Asking Clinical Questions

Asking questions is the basic key to improving your medical knowledge and detecting out-of-date information in your current knowledge.  The medical literature identifies two problems: we don't ask enough questions, and we don't seek answers to all the questions we do ask.

Curiosity killed the cat! A lack of curiosity might someday kill a patient. You must be more curious than average, or you would not be reading this page.

Practice Exercises

On a particular day, take a moment after each patient
Think about what questions regarding the care of that patient have remained unanswered. Write down each question on a separate piece of paper. Some questions will be simple, such as "What is the dosage of drug A?" and can easily be answered by referring to your copy of the CPS (Canadian: Compendium of Pharmaceuticals And Specialties) or the PDR (USA: Physician's Desk Reference). Others will be more complex, such as "What is the best initial treatment for Type II diabetes?"

At the end of the day
Take a few minutes to review your questions, then search for an answer in one or more of your reference texts. Check the publication date on each reference source. What is the probability that this information has changed since it was published? What is the probability that it is still accurate?

These exercises will help you ask more questions in your daily practice. Most questions about a patient-based problem will take the form: "What intervention will best improve the health of this patient with this problem?"

Find the time
One difficulty with adopting a new idea is to find the time and motivation to work in it. Find a way to reward yourself for applying new ideas!  

Keep a notepad (or prescription pad) in your pocket
Write down each clinical question when it arises.

Designate one office day as a "question day"
Create at least one question about every patient encountered on that day?  

Save the questions that you have created
When you have twenty questions, review them all. What do they tell you about your information needs?

Choose the most interesting question from your list
Using your current knowledge; what do you believe the correct answer to be? When and where did you learn that information? Is it possible that the information is out of date?

Look up the answer to your most interesting question
Did you have to modify the question to make it easier to conduct the search? How up-to-date and reliable was the source of the answer? If it was a textbook or journal, what was the year of publication?