title: Medical Students' Understanding of Directed Questioning by Their Clinical Preceptors.
abstract: Phenomenon: Throughout clerkship, preceptors ask medical students questions for both assessment and teaching purposes. However, the cognitive and strategic aspects of students' approaches to managing this situation have not been explored. Without an understanding of how students approach the question and answer activity, medical educators are unable to appreciate how effectively this activity fulfills their purposes of assessment or determine the activity's associated educational effects.
  
  
  METHODS
  A convenience sample of nine 4th-year medical students participated in semistructured one-on-one interviews exploring their approaches to managing situations in which they have been challenged with questions from preceptors to which they do not know the answer. Through an iterative and recursive analytic reading of the interview transcripts, data were coded and organized to identify themes relevant to the students' considerations in answering such questions.
  
  
  RESULTS
  Students articulated deliberate strategies for managing the directed questioning activity, which at times focused on the optimization of their learning but always included considerations of image management. Managing image involved projecting not only being knowledgeable but also being teachable. The students indicated that their considerations in selecting an appropriate strategy in a given situation involved their perceptions of their preceptors' intentions and preferences as well as several contextual factors. Insights: The medical students we interviewed were quite sophisticated in their understanding of the social nuances of the directed questioning process and described a variety of contextually invoked strategies to manage the situation and maintain a positive image.
authors.affiliation: a Centre for Health Education Scholarship and Division of Geriatric Medicine, Faculty of Medicine, University of British Columbia , Canada.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lo
authors.affiliation: b Centre for Health Education Scholarship and Department of Surgery, Faculty of Medicine, University of British Columbia , Canada.
authors.forename: Glenn
authors.initials: G
authors.lastname: Regehr
mesh_terms: D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D011231:Preceptorship; D036301:Qualitative Research; D013337:Students, Medical / Q000523:psychology*
keywords: Clinical teaching; Socratic method; pimping; student questioning