October 25, 2024 • 21 mins
In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., interviews Timothy Long, M.D., about the importance of asking good questions in healthcare settings, such as when you’re with patients, as an educator, or at a conference or presentation.
Timestamps:
00:00 Introduction
01:58 Developing the skill of asking good questions
06:37 Characteristics of effective questions
11:45 Effectively using questioning techniques as an educator
15:33 Considerations for asking questions in large group settings
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:06):
This is Lab Medicine Rounds, acurated podcast for physicians,
laboratory professionals andstudents. I'm your host, Justin Kreer,
a transfusion medicine pathologistand assistant professor of laboratory
medicine and pathology at Mayo Clinic.
Today we're roundingwith Dr. Timothy Long.
Dr. Long is a professor of anesthesiologyand a physician in the Department
(00:29):
of Anesthesiology and perioperativemedicine at Mayo Clinic in Rochester,
Minnesota.
He's also the past programdirector for the Anesthesia
residency, and it has been along time colleague of mine.
Thanks for joining us today, Dr. Long.
Yeah, my pleasure. Thanksfor having me Justin.
So I wanted to ask you here today to
(00:53):
round on this question of how can we
ask good questions in medicine?
Partially because I know your longtimehistory is really a master educator
here at Mayo Clinic,
very well liked by your trainees,
and certainly every timewe have an anesthesiologist rotate through transfusion
(01:17):
medicine,
we're always blown away about thehigh quality learners that you guys
are cultivating.
But I also just recentlysaw you at a conference
where as many listeners mightknow as junior faculty or
faculty get asked tomoderate at conferences,
(01:38):
usually one of the expectationsis that you've got kind of a
question or two ready to goto ask presenters. And I,
again,
was really just very blown awayto see how artfully you kind of
pulled a lot more of the marrowout of a presentation with your
questions. So with that background,that's what I asked you here today,
(02:02):
and I just wanted our audienceto know why we're talking to you
today.
But maybe for that we can launchin with why is it important for
healthcare professionalsto develop this skill
of asking questions?
Yeah. Well, first of all,thanks for those kind comments.
(02:24):
I enjoyed having you in ourconference and we can get into some of
the, I think the asking a question
really,
the type of question you're going to askis going to be different based on the
setting you're in. And whenI think about healthcare,
particularly academic healthcare,
(02:47):
we're thrown into so many settingswhere you have to be a good
questioner. And it is obviouslyimportant for patient care.
It's obviously important for education.
When you think about learners,
they learn in different ways.
But if you can get them to discoverthat knowledge on their own through
(03:10):
questioning that you're asking,
rather than just conveyinginformation to them,
transferring information to them,
it's going to stick with themfor a much longer period of time.
And I also think it's importantfor open-end a dialogue,
having conversation, learning together,
being vulnerable togetherin the learning environment.
(03:31):
So I think it's an important topicand one I haven't given a whole lot of
thought to until you askedme to come on this podcast.
So it's really, I'm kind oflearning from it as well.
Well, I think it's a hattip that you're a natural.
I don't know.
So you're pointing out setting and just,
(03:53):
I love your pointing out that there'sdifferent settings that physicians
and healthcare professionals might findthemselves at the patient's bedside
as an educator. And the last one youwere talking about is conversations,
which am I hearing you ismaybe those conversations
are like if you and I graba coffee together and being
(04:18):
that kind of ideal of a continuous
learner or what's the phrase,
master adaptive learner?
Is that what you're talking about?
Yeah, I think so. And whenI'm thinking about it,
I'm thinking about me in the clinicalenvironment, one-on-one with a trainee,
(04:42):
and I may have a principalthat I want to teach
them, and it's really easy forme to tell them this principle.
And now I've done my work and it's great,
and I've done intraoperative teachingand we're all happy and they go home and
then they forget it the next day. Versusif I've got this principle in mind,
(05:03):
I then can back it up a fewsteps, start with questioning,
and now they're discoveringwhat that answer is.
So that's one setting where I think
questioning is really important, and Iprobably have developed that over years.
I'm also, I don't knowif you know this Justin,
(05:23):
but I'm a board examiner for ourboard, and that's a different setting.
