Asking Questions in Class: Influencing Learning and the Learning Environment

Welcome everybody good afternoon I've been doing several really great observations for online teaching over the past several weeks to months actually and I think one of the the most positive things that I've seen with all of these interactions is how interactive our faculty have been with our learners despite the fact that they're having to teach at a distance and I think that one of the ways in which they do this best is by asking questions and so there's sort of an art texting questions with your learners particularly if you're doing it from a distance and I think you know when you're engaged in a learning opportunity or a teaching opportunity sometimes it's hard to determine when do I ask the questions what level do I ask the questions do I keep asking questions even when they're not answering so hopefully dr. Andrew Pink's our today's presenter is going to help us to answer some of those questions and help us to ask our questions most effectively to guide the most effective learning so dr. Andrew banks is associate professor and the director of faculty development and the department of basic science education and he's been an outstanding partner with teach and is always willing to collaborate so I'm sure after this session if you have further questions he will be more than welcome he would more than welcome further questions and we'll walk with opportunities to work with you beyond this now if you do have questions today please type them in the chat box periodically dr. things will ask for questions and then if you do have questions you can unmute and unlock your video which can be helpful we've sort of prophylactically blocked video and muted you all on the off set just so that we can keep the bandwidth down so that we can avoid any any issues with static and not hearing so without further ado I'm going for that dr. Beane's take this away Thank You sherry you will need the chat function because if you're not going to ask me questions I'm going to ask you them so and the first one is why do we ask questions so I've got two answers this is Kathy I ask questions to confirm that students are incorporating the information that we're discussing and to confirm that they understand thanks Kathy I know dr. things I have on here that several responses that say to ensure understanding to assess students understanding to gather baseline knowledge to engage and firm understanding to make sure they're awake and hands page again keep them awake and determine whether information provided is being understood and to know if they're following me and allows for discussion all right those are good answers so really we've got a couple of themes there is to ensure engagement and to to ensure that they're actually understanding what you're doing you think this is a form of incest assessment apologies for the turbo Android tonight that's not going to get any better so I have some listed out for myself as well and so first of all is to elaborate that knowledge as well as well as to just assess what they learn is to ask them to take that information and to work with it and to take that information and join it out to other pieces of content and when you elaborate that down knowledge you start building those cognitive networks for little harder and hardwiring those in then the learning is enhanced so to not just process the knowledge but also to get the student to elaborate on it as well next one is it's just a great form of retrieval and the neuroscientists will tell you in terms of the neuroscience of learning if you go retrieve something it becomes more solidified then we start to have that much more robust knowledge base and this is the same as with elaborating knowledge as well making those connections to make a much more robust cognitive network that the students can then later apply to other situations as well I think this is where we had one of our themes develop from from you the group here and it's to assess for understanding and this allows the educator to see where as you obviously pointed out where the students are make sure that they're following you and make sure that they're taking on on the content as you want them to it's also a way to identify whether the students have an Learning illusion is to basically give them that formative testing to ask them a direct or indirect question about the content to see whether they've actually mastered it and not just content that they've experienced the material they've actually taken it on board as well the other thing is to stimulate curiosity and some students you may be asking why we would have to stimulate curiosity and in medical students or residents shouldn't they be naturally curious I'm going to come back to that point and a little bit but we want to develop that engagement I think it was the response but not just an engages students in what you're saying but to actually get them to become curious about the content and to develop that intrinsic rather than extrinsic learning that they want to learn about the material further and not just as ain't Ords a grade and lastly it's a way to have students start to deal with uncertainty nobody's comfortable with uncertainty at all and this is why I've put a maze on there people think mazes are fun because that there are on certain places and you don't know where you're going that's a rare feeling and it needs to be a controlled environment for most people to be content with that level of uncertainty and if you believe in generational stereotypes most recent learners are going to be even more uncomfortable with being uncertain about something so exposing them to uncertainty and questions that they that you pose is a good way for them to become a little more resilient so I'm going to deal with a couple of these that are particularly relevant I think is identifying a learning illusion and stimulating curiosity as well I'll start with stimulating curiosity so in medical