Asking Answerable Clinical Questions Paul J Rummo D

Asking Answerable Clinical Questions Paul J Rummo, D. O. Assistant Professor Orthopaedics Vanderbilt Sports Medicine Center

Asking Answerable Clinical Questions Background Questions general knowledge 2 essential components 1. a question root & verb 2. aspect of health care Foreground Questions specific knowledge 4 essential components 1. patient/problem 2. intervention 3. comparison 4. clinical outcome

Reaction to Knowing / Not Knowing “Cognitive Resonance” – what we know “Cognitive Dissonance” – what we don’t know Turning “Negative Space” into “Positive Space”

Where & How Clinical Questions Arise Central issues involved in patient care – doctors + patients clinical findings etiology clinical man. of ds. experience/meaning diagnostic tests prognosis therapy prevention ddx improvement

Selecting, Scheduling & Saving Questions to Answer Selecting – filter process important to patients wellbeing relevant to knowledge needs feasible to answer within time period interesting recur in practice Scheduling – when questions answered Saving – options

Why Bother Formulating Questions Clearly ? Focus learning time relevant to patients’ clinical & our knowledge needs Suggest high-yield search strategies & forms useful answers might take Communicate clearly w/ colleagues Understand content of teaching Improve as clinicians

Teaching the Asking of Answerable Clinical Questions Recognize – opportunities for learner to build good questions Select – opportunity best fit needs of patient + learner Guide – transforming knowledge gaps into well-built clinical questions Assess – performance + skill for practicing EBM

Teaching the Asking of Answerable Clinical Questions “Educational Prescription” 1. specifies clinical question 2. states question + key elements 3. specifies who is responsible for answer 4. reminds of deadline for answer 5. reminds steps of searching, critically appraising + relating answer back to patient

Teaching the Asking of Answerable Clinical Questions “Educational Prescription” Role Reversal supervise question-building – improve skills admitting our knowledge gaps sustains group morale prepare for role as clinical teacher Patient Presentation