You're probing forknowledge in that setting,
but you're also trying to get depth of
answers. So we're much less interestedin what you might do or if this
is the correct drug or ifthat's the correct drug,
(05:44):
more interested in why is that the rightanswer or why is that the right drug.
So a lot of the questioning that I doin an educational environment focuses on
the why or how are you orwhat is the mechanism of that.
Otherwise,
it's just regurgitation offacts and that's interpreted as
(06:06):
pimping, and it's probably what it is.
And there may be aplace for that at times.
But I think if you want to reallyget depth of knowledge for a trainee,
you really get to the whyand the how and so on.
Let's pick on this a little bit.
I think this is a setting that probablya lot of our listeners can relate to
(06:29):
whichever side they're on of theperson being asked or the person
asking the questions. Because regardless,
I think probably the skill of askingis an important one to develop.
What are a few features thatkind of make for maybe a
higher quality question? I mean,
(06:54):
I don't want to go into good or bad,
but what's going to make fora better question if we back
that.
Up? Yeah, again,
I think it does get to the environmentagain, in the setting that you're in,
when I'm thinking about thelearning environment in particular,
I know where I'm going with myquestioning and it's going to be kind of
(07:17):
leading questions initially,fairly open-ended questions,
and then getting morespecific as we go along.
So my bias in terms of what Iwant to teach is within those
questions. And again,
I think it's more thanjust factual knowledge,
it's really depth of understanding.
(07:39):
So if you can get to beyond thepimping of regurgitating this
fact to me and get to the mechanismor the why of what you're doing,
I think it's a much better question,different settings. However,
as a past program director,and even in my current role,
I do a lot of coachingand advising of trainees.
(08:01):
That's a different kind ofquestioning that you're conducting.
You may have your bias and your opinionof the answer to whatever they're
asking you about, but if you'rereally coaching them appropriately,
you're not giving that to them.
You're having them discoverwhat the answer really is.
So that's open-endedquestions that help them
(08:26):
discover that answer that theyalready know what the answer is.
So again, it's a little bit differentquestioning. And then if we get to
the large group setting, I thinkit's a little bit different.
I've got some opinionson that setting as well.
But I don't know if I answeredyour question. I hope I did.
(08:47):
Yeah, maybe we'll come back to large.
What I'm curious to explore
you're about in these learning settings
about
being open-ended withthe questions and not
factual.
So I'm assuming these are a little bitmore long answer explaining my thought
(09:11):
process to you, that kind of thing.
And you maybe redirecting or pointingout associations that I'm not seeing.
I imagine that takes a littlebit of time as I talk to
faculty. I mean,
time is one of those things that peopleare quite critical of these days or,
(09:32):
and then I've even also heardit on the learner side of,
geez, Dr. Roiter, you couldhave done this a lot quicker,
but again, I asked you to record thispodcast today because I think that
you pull this off in away that your learners are
(09:53):
very enthused.
And also you've developed a facultythat similarly are very good about
taking learners throughthese thoughtful questions.
Do you have any advice for listenerswho might kind of say, yeah,
it sounds nice, but geez, it takes time.
Yeah, I don't think itactually takes a lot of time.
(10:13):
It sounds like it takes a lot of time, but
in our field, in anesthesia,
we're not standing in the operatingroom teaching for an hour.
Our surgeons would get very irritatedwith us if we were doing that for one
thing. But we also, we want our trainees,
(10:34):
our residents really payingattention to the patient.
We can't distract ourselvesfrom the patient for that long.
So the intraoperative teaching thatI'm talking about where you're walking
through a pathway to get to alearning point, it doesn't take long.
I will tell you though,
it takes quite a bit ofexperience and practice in
(10:55):
refining those skills. If you wouldask me to do that 20 years ago,
no way. I don't havethe skillset to do that.
And I'll tell you,
one of the challenges is that it'sless about the time and it's more
about the unpredictability of it.Because if
you just tell somebody thisthought process or this
(11:20):
theory or whatever, it's verypredictable. You know what?
You want to teach them thecontent and you're done.
Versus if you back it up severalsteps and you ask a question,
you don't know what they're going to say.
You may have no idea whatthey're talking about.
It puts you in a vulnerableposition. They may think, well,
this guy doesn't evenknow this content at all.
(11:43):
So you have to be vulnerable.
You have to be willing to not know theanswer to things and to learn together.