education why on earth would we have to promote curiosity and very little work has been done on this but there's some questions that we might pose our medical students and residents really intrinsic learners or extrinsic learners they're all aiming towards a profession are they naturally curious what is their natural baseline for curiosity compared to perhaps graduate students or non college goers and our assumption is is because they've become going through medical education that they're actually naturally curious and that may well be we don't have a baseline for where they come in this is a study done in McGill very good University with Reagan Medical School and what they did was measure two forms of in their medical students over four years that's four year degree they made with two forms one is trade curiosity and state to curiosity the trait is how naturally curious they are in all situations their own personality and then state is how immediately curious they are about a situation in particular and I want you to notice a couple of things here first of all they come in and they're mean curiosity score for trait is up here at around about 66 and this is their first year of medical school and their state curiosity a little lower but in there in the low 60s by the time we've taken them through a year of medical school those curiosity scores are going down they're in medical aged medical education and somehow what we're doing is making them less curious now by the time they get to the third year at that curiosity school start to go back up again and before our third year faculty and fourth year faculty get very confident about that what I want you to notice is they only come back to baseline levels in four years of medical education we've not shifted their curiosity and surely we should be encouraging that and one way to improve curiosity is to ask questions now are the other issue that I wanted to spend a little time on was learning illusion one of the most popular forms of study habit is to read text read it again and then read it again and then the assumption is because you've exposed yourself to that material several times first of all you've read it therefore I didn't know it I read it again now I really know it and then oh really yet again and I totally nailed it and that may not be true in fact rereading material over and over again is a very low-end form of learning style and person one of the most common ones and this can be pretty illustrated by a famous experiment from 1979 which took a very familiar object and that everybody should have now and this penny experiment asked people to score out to actually choose which was the real illustration the penny which had all the characteristics of a penny forty percent of people from this very everyday object couldn't identify the correct one take a minute and I want you to do a couple of things first of all I want you to think about which is the correct illustration of the penny and then I want you to tell me how then I want you to think about how confident you are in that response so take a look at those 15 choose your penny and then think about how confident you are in your response okay everybody has lived with pennies their whole lives or most of me 20 years but since I moved to the states and the correct one is number 12 and you may have thought that you may have got that that right if you're in that 40% of that group that did the original study but how confidently this is something that you see virtually every day now another experiment much more recent one I was going to do this live until I realized that about just under half of the audience listening to this talk would actually have this symbol in front of them they did a very similar experiment with a very common logo the Apple logo and decided to ask how confident were people in guessing the correct one and rather than go through that process again if you you can take a minute to think about which one is the correct one and the Apple users you've looked already haven't you it's B what they found that most Apple users still got it right some Apple users still got it wrong PC users got it wrong more regularly but Apple users were overconfident in how well they thought they were the guessed thing they could frequently were confident about getting the wrong answer when they got the wrong answer so there's that level of learning illusion that I'm pretty confident than I know this material but I hadn't assessed what I what I really know I am trying to apply the information or use that information and that's at that point where I might find out I don't know it quite as well as I should do and this is where questions can come in and be very useful so there's another study here from 2010 and their study divided students into three groups and gave them a passage to read and then I set them on that passage immediately after they after the study and then two days after the study the three groups were divided into students who were allowed to read the passage again the readers and so this these people right here were allowed to read the passage again these students here asked to answer a few questions on the passage and these students here were asked to generate questions on the passage and before and they before they did any testing at all they asked is how well they thought they would do and you see that the readers and those questions thing they're gonna score in the low sixties but those that generated upon the passage before taking a test we're more confidently they're getting into the most 70s there two days after after being tested their confidence is a little less everybody who's dropped down about the same level but how did they do it with performance this is really how they expected to do this is how they really did the readers did less well than they thought they would do those that were tested and me I am after were answered questions before they were tested did better they were these guys were overconfident these