Looking for a quick, engaging activity for your course? Try a slightly different approach to using questions that facilitates peer instruction, promotes deeper learning, and allows for knowledge application. Similar to Team-based Learning, this activity can also give student teams an opportunity to provide rationale for their responses while also providing you feedback on how well students are understanding the material.

Here are the steps you can try: 

  1. Have students pair or team up in small groups.
  1. Present a clinical vignette written in NBME question format with a clear question posed at the end, such as the following: A 65-year-old man has difficulty rising from a seated position and straightening his trunk, but he has no difficulty flexing his leg. Which of the following muscles is most likely to have been injured? 
  1. Allow students to brainstorm five (5) possible answer options. (2 minutes)4. Reveal the actual possible answer options:                                                                                                                               
  2. Reveal the actual possible answer options
    a) Gluteus maximus
    b) Gluteus minimus
    c) Hamstrings
    d) Iliopsoas
    e) Obturator intermus
  3. Have students discuss options and record best answer. (1 minute)                                                                                                                                                                                                          
  4. Either reveal the correct answer or, better yet, have teams respond with their answers. (An audience response system works well or simple laminated cards (ABCDE) or show of hands can also work.)
  1. Ask teams to support their answer choice—e.g., “Team in the back, why did you pick C?” and “Team on the left, why did you pick “B”?
  1. Reveal correct answer.

How do you use questions in class? Share your ideas on Twitter with the hashtag #MedEdPearls.


  • Constructing Written Test Questions for the Basic and Clinical Sciences, 3rd Ed, National Board of Medical Examiners: https://www.nbme.org/pdf/itemwriting_2003/2003iwgwhole.pdf
  • Michaelsen, L. K. (2008). Team-based learning for health professions education: A guide to using small groups for improving learning. Sterling, Va.: Stylus. 


Author BIO

Jean M. Bailey, Ph.D. is a medical education faculty developer. Jean currently holds a position as Assistant Professor and Assistant Dean for Faculty Development at the Virginia Commonwealth University School of Medicine. Jean’s areas of professional interest include teaching and learning, faculty roles, and wellness/resilience. Jean can be followed on Twitter @jeanmb47 and contacted via email at jean.bailey@vcuhealth.org.


#MedEdPearls are developed monthly by the Central Group on Educational Affairs. Previously, #MedEdPearls explored topics including feedback, design thinking, and reflective practice. Thank you for reading and enjoy the Pearls!




#MedEdPearls Team:
Jean Bailey, PhD – Virginia Commonwealth University School of Medicine
Carrie Bowler, EdD, MS, MLSCM (ASCP) – Mayo Clinic
Kristina Dzara, PhD, MMSc (Educators ’16; Assessment ’16; HCE 2.0 ’17) – Saint Louis University School of Medicine
Shanu Gupta, MD – University of South Florida and Tampa General Hospital
Jennifer Hillyer, PhD – Northeast Ohio Medical University College of Medicine
Larry Hurtubise, PhD (HCE 2.0 '16) – The Ohio State University
Anna Lama, EdD – West Virginia University School of Medicine
Machelle Linsenmeyer, EdD, NAOME (Assessment ’07) – West Virginia School of Osteopathic Medicine
Rachel Moquin, EdD, MA – Washington University School of Medicine in St. Louis
Stacey Pylman, PhD – Michigan State University College of Human Medicine
Leah Sheridan, PhD – The Ohio University Heritage College of Osteopathic Medicine
Lonika Sood, MBBS, MHPE – Elson S. Floyd College of Medicine, Washington State University
Mark Terrell, EdD – Lake Erie College of Osteopathic Medicine
Stacey Wahl, PhD – Virginia Commonwealth University School of Medicine