So I think that's the challengewith the questioning approach to
education. It's a lot easier just tosay, here's what you need to know.
Here's the information and walkaway from it. So it takes practice.
(12:03):
And for our listeners, like yousay, the practice you've had,
the experience you've hadover the past 20 years,
what are some things tohighlight for listeners to maybe
in the coming days, weeks that theymight think about being deliberate,
both for educators,
for when they're questioningtheir learners or for colleagues as we're trying to
(12:27):
question each other, learn?
What's your thoughts on tips that peoplecan be a little bit more deliberate to
develop this skill of being able to have
a vulnerable questioning attitude?
One tip I give our residents often,
and this really comes from myexperience at our board exams
(12:52):
as I tell them to think about everythingthat you're doing every day and
ask yourself why with it.
If you can answer the why witheverything that you're doing,
you're going to have depth of knowledge.
You're going to have betterunderstanding of what you're doing.
You're going to be able to sit forany board exam and pass it easily.
(13:14):
But you're also going to be able to havethose conversations with colleagues and
peers that may justifysomething that you're doing.
You may have a surgeon come toyou with a question about patient
comorbidity.
You have to be able to give them ananswer and then justify that answer.
So I think it's just a matterof having a questioning
(13:37):
attitude. And if you can askthose questions of yourself,
then you can ask themof others as well. And
I also think it's importantquestions in general,
because I think it shows somebodythat you care about them and you
care about what they think and
(13:59):
you care that they have some knowledgeand you want to get that knowledge from
them. So this one waycommunication, passive learning,
I think we've done itfor many, many years.
I'm guilty of it just like everybody else,
but it's probably not thebest way to approach learning.
It's probably not the best way toapproach a dialogue with a patient.
Well,
(14:19):
I think you've given me a nice transitionmaybe to the setting of when we're
focusing on our own learning,
when I'm there at yourconference learning,
how might I approach thosequestions where I'm trying to
learn this new information,
(14:40):
I think I want to couch this and recognizethat there are some among us that
really like to learn, hearabout something new, digest,
reflect, think, and thenthey can ask questions.
But I'm more focused on in the moment,
maybe while the iron's hot,
if I'm in a conferencelearning some new information,
are there some thoughts thatyou have on how I can in the
(15:04):
moment take advantage of having theexpert there at the podium and ask some
clarifying questions to helpsolidify this new learning?
I can tell you myapproach to it. First off,
I think you have to be a reallycareful listener, thoughtful listener.
And that probably gets,
I think you could say that aboutthe educational environment.
(15:27):
One-on-one with a trainee too. If you'reasking them a series of questions,
you need to think about what they've said.
You need to listen to 'em inorder to ask the next question.
But in a big group setting,you have to be a listener,
try to identify where those gaps are.
What I do is I thinkabout the audience that is
(15:49):
there, and I think about, well,
if I'm sitting in the audience andI know nothing about this topic,
what might somebody be questioning?
Where do they need clarityon a particular issue?
And I think we've probably allseen this where somebody gives a
presentation at a nationalmeeting or something,
and then there's a rush to themicrophone for somebody to ask the most
(16:13):
complex question you can imagine todemonstrate how smart they are. And
they probably really are that smart.
And I apologize to thosethat are super smart,
but I think sometimes that shutsdown the conversation a little bit.
Who wants to follow thatguy with that question?
I don't want to ask my simple question.
What might be that simple question ison the minds of 90% of our audience.
(16:37):
So I try to keep it pretty simple in that
setting. And again, I'm trying toopen up a dialogue with people.
I'm trying to ask the questionsthat may be on other people's minds,
and they may be really simple.And as we've all heard many times,
there is no dumb question,
(16:58):
but some people are afraid to ask whatappears to be a simple question in front
of a large group like that. So Idon't think it has to be complicated,
and it doesn't have to be. Well,
the question should not bemore complicated than the answer. How about that?
I really like that.
(17:18):
I think you're hitting the nail on thehead as far as what resonates with my
experience. I think for a long time,
I would often sit on my hands whenI would be listening to something.
I don't have anything smart to ask.
Or like you're saying sometimes,
particularly in nationalmeetings, you just feel like, wow,
(17:41):
here's these amazing, insightfulquestions. Who am I to stand up?
