Faculty Instructional Development

 

What about Pimping?

In medical education, many call the process of using inquiry in clinical settings, "pimping". Pimping in its derelict form is "exploitation". However, exploitation is not the intended purpose.

The intended purpose is to ask questions that encourage the learner's active participation in thinking through the problem and finding a solution, without having to rely on the instructor to provide answers.  In other words, the true intent of "good" pimping is to activate what the learner knows as well as their skills in active, critical thinking and problem-solving.

In large part, the controversy around the term "pimping" has detracted from the concept of inquiry-based teaching in clinical settings. When done professionally and thoughtfully, inquiry-based teaching - by whatever name we choose to use - is effective teaching.  Thus, effective questions are required. We can describe effective questions by what they are, as well as what they are not.

When Is Inquiry Ineffective?

Ineffective inquiry may discourage learners and hinder the learning process. Ineffective questions, for example, would not promote critical or creative thinking. Known-answer questions are important to establish the learner's knowledge base. But, once an educator has a good sense of the learner's knowledge base, it makes no sense to continue to ask known-answer questions that model rote learning methods, or that might be intended to "trip-up" the learner.

Other types of ineffective questions are those that are calculated to embarrass a learner. One example, is when we ask students a question for which we may reasonably caculatre they do not have the funds of knowledge to answer or to determine the answer.

Thus, ineffective questions …

  • Confuse the issues

  • Misdirect attention

  • Require less depth of inquiry or reflection

  • Promote assumptions or discourage exploration

  • Negatively affect confidence - whether bouying false confidence or causing learners to feel inordinately less confident.

Effective Questions Promote Learning

"Pimping" - that is, priming students with questions to promote learning, by asking effective questions in a professional manner, is effective teaching.

Thus, it's not what we call it, but what we are doing that counts! If we use EFFECTIVE inquiry, we can be effective educators.

References

  • Brancati, FL. The art of pimping. JAMA, 262(1), 89-90; 1989.

  • Detsky, AS. The art of pimping. JAMA, 301(13), 1379-1381; 2009.

  • Kost A. and Chen FM. Socrates was not a Pimp: Changing the paradigm of Questioning in Medical Education. Academic Medicine. 90(1):20-24; 2015.

  • Tofade T, Elsner J & Haines ST. Best Practice Strategies for Effective Use of Questions as a Teaching Tool. American Journal of Pharmaceutical Education, 77(7); 2013.

  • Taylor EW, Tisdell EJ & Gusic ME. Teaching beliefs of medical educators: perspectives on clinical teaching in pediatrics. Medical Teacher 29(4);2007.

  • Van Schaik KD. Pimping Socrates. Opinion, in JAMA 311(14), 1401-1402; 2014.