• Céline Bourquin, Friedrich Stiefel, Alexandre Berney, and Pascal Singy.
• Psychiatric Liaison Service, Lausanne University Hospital, Les Allières, 1011 Lausanne-CHUV, Switzerland. celine.bourquin@chuv.ch
• BMC Med Educ. 2012 Jan 1;12:8.

BackgroundThis exploratory study investigated the motives of medical students (N = 63) for using indirect questions of the type I don't know if [you have already heard about chemotherapies], I don't know how [you are], or I don't know what [you do for a living] in simulated patient interviews during a communication skills course.MethodsI don't know questions (IDK-Qs) were observed during the initial evaluation of students' communication skills; they were systematically identified through video screening and subjected to a qualitative content and discourse analysis considering their context, their content, their intent and their effect on the simulated patients. To evaluate the specificity of medical students' IDK-Qs, the data were compared with a data set of oncologists (N = 31) conducting simulated patient interviews in the context of a Communication Skills Training (CST).ResultsDuring the interviews, 41.3% of the students asked 1-6 IDK-Qs. The IDK-Qs were attributed to three content categories: medical/treatment questions (N = 24); lifestyle/psychosocial questions (N = 18); and "inviting questions" questions (N = 11). Most of the IDK-Qs had an exploratory function (46/53), with simulated patients providing detailed responses or asking for more information (36/53). IDK-Qs were rare in the oncologist sample compared to the student sample (5 vs. 53 occurrences).ConclusionsIDK-Qs showed a question design difference between medical students and oncologists in simulated patient interviews. Among other reasons for this difference, the possible function of IDK-Qs as a protective linguistic strategy and marker for psychological discomfort is discussed.

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