But I think that's likewe're saying, this is the,
and we see this too atmeetings where, okay,
maybe some questions get askedor maybe no questions get asked,
but still there's a rush to thespeaker once the session is closed to
(18:01):
maybe more privately askmy simpleton question.
Thinking about your role in coaching,
and now I'm thinking about both learners,
junior faculty,
how do you coach them tocultivate that a little bit more
(18:23):
self-efficacy of advocatingfor their own learning in
these situations?
I think a lot of it is role modeling.
Nobody ever taught mehow to be an educator.
I don't have a master'sin education or anything.
I learned how to be ananesthesiologist. So
(18:46):
in the way I approached it was I thoughtabout the great educators that taught
me, and I tried to gainfrom them what I could.
I also thought about those whowere not great educators. I'm like,
I don't want to replicate that.
So I think a lot of what we do ingraduate medical education does come down
to role modeling.
(19:07):
Our trainees will pick up on this,and then when they join our staff,
they're going to hopefully have asimilar approach or somewhat modified
something that works better for them,
but at least they've experiencedthat kind of educational model.
I'd love to tell you that Iforget how many faculty we have,
maybe 180 faculty in our department.I would love to tell you that all of them
(19:30):
are great educators and they'requestioning, but that's not the case.
But you have to have a core of them.
And we've worked on facultydevelopment through,
we have annual facultydevelopment opportunities,
mostly for those who havejust joined our staff.
So we try to get to 'em earlyand give them some of these
(19:54):
skills.
And I know our current programdirector and program leadership,
they work really hard ondeveloping this growth mindset
within our traineesand within our faculty.
And I think we've probably all heardwhat growth mindset versus a performance
oriented mindset. We want ourtrainees asking questions,
(20:18):
being vulnerable. We want ourfaculty doing the same thing.
So it takes a long time
to foster that kind of environment.
And I would say we're in theinfancy of that in our department.
I'd love to tell you, we wereall experts at it, but we're not.
It takes a lot of time and effort.
You're being honest and vulnerable,
(20:40):
and we certainly appreciatethat our audience does as well.
I want to transition back really quickbefore we close out about the large group
setting.
I know a lot of us certainlyhave some work in that area,
and you said you have somestrong thoughts on it. So.
Yeah, most of it is keepingthose questions simple.
(21:04):
I see very often,
and sometimes people comeup to a microphone or a large group and they're not
asking a question, they'remaking a comment. Well,
hopefully that comment is therefor others to gain knowledge,
and it frequently is,
but we've all seen the person that getsup there just that they want to show how
(21:25):
much knowledge they have.
So I'm very mindful of thatwhen I'm in front of a group
like that. I'm not speakingto show people how smart I am.
I'm trying to learn myself.
I'm trying to help others learn byasking questions that maybe others
are thinking about, but they don'twant to get up to the microphone.
(21:51):
But it's kind what I've,
over the years kind of observed,
and I think I've learned from it. And
yeah, I'm not sure if thatanswers that question, but.
Absolutely. And it'shelpful for me to hear too,
because I think about myselfand something that I've
(22:13):
relatively recently in the last coupleof years started getting involved with
our medical school and teaching,
which is in the preclinicalyears is large group,
and being mindful ofwhich questions should be
answered in front of the groupand which questions should be.
That's an interesting question.Let's follow up after class.
(22:38):
Right, right.
So maybe as a parting question forthis podcast for our listeners,
do you have any kind of partingadvice for medical educators
about asking their learners questions?
Yeah, I think getting comfortable,
being uncomfortable because it isuncomfortable with that unpredictability
(23:01):
that we already talked about. Andjust get in there and be bold.
I think you have to do it.
You have to be willing to admitwhen you don't know something,
that vulnerability, I think ourlearners appreciate that too.
And you can learn together. There'smany ways to handle that. Well,
that's an interesting response.I don't know the answer to that.
(23:24):
Let's explore that further.
So there's many ways that you can navigate
that unpredictability,
but I think you just have to get inthere and be bold and practice it a lot.
We've been rounding with Dr. TimothyLong about the art of asking questions.
Thanks for taking the timeto talk about this with us.
(23:47):
Well, it was my pleasure.Thanks for having me, Justin.
And to all of our listeners,thank you for joining us today.
