gms | German Medical Science

Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)

15.09. - 17.09.2022, Halle (Saale)

Too much time or not enough? Teacher wait time after questions in case-based clinical teaching

Meeting Abstract

  • Janina Häusler - TU München, München, Deutschland
  • Marc Grünewald - TU München, München, Deutschland
  • Theresa Pfurtscheller - TU München, München, Deutschland
  • Tina Seidel - TU München, München, Deutschland
  • Pascal O. Berberat - TU München, München, Deutschland
  • presenting/speaker Martin Gartmeier - TU München, München, Deutschland

Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA) und des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ). Halle (Saale), 15.-17.09.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV-10-03

doi: 10.3205/22gma061, urn:nbn:de:0183-22gma0612

Published: September 14, 2022

© 2022 Häusler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Posing questions to students is an essential technique that clinical teachers use across different instructional formats, from bedside teaching to problem- or case-based learning. However, asking questions in didactically meaningful ways is not trivial, e.g. regarding the degree of complexity of questions or the amount of teacher wait time (TWT) after posing a question [1]. Especially when complex subject matter is discussed, TWT is valuable because it gives students time to activate prior knowledge and reflect on possible answers. Prior studies, mainly from school-related settings, confirm this notion and investigate, among other aspects, the average length of TWT [2]. However, TWT has not been systematically investigated in medical education. In our analysis, we differentiate between TWT that is terminated by a verbal contribution from a student (TWT-s) or by the clinical teacher (TWT-t), for example, by providing further explanation.

Methods: We video-recorded 32 case-based seminars in undergraduate medical education in the areas of surgery and internal medicine. The sample included 21 different clinical teachers and 398 medical students. The video-recorded seminars were coded with good reliability to give insights into teaching quality and students’ learning opportunities using video analysis software.

Results: In our sample of case-based seminars, 27.3% of all teacher questions were followed by TWT. On average, TWT-t lasted 3.7 seconds and TWT-s 3.8 seconds. We observed a large variation regarding both variables in seminars led by different teachers. Further, we found a tendency toward longer TWT-t after open and elaborative questions and substantially longer TWT-t after reasoning questions. Moreover, after TWT-t, teachers mainly posed further questions, provided students with assistance, like deeper explanations of subject matter.

Discussion: The present study provides first insights into TWT frequency, duration, and its dependency on prior questions in a medical education setting. We found that on average, clinical teachers provided ample TWT and adapted TWT to the complexity of their questions. On the other hand, we found great heterogeneity in our sample, so some teachers did allow students only very few time to ponder about their questions. We hope our study can inspire medical educators to purposefully use TWT as an easily accessible tool that can encourage students to reflect upon and respond to teacher questions. We encourage future research on this phenomenon in different formats in medical education in order to better contextualize the present results and give evidence-based recommendations to medical educators.

Take home messages:

  • Providing wait time after a question is a straightforward but effective teaching method
  • TWT helps students reflect upon questions and find good answers
  • Clinical teachers in our study allowed close to four seconds of wait time

References

1.
Iksan Z, Daniel E. Types of Wait Time during Verbal Questioning in the Science Classroom. Int Res High Educ. 2016;1(1):72-80. DOI: 10.5430/irhe.v1n1p72 External link
2.
Heinze A, Erhard M. How much time do students have to think about teacher questions? An investigation of the quick succession of teacher questions and student responses in the German mathematics classroom. ZDM. 2006;38(5):388-398. DOI: 10.1007/BF02652800 External link
3.
Tobin K. The Role of Wait Time in Higher Cognitive Level Learning. Rev Educ Res. 1987;57(1):69-95. DOI: 10.3102/00346543057001069 External link