guys were under confident and it turns out that those are generated questions got it about right but their performance was no better than those that entered answer questions rather than generated them two days they were tested again on details of that read passage everybody's performance have gone down it all started to forget but it was still the unanswered questions and even generated questions they thought about their the material much harder than those that had simply reread it so certainly asking questions had a huge benefit and nearly 15-point difference here between the two people the scores of those two groups asking questions is very very powerful so we're going to do a little exercise right now and you can write in the the chatroom very common scenario for a medical education here as we're going to have a quick vignette and then we're going to ask the students questions this could be a scenario on on rounds it could be the start of a test question so 55 year old woman presents with 24 hours of Shor's breath sio2 is low of 88 she's got chest pain which is sharp she's lightheaded when she changes position and she's now in the edie if you had that scenario for your students and you present that in the classroom or in the clinic as he present such a patient what kind of questions would you ask students chad has come up with what else do you want to know explain the pathophysiology what conditions in the lung would cause pain how do you interpret this presentation history for how you asking a psychologist about this why would this patient be like feel light-headed those responses are really good because they're not usual and I know that some of you have done this will workshop before and so I'm gonna stop there because the most common questions that are asked in question now in the classroom don't start off with why or explain they start off like this these are the common questions for such a scenario what is the most common cause of chest pain in the middle-aged woman what is your differential diagnosis what do you not want to miss here what do you think our arterial co2 is high or low so to the psychologists there and what is the first test you should order and this is the most common sort of question that you will see because the commonality nor were these questions is they all begin with what and that wasn't quite with how you responded which is great because what question is presented you with a problem in the classroom problems that they present in a classroom as they frequently just asked for basic facts so the first question you know what is the most common cause of chest pain in the middle-aged woman if the students don't know it they're stuck and they're trapped in not knowing what is you're different and so they all produce one two three word answers as well that was short what it was the first test you should order well the answer that you will likely get there is EKG what is your differential diagnosis might be myocardial infarction or pleural effusion and these are very sort of stop-start responses that don't really lead to anything significant discussion they're dead ends and they're challenging questions and they produce either right or wrong answers it puts the more timid student at risk of being proved wrong and they're challenging almost aggressive in the way that you can ask these questions is you either know this or you don't it's not going to lead to an open discussion it's almost punitive if they're going to get it wrong and maybe congratulatory if they if they get it right but if they come to high-risk question to answer if you're in a large group and you're a timid student so we're not going to really develop full answers here and so these are the most common ones not obviously in this group so we'll doing a good job here so how are we going to use these questions more effectively well we all know from previous teach workshops and and recent literature that the role of the medical educator is changing and it's getting away from that interpretation of or delivery of just straight fat here because the students have much more ready access to to information than older generations ever did it becomes much more important for us to be a guide through that information rather than just to deliver it and that teach the students how to gather that information and how to apply it and how to analyze it that is the proposed changes at to the role of medical education medical educator now so really it's for us to get those students up Bloom's taxonomy up to a higher level and if we can do that and we ask questions that are at the level of tech asking the students to analyze information rather than regurgitate it we see a much greater before increasing performance so a lot of studies have looked at this this issue there's a wide range of performance gains there studies have included K through 12 as well as undergraduate and and medical school students so but we see significant gains lowest being 12% highest being 27% so if we get our questions up to that level in the classroom and ask our students to just for GERD you take information with those one-word answers then we can start to see significant gains we're asking him to work with that information to collaborate on that information but as I said 80% of classroom questions aren't up at that level 80 percent again a large number of studies so an approximate number I've given you here but 80 percent of them are asking for that regurgitation of information what was the most common cause of chest pain in the middle-aged woman it's a one-word answer and it's just asking for nothing more than a regurgitation so when unlikely to get those performance gains that we've seen missed of course Calvin and Hobbes is always reliable on the educational front and Calvin is doing the his tests and asked where did the Pilgrims land when did the Pilgrims land at flemeth's Rock he writes down 1620 announced to his teep to his exam as you can see I've memorizes his utterly useless