It's worth the wait: optimizing questioning methods for effective intraoperative teaching.

Area of Science:

• Medical Education
• Surgical Training
• Cognitive Learning Theory

Background:

• Effective questioning is crucial for resident education during surgery.
• Higher-level questions and longer wait times (over 3 seconds) promote deeper learning and better retention.
• Intraoperative learning environments require specific strategies for optimal knowledge transfer.

Purpose of the Study:

• To investigate the nature of questions asked during intraoperative surgical education.
• To analyze the cognitive level of questions and the wait times for resident responses.
• To identify opportunities for improving teaching effectiveness in the operating room.

Main Methods:

• Observation and recording of 12 laparoscopic cholecystectomies.
• Transcription and classification of all questions using Bloom's Taxonomy.
• Measurement of question-to-response wait times.

Main Results:

• 84% of 133 questions were at Bloom's levels 1-3; only 6% were highest level.
• Average wait time for resident response was 1.75 seconds; attendings intervened after 2.50 seconds.
• Question complexity and wait times did not differ by resident year, indicating a lack of tailored questioning.

Conclusions:

• Current intraoperative questioning primarily targets lower-level thinking, limiting complex responses.
• Short wait times (under 2 seconds) impede opportunities for higher-order thinking development.
• Increasing question complexity, tailoring to learner level, and extending wait times can enhance resident learning and retention.