Intraoperative questioning to advance higher-order thinking

Background The type of question asked elicits a particular response. The purpose of this study was to determine what types and levels of questions were asked in the operating room. These insights are important for understanding how questions are used to advance learners. Methods 12 laparoscopic cholecystectomy operations were observed and recorded at a single institution. Intraoperative questions asked by faculty were transcribed for all cases. Using revised Bloom's taxonomy, questions were classified into one of 5 levels: (1) remembering , (2) understanding , (3) applying , (4) analyzing , (5) evaluating . Results 141 questions were asked by faculty and ranged from 0 to 34 questions per case. Classification of questions showed there were 43 remembering , 29 understanding , 47 applying, 13 analyzing , and 8 evaluating questions asked. Conclusions Questioning was predominately classified at lower-order and mid-level thinking skills (120/141). Integrating intraoperative questions at higher-order levels has the potential to guide trainees into progressively complex thinking and decision making.