We invite you to share your thoughtsand suggestions via email to MCL
education@mayo.edu. Ifyou've enjoyed this podcast,
please subscribe untilour next rounds together.
We encourage you to continue to connectlab medicine and the clinical practice
(24:09):
through educational conversations.
This is Lab Medicine Rounds, acurated podcast for physicians,
laboratory professionals andstudents. I'm your host, Justin Kreer,
a transfusion medicine pathologistand assistant professor of laboratory
medicine and pathology at Mayo Clinic.
Today we're roundingwith Dr. Timothy Long.
Dr. Long is a professor of anesthesiologyand a physician in the Department
(00:29):
of Anesthesiology and perioperativemedicine at Mayo Clinic in Rochester,
Minnesota.
He's also the past programdirector for the Anesthesia
residency, and it has been along time colleague of mine.
Thanks for joining us today, Dr. Long.
Yeah, my pleasure. Thanksfor having me Justin.
So I wanted to ask you here today to
(00:53):
round on this question of how can we
ask good questions in medicine?
Partially because I know your longtimehistory is really a master educator
here at Mayo Clinic,
very well liked by your trainees,
and certainly every timewe have an anesthesiologist rotate through transfusion
(01:17):
medicine,
we're always blown away about thehigh quality learners that you guys
are cultivating.
But I also just recentlysaw you at a conference
where as many listeners mightknow as junior faculty or
faculty get asked tomoderate at conferences,
(01:38):
usually one of the expectationsis that you've got kind of a
question or two ready to goto ask presenters. And I,
again,
was really just very blown awayto see how artfully you kind of
pulled a lot more of the marrowout of a presentation with your
questions. So with that background,that's what I asked you here today,
(02:02):
and I just wanted our audienceto know why we're talking to you
today.
But maybe for that we can launchin with why is it important for
healthcare professionalsto develop this skill
of asking questions?
Yeah. Well, first of all,thanks for those kind comments.
(02:24):
I enjoyed having you in ourconference and we can get into some of
the, I think the asking a question
really,
the type of question you're going to askis going to be different based on the
setting you're in. And whenI think about healthcare,
particularly academic healthcare,
(02:47):
we're thrown into so many settingswhere you have to be a good
questioner. And it is obviouslyimportant for patient care.
It's obviously important for education.
When you think about learners,
they learn in different ways.
But if you can get them to discoverthat knowledge on their own through
(03:10):
questioning that you're asking,
rather than just conveyinginformation to them,
transferring information to them,
it's going to stick with themfor a much longer period of time.
And I also think it's importantfor open-end a dialogue,
having conversation, learning together,
being vulnerable togetherin the learning environment.
(03:31):
So I think it's an important topicand one I haven't given a whole lot of
thought to until you askedme to come on this podcast.
So it's really, I'm kind oflearning from it as well.
Well, I think it's a hattip that you're a natural.
I don't know.
So you're pointing out setting and just,
(03:53):
I love your pointing out that there'sdifferent settings that physicians
and healthcare professionals might findthemselves at the patient's bedside
as an educator. And the last one youwere talking about is conversations,
which am I hearing you ismaybe those conversations
are like if you and I graba coffee together and being
(04:18):
that kind of ideal of a continuous
learner or what's the phrase,
master adaptive learner?
Is that what you're talking about?
Yeah, I think so. And whenI'm thinking about it,
I'm thinking about me in the clinicalenvironment, one-on-one with a trainee,
(04:42):
and I may have a principalthat I want to teach
them, and it's really easy forme to tell them this principle.
And now I've done my work and it's great,
and I've done intraoperative teachingand we're all happy and they go home and
then they forget it the next day. Versusif I've got this principle in mind,
(05:03):
I then can back it up a fewsteps, start with questioning,
and now they're discoveringwhat that answer is.
So that's one setting where I think
questioning is really important, and Iprobably have developed that over years.
I'm also, I don't knowif you know this Justin,
(05:23):
but I'm a board examiner for ourboard, and that's a different setting.
You're probing forknowledge in that setting,
but you're also trying to get depth of
answers. So we're much less interestedin what you might do or if this
is the correct drug or ifthat's the correct drug,
(05:44):
more interested in why is that the rightanswer or why is that the right drug.
So a lot of the questioning that I doin an educational environment focuses on
the why or how are you orwhat is the mechanism of that.