fact long enough to pass the test question I now intend to forget it forever you've told me nothing except how to cynically manipulate the system congratulations so that's not our role anymore is to just ask them to regurgitate facts we need them to actually get and something more substantial out of this what happens to the classroom if we do start asking those higher order questions not just asking for a birch attention and quick one-word ask for factoids the result of numerous and quite remarkable first of all the student stay on task much more readily once they're asked higher order questions X and given a more significant question to deal with the students responses also get longer they start giving you more information then there's your opportunity to start looking for that learning a loser looking for knowledge KX is now the students giving you more information on the content that they think they know although they do know or they don't know so we you as the educator start getting more feedback from the student once you started asking more of them and not only do you get more feedback from each individual and you'll get more contributions from more individuals so you start getting a greater quantity to water for information to work with as an educator the students start to also operate amongst themselves which is wonderful so you start to get an increase in peer peer interaction once they start to have to really think they will seek help they will generate help for others and start to enter a interact much more readily once they're given a much more substantial test to do higher up Bloom's taxonomy the students start to use complete sentences in their in their responses as well now this may sound a little bit obscure but I can ask a fairly complex question about pulmonary shunt physiology and I will have a student just shout VQ as the answer and that doesn't tell me very much I know that they're in the ballpark and they probably do know the answer but it doesn't really help me develop an understanding of the students full knowledge or lack thereof they also start to think more they'll also be braver about being wrong because you've given them that wiggle room in a more elaborate question to actually maneuver their thinking the speculation spin is promoted as well so they start to actually think more and am more open about being wrong and more much more discussive as well yeah and it'll also turn around to you and ask more relevant questions so that discussion context being developed can start with love you know these seven points come from a amalgam of about 15 papers I've squashed everything and summarized everything together but is it strong evidence that all these can happen and this seemed as if it's an almost a magic bullet for a silver bullet for the for the clash and the solution therefore is just to simply ask higher order questions so why aren't we all doing it and come to that in a minute because we're not doing it very regularly or only 20% of the time because it's hard when we get those more speculative answers and when the students are providing those with complete sentences and they are being discussing more openly amongst themselves we start to see their thinking and we don't just see whether they've got the answer right or whether they've got it wrong we start to see where they go and we start to see what their metacognitive processes as well so that allows us to assess what the student how they're assessing the problem and it allows us to see and help them develop their metacognitive skills to go back and think how well they've done I think where they went wrong and to start to self-reflect medical students early medical students are do not have strong metacognitive skills they don't tend to self reflect as much as they perhaps need to start to develop that skill so that they can become effective self reflective physicians we can also start to look for cognitive bias as well whether the preconceptions are actually established and we can break through some of those biases but as you start to see their thinking you can develop it and be that role model for that lifelong learning of being able to assess how well they're doing in terms of that cognitive process and at sea and where how you could differ help them develop it so with that now many of you did rather well with the with the other questions let's go through this case against the asking instead of those fact Windell questions of wounding questions that might track students in one-word answers we've already had some pretty good responses but what I wanted to do is just take a couple of minutes now and develop mean questions and see how well we can do to get up Bloom's taxonomy to application or something that will allow us give the students room to answer without trapping them in a one-word answer or a right or wrong answer how would you figure out why she has become lightheaded I'll talk about how comfortable a length the time it is before we wait for an answer or move on a little bit explain to us psychologist what you think is going on Thank You fantasy again review the basic physiology with you appears can you identify interconnections in these symptoms alright thank you so I've got some examples here this is these are a selection of questions why is the Leo 2sat the concern why would you change why would the change in position produce lightheadedness very similar to one of the questions that I was given by you guys how might a chest pain be related to to our oxygen saturation how would knowing she had a high arterial pco2 and influence your diagnosis so the big difference to these and obviously as agreeably did rather well the first time for the big difference is they were asking how or why questions and this is exactly what you've asked done coming your second responses as well asking that how or why or predict not what we're asking explained instead of which and giving choice allows the learner to this move and and that doesn't track them in