This article was originally published in the AMWA Journal.
All of us have suffered the consequences of expensive, unasked questions in both our professional lives and our personal lives. As medical communicators, we must ask good questions to elicit information, but many of us lack adequate training in this skill. Add to that the natural reticence of some medical communicators, and it is no wonder that we walk away from interviews with subject matter experts or client meetings wishing we had remembered to ask X, Y, or Z. This article offers information as to why questions are so important, what types of questions are useful, how to strategize your questions, how to handle people answering the questions you ask them, and how to answer questions that others ask you.
Why Are Questions Important?
We have all experienced the pain of unasked questions. When I was interested in replacing my windows with casement windows, I asked the salesman if I could clean the outside of the window from inside the house. The salesman assured me that I could. After the windows were installed, I found that a person with a 28-inch arm could clean each window from inside—but I have only a 24-inch arm. I failed to ask the right question: “Can a person with a 24-inch arm clean this particular width window?”
If you ask the right questions, it is more likely that you will get the information you need. A former secretary of the Department of Defense once famously spoke of the “unknown unknowns”; often, we don’t know what we don’t know, and asking questions in a logical, orderly way may uncover surprises that we need to explore. Good questions (and honest answers) will save you money and time.
If you are shy or question-phobic, reframe the concept of “asking questions” by calling it “discovery skills”: everyone needs discovery skills.
What Types of Questions are Useful?
There are many different types of questions.
- Permission questions demonstrate your positive intent in asking questions. They show respect and help you build trust.
- Let me ask you…
- Could you tell me more about the audience for this article….?
- May I get some more information about….?
- Open-ended questions stimulate thought and encourage continued conversation. They cannot be answered with one word or with a simple “yes or no” response.
- What items are critical to ZZZ?
- What are the risks?
- How does this subassembly fit into the overall drug delivery?
- What are some unique characteristics of this clinical trial? How does it differ from the XYZ trial?
- Closed questions elicit “yes” or “no” answers or verifiable data. Once answered, this type of question may preclude further conversation without asking another question.
- What format do you need?
- Is there an internal style guide that I need to follow in addition to the American Medical Association Manual of Style?
- What is the word/page limit?
- Probing questions help you explore more in a certain direction. You can elicit further detail by asking probing questions.
- Why is that?
- How would that look?
- What if…?
- Tell me more about…
- Encouraging statements pose as questions and help speakers keep going without overt interruption. Silence is a great encourager!
- Uh huh…
- I see…
- Oh, that’s interesting.
- Restatement/paraphrase questions show that you have been listening. They can keep the communication open, perhaps by showing that you are listening and want to clarify your perceptions. They are also a graceful way to check up on inconsistent information.
- Let me play this back to you…
- Here’s what I have heard so far. Let me state it in my own words to make sure that I understand it correctly.
- Catchall questions invite further information. As you listen to the answer, you might receive verification of information already offered. In addition, catchall questions might elicit another viewpoint.
- Would you like to tell me anything I haven’t asked you about?
- What haven’t we discussed that might be relevant?
- What else is important for me to know?
- Checking questions help you further clarify conflicting information, especially if answers have diverged from expectations.
- Please explain that a little further…
- Help me understand your intention…
- Tell me more about…
Once you have brainstormed your list of questions, it is important to plan your questioning strategy. I like to start with open-ended questions (“Please give us your vision of the course that you want us to build for you”), then move on to more specific questions (“How many interactions would you like in a given time period?” or “Do you have prior course materials that you could share with me?”). If you find that your specific questions are eliciting information that conflicts with earlier information, you might need to go back to more open-ended questions. (“Tell me again your vision for this project?”)
Before you start offering questions, you must first establish a relationship with the interviewee or group that you are interviewing. You must convince them of the following:
- You care about their issues.
- You are honest.
- You want to understand their truth.
- You do not have an axe to grind.
- You meet your commitments.
You might help further the relationship by a diplomatic statement of purpose. (“We’re all interested in understanding your truth”) or by starting with a few social questions (“How was your trip?” “How is the hotel?” “Is this your first time visiting our company?”) Questions not related to your area of discovery may help warm them up and show them how easy it is to answer your questions. It is probably best to avoid questions about politics, religion, or sports.
Then, you can start your discovery in a nonthreatening manner:
- Aim for dialogue, not interrogation.
- If you have 2 questions in one, separate them. The clarity of the questions will be improved, and you will prevent the interviewee from inadvertently giving one answer for both questions.
- Be mindful of different cultures; not every culture likes being questioned. You may need to consider avoiding eye contact; instead, try focusing on a person’s lips.
- If your interviewee does not immediately answer your question, count silently to 10 to allow time for the person to formulate an answer. After 10 seconds, you might offer a paraphrased question or a different question. Of course, probing and encouraging questions are always appropriate at any time. Catchall questions may be most helpful at the end of a question session.
- Listen. We can all learn to listen better.
- Use body language to show you are listening; lean toward your audience and focus on them when not writing.
- Take notes.
- If you can get permission, record the question-and-answer session.
- When asked a question, pause for a few seconds to think about your answer. It may be helpful to restate the question to help you think through your answer.
- If you are not sure how to answer a question, ask a clarifying question to give yourself time to collect your thoughts. (“Could you help me understand what you mean by X?”)
- If you are in front of a group of people, restate the question to help those who may not have heard it. Be sure to restate the question exactly as it was asked.
- If, however, you need to rephrase the question in order to answer it, ask the questioner if your paraphrase or restatement is OK with him or her; this shows your respect for the questioner.
- If you still don’t have an answer or don’t want to provide it right away, turn the tables on the questioners and hear how they answer the question.
Become a Better Questioner
- Be serious about improving your discovery skills. Asking the right questions is a crucial skill for any profession.
- Start today: Make a list of questions you recently neglected to ask and write down what your ignorance cost you. The next time some “failure” occurs in your work group or in your own life, ask yourself “What question didn’t I ask that needed to be asked?” Keep your lists of questions and review them frequently!
- Hang out with a 2-year-old and listen carefully to his or her questions. What can you learn?
- Practice being a 2-year-old. When you are on a walk or driving your car, consciously form questions. (“Wonder why the snow is completely melted in that spot?” “Why is all the traffic in the left lane?”)
- For fun online practice, go to www.20q.net to play “20 Questions” against artificial intelligence.
Always listen for good questioning behavior. I once consulted my physician about a black spot under my toenail. He asked, “What can you tell me about this spot?” What a great open-ended question to start with. I felt empowered in his discovery process. I have added that to my questions repertoire.
You can never have too many questions up your sleeve.