As a nursing instructor, using effective questioning techniques can significantly enhance students’ clinical judgment skills. Thoughtful and strategic questioning encourages critical thinking, reflection, and the application of theoretical knowledge to real-world patient care scenarios. Here are some strategies to use questioning effectively in nursing education to improve students’ clinical judgment:

1. Open-Ended Questions: Encourage students to think deeply and critically by asking open-ended questions. These questions do not have a single right answer and require students to explore different perspectives and possibilities. For example, instead of asking, “What is the correct nursing intervention for this patient?” ask, “How would you approach this patient’s care, considering their current condition and medical history?”
2. Case-Based Questions: Present students with real or hypothetical patient cases and ask them to analyze the situation and propose appropriate nursing interventions. Discuss the rationale behind their choices and encourage them to consider potential outcomes and complications.
3. Socratic Questioning: Use the Socratic method to guide students through a series of thought-provoking questions that lead them to arrive at conclusions independently. This approach helps students develop their critical thinking abilities and enhances their clinical judgment skills.
4. Why-How-What Approach: When discussing patient care plans or clinical decisions, follow the “why-how-what” approach. Start by asking why a specific intervention is chosen, then explore how it will be implemented, and finally, discuss what outcomes are expected. This method encourages students to consider the rationale behind their actions and the impact on patient care.
5. Predicting and Evaluating Outcomes: Encourage students to predict potential patient outcomes based on their proposed interventions. Ask follow-up questions to explore the possible positive and negative consequences of their decisions. This exercise helps students connect their actions to patient well-being and safety.
6. Reflective Questions: After clinical experiences, simulations, or case studies, use reflective questions to help students assess their performance and clinical judgment. Ask them to identify what went well, what challenges they faced, and how they could improve their decision-making in similar situations.
7. Ethical Dilemmas: Present students with ethical dilemmas commonly encountered in nursing practice. Engage them in discussions about how their clinical judgment and decision-making process may be influenced by ethical considerations.
8. Group Discussions and Peer Learning: Encourage group discussions where students can share their perspectives and learn from each other. Peer learning fosters collaboration and exposes students to diverse viewpoints, enriching their clinical judgment abilities.
9. Real-Time Decision-Making: During clinical rotations, challenge students to think on their feet by asking questions about patient care in real-time. This exercise simulates the fast-paced nature of nursing practice and helps students develop quick and effective clinical judgment.
10. Feedback and Follow-up: Provide constructive feedback on students’ responses to questions and track their progress over time. Follow up on previous discussions to reinforce learning and allow students to demonstrate how they have integrated feedback into their clinical judgment process.

Examples of Questions you can Ask to Help Students with Clinical Judgment

1. “How would you prioritize the nursing interventions for this patient, considering their current condition and medical history?”
2. “What are some potential factors that could be contributing to this patient’s symptoms, and how would you go about further assessing them?”
3. “Describe your thought process when determining whether to escalate care for a patient who is showing signs of deterioration.”
4. “In this patient scenario, what are some alternative approaches you could consider for pain management, and how would you decide which one to implement?”
5. “Imagine you encounter a patient whose cultural beliefs differ significantly from your own. How would you approach providing patient-centered care while respecting their cultural preferences?”
6. “When dealing with a complex wound, how do you decide on the most appropriate dressing and wound care regimen for the patient?”
7. “Describe the steps you would take to ensure medication safety when administering high-risk medications to multiple patients simultaneously.”
8. “In a situation where a patient’s values and preferences conflict with the treatment plan, how would you handle the ethical dilemma?”
9. “What information would you seek from the patient and their family to better understand their psychosocial needs and support systems?”
10. “Discuss your approach to gathering evidence-based practice resources when facing a new and unfamiliar patient condition.”
11. “How would you adapt your communication style when providing education to a patient with limited health literacy?”
12. “When preparing for a patient handoff, what critical information would you include to ensure continuity of care?”
13. “In a rapidly changing clinical situation, how do you maintain situational awareness and make swift but informed decisions?”
14. “When encountering a potential medication error, what immediate actions would you take, and how would you prevent similar incidents in the future?”
15. “Explain how you would assess the effectiveness of a patient’s treatment plan and modify it based on their progress.”
16. If you implement this specific nursing intervention for the patient, what are the potential short-term and long-term outcomes you would expect to see?”
17. “What are some of the potential complications that could arise from the medication regimen you’ve suggested, and how would you monitor the patient for these adverse effects?”
18. “Based on the patient’s current condition and response to treatment, what do you anticipate will be the next steps in their care plan?”
19. “Imagine the patient’s family has concerns about the proposed surgical procedure. How would you address their fears and help them understand the potential benefits and risks involved?”
20. “Considering the patient’s comorbidities and medications, what potential drug interactions should you be vigilant about when adding a new medication to their regimen?”
21. “If you choose not to intervene in this particular patient case, what are the potential implications for the patient’s health and well-being?”
22. “You’ve administered a potent pain medication to a post-operative patient. How would you evaluate its effectiveness, and what alternative pain management strategies might you consider if the patient’s pain persists?”
23. “The patient is refusing a crucial diagnostic test. What are the possible outcomes of this decision, and how would you approach this situation to ensure the patient receives appropriate care?”
24. “Considering the patient’s age and underlying health conditions, how might their recovery differ from a younger patient with a similar diagnosis?”
25. “The patient’s lab results show abnormalities in their liver function. What implications might this have for their medication management and overall treatment plan?”
26. “You suspect the patient is experiencing a medication side effect not previously documented. How would you further investigate this, and what steps would you take to prevent further complications?”
27. “You’re planning to discharge the patient with a chronic condition. How would you assess their readiness for self-care management, and what could happen if they struggle to adhere to their treatment plan?”
28. “If you decide to use an alternative communication approach with a non-responsive patient, how would you evaluate the effectiveness of this intervention?”
29. “The patient’s vital signs indicate a subtle decline in their condition. What actions would you take immediately, and what outcomes are you hoping to achieve by intervening promptly?”
30. “You suspect the patient may be experiencing a psychological response to their diagnosis. How might addressing their emotional well-being impact their overall recovery and treatment outcomes?”

Remember that the goal of questioning in nursing education is not just to test students’ knowledge but to guide them in developing their clinical judgment skills. Creating a supportive and inquisitive learning environment empowers students to think critically and make sound decisions that positively impact patient outcomes.

References

Craig, J. L., & Page, G. (1981). The questioning skills of nursing instructors. Journal of Nursing Education, 20(5), 18-23.

Merisier, S., Larue, C., & Boyer, L. (2018). How does questioning influence nursing students’ clinical reasoning in problem-based learning? A scoping review. Nurse education today, 65, 108-115.

Nicholl, H. M., & Tracey, C. A. (2007). Questioning: a tool in the nurse educator’s kit. Nurse education in practice, 7(5), 285-292.

Saeed, T., Khan, S., Ahmed, A., Gul, R., Cassum, S. H., & Parpio, Y. (2012). Development of students’ critical thinking: the educators’ ability to use questioning skills in the baccalaureate programmes in nursing in Pakistan. JPMA. The Journal of the Pakistan Medical Association, 62(3), 200.