Wednesday, 1 October 2014

Can nurse education make you a better teacher by asking better questions - Part Two


In my previous post I adapted the work of (Stillwell, Melnyk, & Williamson, 2010)  to help evidence-based educational practitioners go about the task of devising well formulated questions.  In this post I intend to further adapt Stillwell et al's work  and look at the differing types of questions that can be asked.   But first a quick recap

PICOT is an acronym for the components of a clinical question and are as follows:
P — Patient or Problem. How would you describe the group of patients or problem?
I — Intervention. What are you planning to do with your patients?
C — Comparison. What is the alternative to the intervention (e.g.different intervention)?
O — Outcomes. What are the effects of the intervention?
T  - Time.  What time does it take for intervention to achieve the outcomes.

Question types

Having created a well-formulated question, it is worth reflecting on the type of question-which has been created and is illustrated in the following table and which has been adapted from (Stillwell, Melnyk, & Williamson, 2010).

Question type
Definition
PICOT question
Pedagogical intervention
To determine which pedagogical intervention leads to the best outcome for pupils/outcomes
For students requiring students requiring additional learning supported how does the provision of 1 to 1 support compared with group support affect retention rates in the first term?

Etiology
To determine greatest success/risk factors
Are level 3 BTEC Extended Diploma students who have grade C or above in GCSE Mathematics compared with those students who do not, more likely to successfully complete their two year programme of study?
Diagnosis
To determine which test is more accurate in diagnosing learning needs
For students requiring support in the development of English skills,  are GCSE grades a better indicator of needs compared to specific on-line screening tool (eg BKSB)?
Prognosis or prediction
To determine the course over time and likely complications of a particular condition or pedagogical intervention
Do weekly tutorials for students with poor records of attendance improve timely completion of coursework within three months of the initiation of the weekly tutorials?
Meaning
To understand the meaning of an experience for a particular group of  students
How do further educations students with grade D or below in GCSE English perceive re-siting GCSE English during the first year of post-16 education?

Straus et al 2010 have suggested a series of filters which could be used to identify the most appropriate question to ask in a particular situation.  I have adapted the suggested filters so they can be easily transferred to an educational setting.
  • Which question, if answered, will be most useful for our learners' well being - academic or personal?
  • Which question will be most useful for subject leaders, heads of department in gaining a better understanding of the issues at hand?
  • Which question will be most useful in helping to improve the department, school or college?
  • Which question is most likely to re-occur and will need to be revisited in the future?
  • Which question is most interesting to you as an evidence-based practitioner and contribute most to your personal professional development?

I'm sure that some colleagues are saying that they do not have sufficient time to formulate questions in such a structured manner.  On the other hand, as Strauss et al (2010) so clearly articulate - again amended for evidence-based educational practitioners - there are a number of clear benefits of such an approach:

  • Focussing our scarce professional development time on the needs of our learners.
  • Making it easier to communicate with colleagues.
  • As our knowledge grows we are role-modelling to our colleagues lifelong learning


I hope you agree with me that by asking better questions we can expand our skills as evidence-based practitioners.  In future posts  I will continue to explore the challenge of asking better questions and will be drawing upon a number of differing perspectives.

References

Straus, S.E., Glasziou, P., Richardson, W. S. & Haynes, B.R. (2010)  Evidence Based Medicine : How to practice and teach it, (4th edition), Churchill Livingston.
Stillwell, S. B., Melnyk, B. M., & Williamson, K. M. (2010). Asking the Clinical Question : A key step in evidence based practice. American Journal of Nursing, 210(3).

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