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Explanatory Notes
Guided Learning Experiences - Factual versus Higher-Order Questions
Factual questions ask learners to recall “bits” of isolated information (facts) from memory. A factual question might be, “What is Mrs. Jones’ hematocrit this morning?”
A response to a factual question cannot be derived; responders either know the answer or they do not. Since the ability of residents to recite facts is often unrelated to their ability to see relationships between pieces of information or use that information to solve problems, focusing on factual information during a Guided Learning Experience can be counterproductive.
Higher-Order Questions
Conceptual questions require that learners recognize the shared qualities or characteristics of an event, object, or state. A “syringe” would be an example of a simple concrete concept. A learner who understood the concept of “syringe” could identify many different examples of a syringe even if they appeared dissimilar. The ability to classify objects, physical states, or events by their shared characteristics is the cornerstone of medicine. Diagnosing disease depends on physicians’ ability to identify a constellation of signs and symptoms as common to a defined physical state, such as “pneumonia.” By asking conceptual questions, residents learn to recognize concepts and use that knowledge in their interactions with patients.
Examples
- Compare and contrast the signs and symptoms of pneumonia with those of bronchitis.
- Among the differences are there any signs or symptoms that are pathognomonic for pneumonia?
Principle level questions require that learners understand relationships between concepts. Most often these relationships are stated as principles or “rules.” These “rules” may be absolutes, such as “hot air rises,” or they may describe probable events, such as “Over-consumption of food results in weight gain.” Principles are often presented as “if … then” statements. By understanding principles, residents are able to predict the physiologic course of disease, probable reactions of disease to specific treatments, and the probable reaction of patients to “bad news.” By asking principle level questions, residents learn to use the absolute principles of science and predict medically-related outcomes with some certainty.
Examples
- Explain how differential pressures in the chambers of heart facilitate the movement of blood from the atrium to the ventricle?
- Describe the strategies you might use to help a patient initially cope with a diagnosis of breast cancer.
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