Questioning learning styles

I spend time with students doing rotations in family medicine/primary care in district hospitals. Students who were on call, present a patient they have seen during the early morning doctors’ handover meeting. The students are then asked questions around the patient’s presentation, the physical examination and the diagnosis, including differential diagnosis. Students often experience this as a grilling. They are afraid of being shown up wanting, not knowing what is expected of them and being humiliated in the process.

I prefer to ask students questions, rather than giving them information. When I start with a new group of students, I explain to them that I ask a lot of questions not to humiliate them or to show them up as lacking, but to facilitate their learning around the patients they see, to help them to identify gaps in their knowledge, to formulate learning needs for them to explore.  I want to facilitate their learning by asking questions that make them think, explore the knowledge they have gained so far, to make them curious to find out more.  My agreement with them is that I will follow up on their identified learning needs the next morning to l hold them accountable. When I ask a question to one student and the student does not have the answer, I invite him or her to involve their fellow students. By doing this I hope to make it also a group learning experience.

 How can I do this so that the students do not experience this as  ”grilling”? Can I create a safe or safer container where the students can respond to questions without the fear of being wrong?

After one early morning round, I engaged with the students around their experience of my style of teaching (I prefer ‘facilitation of learning’), asking questions rather than giving information and providing answers. There initial response was that that they find questioning useful because it opens them up to areas where there are gaps in their knowledge.  However, it depends on how the questions are being asked, the tone of voice, the facial expression of the person asking the question. At times their experience is traumatic when the person asking the questions becomes intimidating. This leads to anxiety which makes them unable to give even the answers that they know because they are so nervous. Comments like “do we teach you things like that”, gives the impression that they are wrong and not where they are expected to be. Previous intimidating experiences influence the way they react even now and an underlying anxiety prevails.

And about my style of asking questions? One student concluded that they like my “superficial” (non-judgemental) grilling, “about 30% grilling”! They also like the fact that I refer to guidelines and then open the guidelines with them. It gives them direction as to where to go with their learning need. They also appreciate moments of content teaching in-between.

  Perhaps I need to find more of a balance between teaching content and facilitation of learning through asking questions.