this right or wrong answer that you can end up allowing them to develop their answer and develop it with them so identifying those connecting to connections in these symptoms was was one of them one of it was Kathy suggestions and it allows them to stop and take time to think about that content and start piecing those pieces together and elaborating on the knowledge that they have as they suggested good questions should do at the beginning of this presentation so it allows the learner to move and it allows the student as well to get something right not everything they say needs to be right but it allows them to get something right that you can reinforce their correct statement that they want maybe build confidence in that you but doesn't leave them tomorrow lines like I mean asking is that co2 gonna be high or low they say low as no it's going to be so I proved them wrong in front of their peers this allows them to maneuver and get at least something right I'm going to come back to that point in a second it also of course reveals their thinking and this is what you're really hunting for is not only just do they get the right answer but how did they arrive at that answer by asking these more elaborate how why predict or explain questions you get that much fuller answer and you get much more information as an educator and it stops them guessing as well so when I asked about high or low co2 for this patient they may get it right through a gas runs that but I will never know that so if I change the co2 do question two why or how then I can get a much better understanding of their basic and basic ability to process and information allows you to also build on their their ads for as well and if they're not doing very well and they're only getting halfway there it allows you are opportunity to instead of declaring them to be wrong allows you to ask them questions if they get stuck or to give them hints to help them along as well so you can get over a small head and also that they can achieve their learning goal if you were able to actually identify those hurdles why are we doing this a little too hard it's because it's hard it's difficult and it takes preparation and when I started to monitor my own question asking in classroom I realized how many watts I started with and I really have to focus on preparation and building those questions are up because they're really difficult to generate on the fly and I challenge you when you're in front of your learner's next time to actually come on us and we think when you're asking a question what word did your question start with if you're like me and before you became much more adept at this then it was nearly always what rather than why because they're hard to develop to lead the student down that road of learning and down that road of learning you can plan your destination if you put in series block Y questions throughout your classroom or clinical time you can have that that sequence of questions set up to lead their student all the way through to the end and your meet your learning objectives so for example I will ask why the questions about a pulmonary patient with obstructive lung disease but I ask piecemeal why questions all the way to the end to answer an overall learning goal but there take strategized and that's really got to be built into your less to the planet is to be done effectively and to do that one way to follow that plan throughout your without throughout your classroom time or clinical time it's descriptive question particularly in the classroom included in the PowerPoint so it gives you that benchmark of leading a student through your learning plan so that there are you're establishing that depth at that goal but don't stick to that plan to do rigidly remember you're supposed to have been promoting curiosity in these excuse and so if the students take you off topic a little then they let them go don't bring them back to to your script that's not hard and fast and you can still pull out of those teachable moments even if there are unplanned and maybe deviate but not go off top deviate from your plan but not go off topic so how are you going to do this in a safe learning environment and we all know that asking questions often met with stunned silence and so there's kind of little things that we can do to the address that we talked about earlier on getting comfortable with being uncomfortable that uncertainty I make your own limits be comfortable with being uncomfortable I will be those questions that I don't know the answer to and I congratulate the student for a really good question I've never thought about that I'll admit it or I don't know but be completely open about it and no hand waving you you're developing that role model for being curious lifelong learner be excited about getting a question that you can't answer and congratulate the student and call it a good question no hand waving of you don't need to know that yet or you'll learn that later you're killing curiosity without answers such as those so a little bit as I mentioned with your strategic question planning if you take that route don't be too rigid with your lesson plan and go with their curiosity and go with their ideas as well if they want to know something help them learn it even if you don't know the answer immediately support their curiosity its recur throughout your lesson and even ask questions of the students to encourage that curiosity people when you get a good answer or get a good question be physically excited about it it's it promotes that enthusiasm it promotes engagement and yet again promotes that curiosity in the students it's part of your role model as an educator is to is to bestow that curiosity and enthusiasm and to demonstrate it to you let the note students know why you are asking questions because otherwise it can seem aggressive that you're testing them frequently they're the learner may be gone through a history of just rigorous testing through high school through undergraduate