Questioning strategies in Healthcare Training develop critical thinking, decision making, and problem solving in students. Bloom’s taxonomy of the six levels of cognitive learning can be used to provide a framework for creating questions. Bloom’s taxonomy starts from the simplest level of learning to the most complex level.  Simplest levels denote Knowledge and Complex levels denote Evaluation.

Sample Question for Knowledge Test:

Intravenous Urogram

Knowledge Test

Asking a learner to define Intravenous Urogram, (IVU) would test his/her knowledge levels.

Sample Question for Evaluation:

Intravenous Urogram

Complex Evaluation

A question is posed to the learner to  assess a request to perform an IVU on a patient allergic to iodine. Experiential activities/ simulations can be built to guide the learner in decision making. In this case, the learner gets to immerse in a simulated scenario, evaluate patient vitals, reports and assess the conditions under which an Iodine-allergic patient can be subjected to Intravenous Urogram.

Studies:

A baccalaureate nursing program study determined what proportion of terminal objectives for clinical nursing courses are high level objectives (analysis, synthesis, evaluation), and are the kinds of questions asked by teachers and students during clinical conferences of a high level also.  Despite the fact that stated objectives specified higher cognitive-level thinking, lower-level questions comprised 98.94% of the total number of questions asked by teachers and students in the clinical conferences surveyed.

Another study was performed within an Australian nursing program to examine clinical teachers’ use of questioning strategies.   The teachers’ years of classroom and clinical teaching experience, years of clinical experience, and academic qualifications were studied to see if an association between various qualifications and levels of questions existed.  Bloom’s taxonomy of the cognitive domain was used as a framework for the study.  The findings revealed clinical teachers asked more low-level questions (91.2%) than high-level questions (4.4%).

Lower level questioning do not promote critical thinking as they only trigger recall of information in the learner’s mind.  A simple recall of information does not enhance students’ understanding of the information in a meaningful way. Higher level questioning facilitates the development of critical thinking because it is aimed at higher cognitive levels, which involves application, analysis, synthesis and evaluation.   Educators should take advantage of stimulating questions more often to help create meaningful active learning instead of just prompting the simple recall of knowledge from students.

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