Otherwise,
it's just regurgitation offacts and that's interpreted as
(06:06):
pimping, and it's probably what it is.
And there may be aplace for that at times.
But I think if you want to reallyget depth of knowledge for a trainee,
you really get to the whyand the how and so on.
Let's pick on this a little bit.
I think this is a setting that probablya lot of our listeners can relate to
(06:29):
whichever side they're on of theperson being asked or the person
asking the questions. Because regardless,
I think probably the skill of askingis an important one to develop.
What are a few features thatkind of make for maybe a
higher quality question? I mean,
(06:54):
I don't want to go into good or bad,
but what's going to make fora better question if we back
that.
Up? Yeah, again,
I think it does get to the environmentagain, in the setting that you're in,
when I'm thinking about thelearning environment in particular,
I know where I'm going with myquestioning and it's going to be kind of
(07:17):
leading questions initially,fairly open-ended questions,
and then getting morespecific as we go along.
So my bias in terms of what Iwant to teach is within those
questions. And again,
I think it's more thanjust factual knowledge,
it's really depth of understanding.
(07:39):
So if you can get to beyond thepimping of regurgitating this
fact to me and get to the mechanismor the why of what you're doing,
I think it's a much better question,different settings. However,
as a past program director,and even in my current role,
I do a lot of coachingand advising of trainees.
(08:01):
That's a different kind ofquestioning that you're conducting.
You may have your bias and your opinionof the answer to whatever they're
asking you about, but if you'rereally coaching them appropriately,
you're not giving that to them.
You're having them discoverwhat the answer really is.
So that's open-endedquestions that help them
(08:26):
discover that answer that theyalready know what the answer is.
So again, it's a little bit differentquestioning. And then if we get to
the large group setting, I thinkit's a little bit different.
I've got some opinionson that setting as well.
But I don't know if I answeredyour question. I hope I did.
(08:47):
Yeah, maybe we'll come back to large.
What I'm curious to explore
you're about in these learning settings
about
being open-ended withthe questions and not
factual.
So I'm assuming these are a little bitmore long answer explaining my thought
(09:11):
process to you, that kind of thing.
And you maybe redirecting or pointingout associations that I'm not seeing.
I imagine that takes a littlebit of time as I talk to
faculty. I mean,
time is one of those things that peopleare quite critical of these days or,
(09:32):
and then I've even also heardit on the learner side of,
geez, Dr. Roiter, you couldhave done this a lot quicker,
but again, I asked you to record thispodcast today because I think that
you pull this off in away that your learners are
(09:53):
very enthused.
And also you've developed a facultythat similarly are very good about
taking learners throughthese thoughtful questions.
Do you have any advice for listenerswho might kind of say, yeah,
it sounds nice, but geez, it takes time.
Yeah, I don't think itactually takes a lot of time.
(10:13):
It sounds like it takes a lot of time, but
in our field, in anesthesia,
we're not standing in the operatingroom teaching for an hour.
Our surgeons would get very irritatedwith us if we were doing that for one
thing. But we also, we want our trainees,
(10:34):
our residents really payingattention to the patient.
We can't distract ourselvesfrom the patient for that long.
So the intraoperative teaching thatI'm talking about where you're walking
through a pathway to get to alearning point, it doesn't take long.
I will tell you though,
it takes quite a bit ofexperience and practice in
(10:55):
refining those skills. If you wouldask me to do that 20 years ago,
no way. I don't havethe skillset to do that.
And I'll tell you,
one of the challenges is that it'sless about the time and it's more
about the unpredictability of it.Because if
you just tell somebody thisthought process or this
(11:20):
theory or whatever, it's verypredictable. You know what?
You want to teach them thecontent and you're done.
Versus if you back it up severalsteps and you ask a question,
you don't know what they're going to say.
You may have no idea whatthey're talking about.
It puts you in a vulnerableposition. They may think, well,
this guy doesn't evenknow this content at all.
(11:43):
So you have to be vulnerable.
You have to be willing to not know theanswer to things and to learn together.
So I think that's the challengewith the questioning approach to
education. It's a lot easier just tosay, here's what you need to know.
Here's the information and walkaway from it. So it takes practice.
