“What Questions Do You Have?”: Teaching Medical Students to Use an Open-Ended Phrase for Eliciting Patients' Questions

Patients frequently do not understand health information received in clinical settings, yet rates of question-asking by patients are low, particularly for patients with lower health literacy skills. Experts recommend that health care professionals attempt to elicit patients' questions by using an open-ended phrase, such as “What questions do you have?” as opposed to a closed-ended phrase like, “Do you have any questions?” We compared question-eliciting techniques used during video-recorded observed structured clinical examinations among medical students who had completed a mostly didactic curriculum on health literacy and clear communication (n = 46) to students who completed a newer longitudinal problem-based communication curriculum (n = 32). Students were not aware that they were being observed for specific communication skills. Compared to controls, students in the intervention group were more likely to spontaneously attempt to elicit questions from a standardized patient (65.2% vs. 84.4%, p = .06), and were significantly more likely to use an open-ended phrase to do so (6.7% vs. 51.9%, p = .0002). The longitudinal communication skills curriculum was successful in creating long-term patient-centered question-eliciting habits. Further research is needed to determine whether eliciting questions with an open-ended technique result in patients asking more or different clarifying questions during the closing phase of clinical encounters. [HLRP: Health Literacy Research and Practice. 2022;6(1):e12–e16.]