Asking effective questions is an important skill for medical students. However, sometimes when ethical or moral questions are raised – such as those concerning abortion or euthanasia – some students may feel compelled simply to blurt out their own moral position or to remain entirely silent on the subject. This resource aims to provide some suggestions on how to ask effective questions in order to encourage dialogue and discussion with peers, whether in a lecture, a small group, or tutorial setting, or even simply among friends.
This resource focuses more generally on effective questions whereas subsequent resources are focused on individual topics such as abortion or euthanasia.
Asking thought provoking questions can demonstrate our own ability as students to think critically and to analyze complex problems, both of which are important skills that our preceptors and group facilitators are seeking to identify.
Questions – as opposed to statements – encourage further thought. Simply stating our position or belief does not invite our listeners to reconsider their own. A question, however, encourages critical thinking and deeper reflection. As noted by Stephanie Gray, “It’s only when we’re asked to explain something that we realize whether we have answers and whether those answers make sense.”
Lastly, questions can help to avoid defensiveness among those with whom we are speaking. Importantly, it positions us as a “co-explorers” of the issue with our group members rather than students who are positioned against them. For instance, by introducing a question based on other sources (news articles, journals), we focus the attention on the source, rather than on ourselves.
Consider the following examples:
“I was reading an article in the Canadian Journal of Anaesthesiology, and the authors were concerned about how physician assisted death would impact the relationship between doctors and patients. What do you think about this concern?”
“One objection I’ve heard is that a lack of restrictions on abortion allows for the request of abortion to terminate a female fetus. What do you think about this, given that it raises the issue of gender discrimination alongside the issue of abortion access?”
How to Ask Questions Effectively?
Not all questions are created equally, however, and thus can have differing impacts.
For instance, a question such as “Why do you believe that killing human beings is a valid medical practice?” is more likely to shut down discussion as it is personally directed against the other person, contains loaded language, and does not demonstrate that we, ourselves, are open to hearing his or her response and to truly listening.
An acronym that may be helpful in generating effective questions and entering into dialogue is what we should aim to be: N-TRL.
N – Neutral in:
T – Tone and body language
R – Responses
L – Language
N – Neutral does not mean that we must agree with the perspectives of the others with whom we are dialoguing. Instead, it refers to adopting a posture of openness and receptivity to the others and their views. By demonstrating that we are interested in and care about the perspectives of the others, we can create a mutual respect and trust between both parties, which allows them to hear, in turn, what we have to say.
This neutrality can be facilitated by being attentive to the following components of our communication:
T – Tone and body language. Our tone of voice communicates a great deal to those with whom we are speaking. An aggressive, condescending, arrogant, or dismissive tone easily contributes to defensiveness and barriers to communication. Instead, a gentle, inquisitive, and friendly tone removes barriers and increases that mutual trust and respect that we are seeking.
Similarly, our body language may send messages. Crossed arms close off the body and send defensive signals, whereas a body that is relaxed, leaning forward and nodding gently in response to the perspectives of others, can indicate an openness and receptivity. When difficult conversations arise we must pay attention to our body language and allow ourselves to relax.
R – Responses. How we respond to others’ perspectives and points (whether in reply to our questions or in the larger context of the group discussion) plays an important role in how others will respond to our perspectives and points. This includes not only the aforementioned tone and body language, but also the words that we use.
For instance, if someone has just recounted a difficult case study involving a patient who is suffering from a progressive and terminal disease, we would appear callous if we simply brushed off their points without acknowledging the significance of what they said.
“That’s a really important and difficult situation that you’ve shared. I share your concern with patient suffering. I wonder, though, if we could explore other mechanisms to control pain before moving to doctor assisted death? For instance, in this study I’ve been reviewing…”
In general, our responses should aim to show that we have heard and understood the points communicated and should point to any common ground that can be established.
“I appreciate your patient-centered approach.”
“I agree that we want to find ways to alleviate suffering.”
Another tool that can be helpful in responses is the use of reflective language. Reflective language refers to a practice of reflecting back to the speaker what we have heard him or her say.
“What I’m hearing you say is…”
This demonstrates that we have been listening and offers the speaker an opportunity to confirm or correct the understanding that we have of his or her perspective.
L – Language. Questions can be much more effective – both in terms of their comprehension as well as the avoidance unneeded defensiveness – when the language used in these questions is common to both parties. For instance, terms that are very familiar to a pro-life or religious audience, such as “culture of life,” “pro-abortion,” “sanctity of life,” may be misunderstood or have negative connotations to those with whom we are speaking. Instead, focusing on our common medical language may be more conducive to our questions and dialogue.
Overall, the resources provided on particular topics aim to encourage us to ask questions that invite discussion and thought. Paying attention to our tone, body language, responses, and language is important in supporting the efficacy of our questions and discussions.
Conclusion: A Few Words of Encouragement
Asking an effective question will, in many cases, cause people to consider our view as having some validity. While it’s not likely to change minds immediately, it can cause others to question their own position.
Discerning the time to speak and the time to stay silent is no doubt a challenge. There are times when it isn’t helpful to question a statement or to challenge a presumption. In the end, however, questioning a presenter, a lecturer, or a professor can, in and of itself, provide balance where there is not any.
Asking a question can elicit unintended responses, and we may find allies in the class just by having asked the question. In fact, this may bring about a positive outcome from a negative experience.
We are primarily responsible for our role in challenging the presumptions surrounding some of these ethical issues, not necessarily for successfully changing minds and hearts.
Remember, we will survive a flustered or embarrassing experience. But by seeking these opportunities, we will improve. We must take a moment to calm our nerves, and then we must go for it.
 Gray, Stephanie. 2015. Love Unleashes Life: Abortion and the Art of Communicating Truth. Life Cycle Books, Toronto ON, p. 11.