(12:03):
And for our listeners, like yousay, the practice you've had,
the experience you've hadover the past 20 years,
what are some things tohighlight for listeners to maybe
in the coming days, weeks that theymight think about being deliberate,
both for educators,
for when they're questioningtheir learners or for colleagues as we're trying to
(12:27):
question each other, learn?
What's your thoughts on tips that peoplecan be a little bit more deliberate to
develop this skill of being able to have
a vulnerable questioning attitude?
One tip I give our residents often,
and this really comes from myexperience at our board exams
(12:52):
as I tell them to think about everythingthat you're doing every day and
ask yourself why with it.
If you can answer the why witheverything that you're doing,
you're going to have depth of knowledge.
You're going to have betterunderstanding of what you're doing.
You're going to be able to sit forany board exam and pass it easily.
(13:14):
But you're also going to be able to havethose conversations with colleagues and
peers that may justifysomething that you're doing.
You may have a surgeon come toyou with a question about patient
comorbidity.
You have to be able to give them ananswer and then justify that answer.
So I think it's just a matterof having a questioning
(13:37):
attitude. And if you can askthose questions of yourself,
then you can ask themof others as well. And
I also think it's importantquestions in general,
because I think it shows somebodythat you care about them and you
care about what they think and
(13:59):
you care that they have some knowledgeand you want to get that knowledge from
them. So this one waycommunication, passive learning,
I think we've done itfor many, many years.
I'm guilty of it just like everybody else,
but it's probably not thebest way to approach learning.
It's probably not the best way toapproach a dialogue with a patient.
Well,
(14:19):
I think you've given me a nice transitionmaybe to the setting of when we're
focusing on our own learning,
when I'm there at yourconference learning,
how might I approach thosequestions where I'm trying to
learn this new information,
(14:40):
I think I want to couch this and recognizethat there are some among us that
really like to learn, hearabout something new, digest,
reflect, think, and thenthey can ask questions.
But I'm more focused on in the moment,
maybe while the iron's hot,
if I'm in a conferencelearning some new information,
are there some thoughts thatyou have on how I can in the
(15:04):
moment take advantage of having theexpert there at the podium and ask some
clarifying questions to helpsolidify this new learning?
I can tell you myapproach to it. First off,
I think you have to be a reallycareful listener, thoughtful listener.
And that probably gets,
I think you could say that aboutthe educational environment.
(15:27):
One-on-one with a trainee too. If you'reasking them a series of questions,
you need to think about what they've said.
You need to listen to 'em inorder to ask the next question.
But in a big group setting,you have to be a listener,
try to identify where those gaps are.
What I do is I thinkabout the audience that is
(15:49):
there, and I think about, well,
if I'm sitting in the audience andI know nothing about this topic,
what might somebody be questioning?
Where do they need clarityon a particular issue?
And I think we've probably allseen this where somebody gives a
presentation at a nationalmeeting or something,
and then there's a rush to themicrophone for somebody to ask the most
(16:13):
complex question you can imagine todemonstrate how smart they are. And
they probably really are that smart.
And I apologize to thosethat are super smart,
but I think sometimes that shutsdown the conversation a little bit.
Who wants to follow thatguy with that question?
I don't want to ask my simple question.
What might be that simple question ison the minds of 90% of our audience.
(16:37):
So I try to keep it pretty simple in that
setting. And again, I'm trying toopen up a dialogue with people.
I'm trying to ask the questionsthat may be on other people's minds,
and they may be really simple.And as we've all heard many times,
there is no dumb question,
(16:58):
but some people are afraid to ask whatappears to be a simple question in front
of a large group like that. So Idon't think it has to be complicated,
and it doesn't have to be. Well,
the question should not bemore complicated than the answer. How about that?
I really like that.
(17:18):
I think you're hitting the nail on thehead as far as what resonates with my
experience. I think for a long time,
I would often sit on my hands whenI would be listening to something.
I don't have anything smart to ask.
Or like you're saying sometimes,
particularly in nationalmeetings, you just feel like, wow,
(17:41):
here's these amazing, insightfulquestions. Who am I to stand up?
But I think that's likewe're saying, this is the,
and we see this too atmeetings where, okay,
maybe some questions get askedor maybe no questions get asked,
but still there's a rush to thespeaker once the session is closed to
(18:01):
maybe more privately askmy simpleton question.
