (2018) describe the use of Bloom's taxonomy when formulating strategic questions intended to stimulate critical thinking when teaching rheumatologic concepts. Last, and perhaps the most systematically structured approach based on Bloom's taxonomy, is the SQF model.…”

“…Socratic questioning and argument analysis approaches tend to focus on asking questions that disable cognitive biases that lead to poor decision making, clinical error, and flawed beliefs (Finn et al, 2016). Hausmann and Schwartzstein (2018) specifically address using questions to disable cognitive biases, such that medical error is reduced. Both argument analysis (Browne & Keely, 2015) and Socratic questions (Toledo, 2015) share similarities with posing strategic questions at Bloom's ( 1956) highest cognitive processing levels.…”

“…In recent years, the use of questioning, also referred to as questioning strategies, questioning techniques, or strategic questioning, has gained allure among clinical educators as a viable teaching tool for maximizing learning (American Speech-Language-Hearing Association [ASHA], n.d.; Barnum, 2008;Cook, Messick, Ramsay, & Tillard, 2019;Phillips, Duke, & Weerasuriya, 2017;Tofade, Elsner, & Haines, 2013). Although questioning in itself may be considered a somewhat generic, ubiquitous method of teaching, if used strategically with intentionality, it may prove to be quite powerful in a teachinglearning context (Dietz-Uhler & Lanter, 2009;Hausmann & Schwartzstein, 2018;Tofade et al, 2013).…”

“…Additional evidence has also suggested that formulating productive questions appropriate to the needs and skill level of the learner may be more complex than initially thought (Barnum, 2008;Tofade et al, 2013). For example, assessing the level of difficulty, phrasing, type, sequencing, frequency, and timing of the question may all influence a successful learning outcome (Barnum, 2008;Cook et al, 2019;Hausmann & Schwartzstein, 2018;McCrea & Brasseur, 2003;Tofade et al, 2013). To add to the complexities, students may demonstrate higher productivity in accessing and exercising higher order thinking functions in a learning environment that is considered psychologically safe and positive by the learner (Burningham, Deru, & Berry, 2010;Curtis, Helion, & Domsohn, 1998;Detsky, 2009;Pitney, Ehlers, & Walker, 2006;Thrasher, Walker, & Weidner, 2018;Tofade et al, 2013).…”

The Burden of Rheumatic Diseases in the Community: Raising Awareness in Primary Care

“…Although this was increased after relevant education, PCPs were not consistently engaged in their clinical routine [23]. As robust diagnostic criteria do not exist for the majority of RMDs and the existing prediction models for rare conditions are not likely to be effective in primary care software [24], the education of PCPs on rheumatic and musculoskeletal conditions re-emerges as challenging but promising task [25,26].…”