and medical school even and it's been five States and to get something wrong is is difficult for them and so to tell them that you're doing this to enhance their learning is a powerful tool it will relax them and actually promote in your classroom environment as well that you are doing this not to give them a grade but to actually enhance their learning so what do you do when you're actually in the classroom this is the picture of Richard Schwartz Pima College colleague of mine from Boston and research and education member of mine first thing to notice is he's smiling it looks enthusiastic doing that goes a long way if you're brave enough start your class with a question rather than anything else come up with a slide with a mini lecture but get the students engaged immediately even if you they have to think about something that they haven't thought about before that's perfect you're promoting that curiosity again it gives you a benchmark of where your students might be and but starting Artful with why do you think this happens as as a way to get that student is a great icebreaker to get them to work in groups just get them immediately immersed into that into the material by thinking about it rather than just listening to you now there's two wait times and where this is the infamous one that when you've asked a question how long do you wait for an answer and of course educators are infamous for leaving very little time between asking ending their question and not answering it themselves estimates are between one and three seconds and don't wait you've just asked now why question in particular or a how question give them time to think seven seconds is a long time when you've got dead air in a classroom or in front of that group of residents and it's uncomfortable but it's not just uncomfortable for the student probably be uncomfortable for you so wait at least seven seconds and if you go over ten its regarded may be perceived according to a couple of papers as being punitive so if you go over 10 seconds us maybe - are we imagine gap for answered look before you and either enter and rephrase the question or encourage an answer or the worst case scenario to answer the question there's a seven to ten and this is Richards one one one of his rules in the classroom is never leave a student not having said something correct you have with these why what why how explain questions opportunity to rephrase the students answer or provide them a hem Auto to lead them through you've got that support rather than that yes No one two three word answers that don't give you that opportunity but if they are struggling help them but don't move on from that student without having given them opportunity to have had something to contribute to the class once they've answered that question either fully or partially or correctly or incorrectly with your help some of it will have been correct where's the rest of the cracker class if they agree or have something else to offer now this means that they don't get away with your question just being answered by the bio student over there they've still got to contribute and it denotes that you have this expectation that they're going to still be engaged if you get that superficial response such as the example I gave before that blurted out veq when I ask a complex question don't move on from it don't say yes that's right for what did yeah that's what they really meant ask why or if the student becomes uncomfortable don't ask the whole question yes VQ is what's vq you see there's a wall question why is VQ relevant and why is this low oxygen saturation occurred because of the EQ so don't move on if you do get that blurted out incomplete or superficial response you're looking for that analyze make sure that the student can get there here's whate time number two and this is one of my cardinal sins in the classroom that I've become much more cognizant of and have tried to correct wait nine wait time at number two is once you start the student starts responding there is a great tendency for you to finish their question and say yes good BQ so I'm gonna fill in all the missing gaps for you you're cognizant of your classroom time you don't want a rambling answer we've got to move on because we've got to get all through with all this material let the student finish let them have a complete answer and even leave a gap when they finish talking now that gap when they finished talking can encourage a longer response or is opportunity for other students to step in before you rush in as the educator at the room and take over so leave that gap there as well applauding a student reinforcement is important it depends particularly on the student some will require it some will not whatever you do don't overdo it or of course it becomes meaningless and here's your nemesis in the classroom is in your learning environment can be absolutely destroyed by smarty-pants the student in the classroom who can frustrate or deter other students with their persistent answering arm straight up in the air every time they want to get every question and it means that the other students can a non engage they step back and so don't have to do anything it can also be a great deterrent by frustrating the other students in the classroom they're smarty pants in the classroom the high flyer they've given up a tunity can start asking these very call answering in a very complex manner adding lots of detail really wanting to tell you how much they know and now that may not be the right level that we need to go to it may be too deep it may be time to frustrate the other learners who aren't there yet and that's when smarty pants can start you shut your classroom down a little or your clinical group they can take you off topic very quickly as well so to demonstrate their knowledge and their powerful curiosity about your topic they will there be your way and very complex questions not only just providing complex answers but allow you be a distraction to your strategy