Thinking about your role in coaching,
and now I'm thinking about both learners,
junior faculty,
how do you coach them tocultivate that a little bit more
(18:23):
self-efficacy of advocatingfor their own learning in
these situations?
I think a lot of it is role modeling.
Nobody ever taught mehow to be an educator.
I don't have a master'sin education or anything.
I learned how to be ananesthesiologist. So
(18:46):
in the way I approached it was I thoughtabout the great educators that taught
me, and I tried to gainfrom them what I could.
I also thought about those whowere not great educators. I'm like,
I don't want to replicate that.
So I think a lot of what we do ingraduate medical education does come down
to role modeling.
(19:07):
Our trainees will pick up on this,and then when they join our staff,
they're going to hopefully have asimilar approach or somewhat modified
something that works better for them,
but at least they've experiencedthat kind of educational model.
I'd love to tell you that Iforget how many faculty we have,
maybe 180 faculty in our department.I would love to tell you that all of them
(19:30):
are great educators and they'requestioning, but that's not the case.
But you have to have a core of them.
And we've worked on facultydevelopment through,
we have annual facultydevelopment opportunities,
mostly for those who havejust joined our staff.
So we try to get to 'em earlyand give them some of these
(19:54):
skills.
And I know our current programdirector and program leadership,
they work really hard ondeveloping this growth mindset
within our traineesand within our faculty.
And I think we've probably all heardwhat growth mindset versus a performance
oriented mindset. We want ourtrainees asking questions,
(20:18):
being vulnerable. We want ourfaculty doing the same thing.
So it takes a long time
to foster that kind of environment.
And I would say we're in theinfancy of that in our department.
I'd love to tell you, we wereall experts at it, but we're not.
It takes a lot of time and effort.
You're being honest and vulnerable,
(20:40):
and we certainly appreciatethat our audience does as well.
I want to transition back really quickbefore we close out about the large group
setting.
I know a lot of us certainlyhave some work in that area,
and you said you have somestrong thoughts on it. So.
Yeah, most of it is keepingthose questions simple.
(21:04):
I see very often,
and sometimes people comeup to a microphone or a large group and they're not
asking a question, they'remaking a comment. Well,
hopefully that comment is therefor others to gain knowledge,
and it frequently is,
but we've all seen the person that getsup there just that they want to show how
(21:25):
much knowledge they have.
So I'm very mindful of thatwhen I'm in front of a group
like that. I'm not speakingto show people how smart I am.
I'm trying to learn myself.
I'm trying to help others learn byasking questions that maybe others
are thinking about, but they don'twant to get up to the microphone.
(21:51):
But it's kind what I've,
over the years kind of observed,
and I think I've learned from it. And
yeah, I'm not sure if thatanswers that question, but.
Absolutely. And it'shelpful for me to hear too,
because I think about myselfand something that I've
(22:13):
relatively recently in the last coupleof years started getting involved with
our medical school and teaching,
which is in the preclinicalyears is large group,
and being mindful ofwhich questions should be
answered in front of the groupand which questions should be.
That's an interesting question.Let's follow up after class.
(22:38):
Right, right.
So maybe as a parting question forthis podcast for our listeners,
do you have any kind of partingadvice for medical educators
about asking their learners questions?
Yeah, I think getting comfortable,
being uncomfortable because it isuncomfortable with that unpredictability
(23:01):
that we already talked about. Andjust get in there and be bold.
I think you have to do it.
You have to be willing to admitwhen you don't know something,
that vulnerability, I think ourlearners appreciate that too.
And you can learn together. There'smany ways to handle that. Well,
that's an interesting response.I don't know the answer to that.
(23:24):
Let's explore that further.
So there's many ways that you can navigate
that unpredictability,
but I think you just have to get inthere and be bold and practice it a lot.
We've been rounding with Dr. TimothyLong about the art of asking questions.
Thanks for taking the timeto talk about this with us.
(23:47):
Well, it was my pleasure.Thanks for having me, Justin.
And to all of our listeners,thank you for joining us today.
We invite you to share your thoughtsand suggestions via email to MCL
education@mayo.edu. Ifyou've enjoyed this podcast,
please subscribe untilour next rounds together.
We encourage you to continue to connectlab medicine and the clinical practice
(24:09):
through educational conversations.
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