The literary works of Sir William Osler

A paper read at the first regular meeting of the Osler Society of McGill University, October 19, 1921.     

A study of clinical questions posed by hospital clinicians.

OBJECTIVE: This article presents the results of complementary research studies on the behaviors of hospital clinicians in asking clinical questions and the relationship between asking of questions, outcome of information searches, and success in problem solving. METHODS: Triangulation in research methods--a combination of mailed questionnaires, interviews, and a randomized controlled study--was employed to provide complementary views of the research problems under study. RESULTS: The survey and interviews found that clinical problems (concerned mainly with therapy and equipment or technology) were expressed as statements rather than questions (average number of concepts = 1.7), that only slightly more than half (higher for doctors) of problems could be solved, and that the majority of clinical questions were not well formed. An educational workshop however improved clinicians' formulation of questions, but the use of structured prompting was found to improve building of hypotheses in the doctors' group without training. The workshop also improved satisfaction with the obtained information and success in problem solving. Nonetheless, for both the experimental and control groups, more structured and complete questions or statements did not mean higher success rates in problem solving or higher satisfaction with obtained information. CONCLUSION: The triangulation methods have gathered complementary evidence to reject the hypothesis that building well-structured clinical questions would mean higher satisfaction with obtained information and higher success in problem solving.