BACKGROUND Case-based learning (CBL) is a highly interactive instructional format widely used in medical education. One goal of CBL is to integrate basic biomedical knowledge and its application to concrete patient cases and their clinical management. In this context, we focus the role of teacher questions as triggers for reproductive vs. elaborative student responses. Specifically, our research questions concern the kinds of questions posed by clinical teachers, the kinds of responses given by students, the prediction of student responses based upon teacher questions, and the differences between the two medical disciplines in focus of our study, internal medicine and surgery. METHODS We analyse 19 videotaped seminars (nine internal medicine, ten surgery) taught by clinicians and attended by advanced medical students. Multiple raters performed a low-inference rating process using a theory-based categorical scheme with satisfactory interrater-reliability. RESULTS We found that medical teachers mostly posed initial (instead of follow-up) questions and that their questions were more often closed (instead of open). Also, more reasoning (than reproductive) questions were posed. A high rate of student non-response was observed while elaborative and reproductive student responses had a similar prevalence. In the prediction context, follow-up reasoning questions were associated with low non-response and many elaborative answers. In contrast, the highest student non-response rate followed open reproduction questions and initial reasoning questions. Most reproductive statements by students were made following closed reproduction questions. CONCLUSIONS These results deepen our understanding of interactive, questions-driven medical teaching and provide an empirical basis for clinical teachers to use questions in didactically fruitful ways.

中文翻译：

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基于案例的学习中的教师问题和学生的回应：医学教育中的视频研究成果。

背景技术基于案例的学习（CBL）是一种高度互动的教学形式，广泛用于医学教育中。CBL的目标之一是整合基本的生物医学知识，并将其应用于具体的患者案例及其临床管理。在这种情况下，我们重点关注教师问题的作用，即引发学生对生殖能力和行为能力的反应。具体来说，我们的研究问题涉及临床教师提出的问题，学生给出的回答，根据老师提出的问题对学生做出的预测以及我们研究重点，内科学和医学这两个医学学科之间的差异。外科手术。方法我们分析了由临床医生教授并由高级医学生参加的19场录像研讨会（9种内科医学，10种外科手术）。多个评估者使用基于理论的分类方案进行了低推理的评估过程，并获得了令人满意的定居者可靠性。结果我们发现，医学教师大多提出了最初的问题（而不是后续问题），并且他们的问题更经常是封闭的（而不是开放的）。此外，提出了更多的推理（而不是生殖）问题。观察到学生的无反应率很高，而精通和生殖的学生反应的患病率相似。在预测的背景下，后续推理问题与无应答率低和许多详尽的答案有关。相比之下，最高的学生无应答率是开放式再生产问题和初始推理问题。学生的大多数生殖陈述都是在封闭的生殖问题之后做出的。