now this is somewhere where their curiosity might be tempered somewhat there's ways to do that first of all with that persistent answering all the time if you just tell them it's somebody else's turn to answer that's a fairly simple solution they may count but I'm sure the okay and if they start getting too complex ask them to discuss it later with you you're very happy you don't want to kill their curiosity but now it's not the time and let's make sure if you do that and you want to defer that question then follow up don't de fobbing them off and producing sort of a hand waving approach and ask them to do this time after class or arrange that that time to take that opportunity to go through that deep alone learning rather than in the classroom which is going to consume time but much more importantly frustrating deter your other students so to summarize as you said the Silver Bullet hard to do but has a profound effect on your learning environment and the engagement of the students which is shift to why and how professions and away from what give the students time to aid I guess the question and then also ask give them time to answer the question as well without jumping in even if the answers that they give is correct that's the more push for that that engaged when pushed for that then that information that you want to determine how well they've really understood the information and promote that pip here once you've got a correct or incorrect or just an incomplete answer you don't necessarily have to take it on yourself punting out to the rest of the group encourage them to be engaged in the process as well and promote that peer peer interaction which is very very powerful the don'ts don't hand way if you don't need to know that yeah this is too deep you'll learn that later somewhere that will be true but you don't kill that curiosity thirty seconds of a little bit more complex material is okay you don't need to do 15 minutes watch out for smarty pants in the classroom and so this is where those complex that complex question that can't be dealt with very quickly or briefly or is happening to regularly make sure that you're staying at the level of the learner and I've done they are distracted by either your own curiosity which may not be shared by the students or by their after a high-flyer in the room and then there's the question that never gets an answer never asked does everyone understand because that's ug followup with the sounds of bags being packed and chairs being pushed back that it's a signifier that the class is over and it's time to go home you really could get anybody you can walk voluntarily in any group put their hand up and say I don't understand and you can do when you've established your learning group oh you live in an environment and that's the great moment but you've got this is almost a pointless question give them something to go out rather just explore their ignorance okay I think that's all that I have and we've got ten minutes if anybody's got any questions I see a couple of questions here I see one from Elena would you start with easier questions and move to more complex questions later no I wouldn't I'd start with the complex questions dive straight there engage that get that process going the easy questions so much as the thing if you're referring to the notes with a factoid all questions tend not to leave your great icebreakers any way to get the classroom working or to get working they turn to substantial and to promote discussion you don't need easy questions get them thinking and I'm thinking from the get-go is my will be my choice too many certainly what the literature and then Chad asks how do you balance asking questions to engage learning curiosity and only covering one of ten things that were required to be covered so your use of the word balances is absolutely I wouldn't so if you're only covering one out of ten things that you were supposed to be covering your balance as well you can if the curiosity is getting out of control which is a wonderful thing then you can like with it it is not just for the smartypants when you shift over to getting that curiosity built up and you may have to say well you can let's discuss this later we've just got this to cover but don't kill it it's okay to miss out a couple of things as long as the students say you know you're honest with the students that hey listen we've had some good discussion yeah we've got some thoughtful feedback I thought thoughtfulness in the classroom these are the two things that we didn't cover that's okay you can if there as long as the students are aware of what was missed you don't necessarily have to get through all ten we all have the luxury of working with highly intelligent people and they're very capable of learning by themselves if they struggle and what you need to do is have that openness that they can come back and say hey those two things that I missed I'm still struggling with and I think that that finding that balances is something of an art form but there's something that comes with a little practice great the next question is is there a good way to balance between asking the entire class as opposed to specific students asking specific students is fairly risky when he left the entire class the higher end wisdom attenti answer and then today you are at risk of intimidating or frustrating the lower end and so it's control if you are separated there in two groups so she'll go to classes such as the Medical School forty students you've got groups small groups of seven or eight then ask the group rather than the full class finding there are a couple of ways to sort of find the individual to ask if you have an introverted student who we know when you posed the question to the whole group but you know that they have an answer that's correct that's when I would ask but I wouldn't say I'd direct the question directly I'll give you an example while I'm giving my active classroom something to do they have their own tasks