Family medicine residents do not ask better-formulated clinical questions as they advance in their training.

Objective: We investigated whether family medicine residents demonstrated increased skill in formulating clinical questions over their 3 years of training.

Methods: We conducted an analysis of 454 questions asked by 49 family physician residents engaged in informal consultation with subspecialists using an e-mail-based system. Clinical question formulation was measured on a scale of 0 to 2 by awarding 1 point each for the presence of a proposed intervention and a desired outcome. Changes in question formulation as residents progressed in their training were assessed using cross-sectional and repeated measures.

Findings: The mean question quality was scored at 1.10, and there was no significant change over the 3 years. Thirteen residents used the e-mail service over their entire 3-year training period. The individual residents showed substantial differences in how well they formulated clinical questions, with their mean question quality scores ranging from 0.38 to 1.45. There was, however, no evidence that the quality of their questions changed as they progressed in their medical training.

Conclusions: Resident physicians asked moderately well-formulated clinical questions, but question formulation did not improve as they progressed in clinical training. Further training in formulating clinical questions may be helpful.