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Letters to the Editor

Ask a Question, Get a Question Back: The Role of the Socratic Method in Clinical Teaching From the Medical Student Perspective

Kumar, Apoorva1; Umasankar, Deekshitha2; Shiatis, Vishal3; Sidiku, Febisayo4

Author Information
doi: 10.1097/ACM.0000000000004616
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To the Editor:

We sincerely thank Abou-Hanna and colleagues 1 for their insightful study on the use of the Socratic method in medical education. As 4 medical students representing 3 U.K. medical schools, we have had a range of experiences with Socratic teaching during clinical placements and concur that this style of question-based training is a significant gray area within clinical education—for everyone involved.

Clinical placements are crucial for navigating the professional and interpersonal facets of the medical profession. Student–clinician interactions may significantly alter perceptions of specialities, with a recent study demonstrating that having a role-model clinician was a significant predictor in the choice of several residencies. 2 Drawing from our experiences, Socratic teaching can enhance rapport between students and clinicians. When used effectively, it highlights a clinician’s enthusiasm for mentoring and enriching learning, thereby adding depth and context to clinical experiences.

The Socratic method has several advantages, including promoting critical appraisal of medical practice and identifying knowledge gaps. 3 We believe teaching with probing questions enforces the application of preclinical medicine into clinical contexts, thus reflecting complexities in patient care and molding well-rounded doctors.

However, as highlighted by Abou-Hanna and colleagues, 1 Socratic teaching may be criticized when humiliation becomes involved. Lempp and Seale 4 also reported that students felt belittled when repeatedly probed by questions they were unable to answer. We speculate that the issue here is not teaching style, but rather the limited effort in guiding students through errors to avoid future mistakes. We appreciate this emphasis on the clinician–student disconnect and agree it may be beneficial to instruct clinicians to normalize errors while learning, subsequently curbing anxieties surrounding question-based teaching.

On a larger scale, we believe these findings have the potential to initiate focus group-style discussions between students and faculties. With many medical schools revaluating the delivery of clinical education programs during the COVID-19 pandemic, this is an ideal opportunity for faculties to involve medical student representatives and jointly design a teaching program for both clinicians and students.

Student representatives could collect data from their cohorts on their preferred modes of incorporating the Socratic method and liaise with medical professionals interested in clinical education. Clinicians could then be trained on effectively using Socratic teaching by encouraging the normalization of errors and remodeling them into teaching opportunities reflecting the needs of the cohort.

Given the various benefits, we reiterate the importance of the Socratic method as an education tool and advocate for the creation of mutually-agreed-upon frameworks to effectively implement Socratic teaching during clinical clerkships.

References

1. Abou-Hanna JJ, Owens ST, Kinnucan JA, Mian SI, Kolars JC. Resuscitating the Socratic method: Student and faculty perspectives on posing probing questions during clinical teaching. Acad Med. 2021;96:113–117.
2. Yoon JD, Ham SA, Reddy ST, Curlin FA. Role models’ influence on specialty choice for residency training: A national longitudinal study. J Grad Med Educ. 2018;10:149–154.
3. Oh RC. The socratic method in medicine—The labor of delivering medical truths. Fam Med. 2005;37:537–539.
4. Lempp H, Seale C. The hidden curriculum in undergraduate medical education: Qualitative study of medical students’ perceptions of teaching. BMJ. 2004;329:770–773.
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