Thank you to Barb Hill, RN, MSN, CNE, CMSRN a Professor of Nursing at The Community College of Baltimore County, Baltimore, Maryland for sharing her Socratic Questions tool on today’s blog.

I gently probed the thinking of Jennifer, an advanced student in my med/surg clinical.

“Tell me about your patient…what do you believe is her primary problem, and what is the best way to address it?”

As she explained her patient’s needs, current clinical data that she interpreted as relevant, and current nursing priority, I continued to ask additional questions.

• “What specific clinical data are you basing your decisions on?”
• “Why did you interpret that data as relevant?”
• “What would you do if your patient developed an increase in pain with a fever?”
• “What are other possibilities or alternatives that she devloped a fever at this stage in her hospitalization?”

Am I intentionally agitating Jennifer by asking numerous questions with many that are clearly non therapeutic because they ask WHY?

Absolutely not.

I am utilzing a time tested strategy that every clinical educator must make time for in the clinical setting to develop the THINKING of students and assess their ability to clinically reason.

Who is Socrates?

Asking questions is the single most effective strategy in the clinical setting to develop the critical and clinical thinking required for practice (See prior blog on Two Questions Students Must Be Asked or last weeks blog on 10 Caring Questions).

This pedagogy is not unique to nursing education, but goes back over 2,500 years to the Greek philosopher Socrates and his approach to learning that is referred to as Socratic questioning.

When teachers use Socratic questioning in teaching, their purpose may be to probe student thinking, to determine the extent of student knowledge on a given topic, issue or subject, to model Socratic questioning for students or to help students analyze a concept or line of reasoning.

This is the higher level of analysis and understanding nursing students require to reason through the nuances and ambiguities often present in patient care.

Purposes 

Socratic questioning accomplishes the following purposes to strengthen student learning:

• To deeply probe student thinking and help them distinguish what they know or understand from what they do NOT know or understand (and to help them develop intellectual humility in the process).
  • Socratic questioning identifies what are student weaknesses so they can be made an eventual strength.
• To help students use these tools in everyday life (in questioning themselves and others). Educators need to directly teach students how to construct and ask deep questions. Students need practice to improve their questioning abilities. This is why educators need to utilize this strategy consistently in the clinical setting as well as classrooms.

Socratic questioning illustrates the importance of using questions to deepen learning. It teaches students to dig beneath the surface of what you think is known and cultivate deep learning.

Integrating Socratic questions will help develop active, independent learners.

This is what we want our students to become!

Preparing the Way for Questioning

But in order to maximize the effectiveness of this pedagogy in your clinical, it is imperative that the nurse educator create a safe environment for students to learn and to make mistakes.

To ask questions and guide learning effectively, the educator must balance promoting and developing thinking without it coming across like an interrogation!

Avoid any hint of confrontation or nonverbal communication that could be interpreted as demeaning.

By asking questions in a positive and supportive manner, this will promote the safe environment students need to maximize their learning.

Reinforce that their response will not influence their clinical grade but is part of the teaching process to develop critical and clinical thinking.

Five Types of Socratic Questions Educators Should Use

To get the wheels turning and make an ancient Greek philosopher practical, here are categories of Socratic questions and the types of questions nurse educators need to be asking students (Oermann, 1997):

Clarification Questions

• Tell me about your client’s condition/problems/needs
• What are the most important client/family/community problems?  Why?

Questions to Probe Assumptions

• You seem to be assuming that your client’s responses are due to _____.  Tell me more about your thinking here.
• On what data have you based your decisions?  Why?
• Your decisions about this client/family/community are based on your assumptions that ______.  Is this always the case?  Why or why not?

Questions to Probe Reasons

• How do you know that ___________?  What are other possible reasons for ____?
• Tell me why?
• What would do if ____?  Why?

Questions on Differing Perspectives

• What are other possibilities?  Alternatives?
• How might the client/family view this situation?  Does anyone view this differently? (in the clinical group)  Why?
• Tell me about different interventions that might be possible and why each one would be appropriate?

Questions on Consequences

• If this occurs, what would you expect to happen next?  Why?
• What are the consequences of each of these possible approaches?  What would you do in this situation and why?

Other Ways to Integrate

Socratic questions should not just be for clinical. In order to prepare students for Socratic questions in the clinical setting, these questions should also be asked in the classroom!

In order to make this possible, there is one small thing that nurse educators must do. Stop regurgitating textbook content!

Instead decrease lecture content by emphasizing what content is most important and then present a salient clinical scenario that illustrates the content that was just taught.

Then utilize these Socratic questions in your classroom to develop not only the DEEP learning of what is most important, but also DEEP THINKING!

In Closing

On the surface, Socrates may appear to be irrelevant to nursing education. Though questions of any kind will provide needed insight regarding the thinking of students, the unique emphasis of Socratic questions go deeper by addressing assumptions and analyze the thinking of nursing students.

A common definition of critical thinking is defined as thinking about your thinking while you’re thinking.

But Socratic questioning will accomplish this needed objective and will help your students think more like a nurse and prepare them for practice after the NCLEX®!

What do you think?
How have you successfully used questions or Socratic questions in your program?
Comment below and let the conversation begin!

References

• Oermann, Marilyn. Evaluating Critical Thinking in Clinical Practice. Nurse Educator Volume 22, Number 5, Sept/Oct 1997
• Socratic Questioning (2016). Retrieved from: https://en.wikipedia.org/wiki/Socratic_questioning