Thursday, July 10, 2008


WHEN LEARNERS GET IT WRONG: Handling Incorrect Responses Without Intimidating the Learner and Turning Off Discussion.

When doing observations of teaching in the classroom and clinics, I often pay special attention to how faculty handle incorrect responses. Some teachers use the incorrect response as a springboard for teaching. Others -move on- asking another student or resident to help out. Another group answers the question themselves while still another group (unfortunately) ridicules or makes fun of the incorrect response. While we all can agree that the last strategy is probably not the best, is there one best way to make sure the learner and the rest of the group are clear about the correct answer while not shutting down that learner or the others that are in the group?

What works for you? Is there one best way? Is there clearly a wrong way? Do we worry too much about hurting our learners feelings?


Lily Pien said...

This is a tough question because as teachers, one always wants to maintain a safe and trusting environment. Hopefully, this type of environment has already been established so that learners recognize that corrective feedback is meant to be helpful, not hurtful. One strategy I will use is to look for something in the learner's response that is "closer to the mark" and expand on that portion of the learner's answer.

Neil Mehta said...

Agree with Lily's comment. I lean towards not "putting down" the learner who volunteered a response. Otherwise it makes it less likely that the learners will respond to other questions.

Finding something in the response that I can leverage for further discussion to move the group closer to the "truth" is something I find helpful. The good thing is that in medicine very few answers can ever be completely wrong. Asking the question in a way that does not put the responder in a spot also helps. Thus instead of asking "What is the commonest congenital heart disease seen in adults" you could ask for "Some congenital heart diseases seen in adults". Then in the discussion that follows you could point out the common ones if the learners don't bring that up.

Anonymous said...

I try to adapt my approach to the the level of certainty in the answer and/or the risk if the group gets the wrong answer ( eg incorrect medication dose). In that case I might directly correct the answer and then ask if the trainees know the evidence supporting the correct answer. If no one does know then I would assign it as a reading for the group.
If the incorrect answer is in an area where there is much leeway I would open up the discussion to the other trainees re alternate approaches and then reinforce the perferred approach with a discussion of the pros and cons of the various approaches.

Anonymous said...

I don't know about all of you, but how I handle it depends on a bunch of factor, most importantly time and the importance of the concept to be learned. Sometimes my students aren't WRONG, they just don't give the answer I was thinking of. I try to not play the "guess what I'm thinking" game, but sometimes it just happens. So when time is a factor, I just correct and move on, or ask another student to help out. I usually don't find that students are very sensitive to that approach. When time isn't a factor, or if I think that the whole group could learn from the studen'ts misconception, we work backwards and see if I can find out where the reasoning process went off track.

Bud Isaacson said...

One strategy that I find useful in the clinic setting (usually one on one teaching) is to probe the learner's reasoning behind their answer. This often allows them to understand why their response is incorrect and leaves the possibility that they can get the answer right without simply being told. For example, if a learner wants to start a medication that would be contraindicated in a patient, I will probe to see if the learner knows the side effects of the medications and then ask them to reevaluate their choice.