they've been given this task to perform I want around the classroom to see how they're doing and I listen to the conversations and I find I hear that introverted student give a really good or at least correct answer or comment I'll come back when we come back as a whole group I'll say I'll ask that question and say hey you had a really good answer for this and lets them engage in a safe way that they know that they've been reinforced already and they can set off into an answer that they know is already correct that that is quite frankly a balance they're picking on students cold is not recommended if you threatened to pick on students cold that's frequently enough though there was an app are that used to be available called pick me I've just told the students I had it on my phone and that it was going to randomly ask when I come up with a name to ask question and I never had the app of my phone but it really picked up the classroom because they thought there was a danger that my name is going to come up and then so I should listen and engage because I want to be ready to go I think another thing that I've heard is really just eye contact with your learners right really sort of engaging with your learners on that level so you can see there's often times you'll see a learner like start to say something and then then they know it all will type in with their answer or something and if that happens you can sort of recognize that maybe they're ready to answer but just can't speak it up love enough yeah I mean your media seats for the students and your awareness of your own classroom is critical and and to Francis's question that that's your starting point is you're assessing it's going to be uncomfortable it's going to be overly zealous and and you can see frustration so you can deal with it and you can even ask a frustrated student you know why you frustrated and get-get peers to help them as well as yourself sorry go ahead you can see is there any damage to a curiosity if you will start stand out in the class with a complex question on a topic of which students do not have a sufficient preparation potentially if you start off if you don't think they are prepared enough then rethink a question you've got to give them something to go on you can't set them up without the building blocks if you if you my personal preference is if you think you are asking something that is overly complex let them know this is tough this is hard what do you think this is a difficult problem and then but really starting off with a complex question I think generates that then engage with overly complex but and maybe some frustration too but too much frustration turns our students off so this is where those that pre-design of those why how questions becomes critical because it's a hard to generate them from the get-go and my immediate default is what so I've got to think and if I'm running through a classroom and already going and then that thinking is hard because I don't do it on very naturally I've got so having them pre-prepared is good you can put them into a strategy but gauging in that preparation you can gauge the level of complexity that is going to generate some frustration which is good but not limiting level of frustration that's going to just turn them off and which no be reaching for the tool that's great and that is challenging yourself because it is really a lot easier to ask those what questions I mean those are the ones that come to us naturally but really speaking deeper I think those are our immediate questions that's what you know that's so it is that quick sort of spot questioning or quizzing that keeps them down at that low level isn't really promoting but it's got to be followed up with that time for thought and if you're going to give a very complex questions let's split them up say it's two minutes thank you so much Andrea this was an excellent exploration and you how to ask questions for effective and a deeper learning I love the my favorite was the Schwartz team rule never leave a student not having said something correct I think that's so important in something that we often don't pay enough attention to I mean everyone likes feeling successful right and you feel more successful in your learning if you're answering something correct and really building on personal successes is one of the key factors to enhancing one's own its self-efficacy which is super important to to effective learning and so I'd like to encourage you all as andrew has to challenge yourselves this week to be very thoughtful if you're teaching anybody this week about how and why you're asking the questions and then reframe your questions in a way to really develop that higher understanding and to really get to what you want to get from your learners and to enhance the learning environment and if you think about for those of you who are involved in teaching the residents and fellows this is one of those ways to really I mean if you're showing enthusiasm like Anders talked about if you're on styling if you're really in crude asking great questions this will automatically this is one of those no-brainers you're encouraging an environment of inquiry which is one of those things that is so difficult for us to get to on those ACGME surveys nobody ever knows what a spirit of inquiry or an environment inquiry really is it really means until you create an environment like this if you create an environment like this it's gonna be second nature for those residents to say absolutely that faculty member created their encouraged a spirit of inquiry or an environment immediately so I challenge you to do that thank you so much Andrew this was lovely if there are no more questions right now we're going to go ahead and adjourn and if you have further questions for dr. banks he can be reached Andrew what's your email address just a bgt ee d yes he is a BT email address so I hope you all have a lovely day thank you for everything you're doing and please stay well enjoy your day.