August 2011 ■ Journal of Dental Education 1073 Use of Questioning During Lectures in a Dental Hygiene Didactic Course Heather M. Hessheimer, R.D.H., M.S.D.H.; Ellen J. Rogo, R.D.H., Ph.D.; Bernadette Howlett, M.S., Ph.D. Abstract: The purposes of this quasi-experimental, one-group crossover study were to determine the effect of questioning dur- ing dental hygiene lectures on low-level and high-level learning and to evaluate student perceptions of questioning. Twenty- three dental hygiene students participated in two control lectures using traditional lecturing methods. The students served as their own controls by next participating in two experimental lectures with questions asked throughout the lecture at both low and high cognitive levels. Student performance was measured with an examination containing low- and high-level questions. The interaction between the group and the level of questions was analyzed using ANOVA, and no statistically signiicant difference was found. Based on a Likert scale (1 to 6), average ratings for student perceptions were as follows: enjoyment of use, 4.5; understanding the lecture material, 4.74; and questioning effectiveness, 4.35. Student perceptions of questioning were positive; however, this strategy was found to be no more effective than the traditional lecture in promoting retention of information. Ms. Hessheimer is Assistant Professor, Department of Dental Hygiene, College of Dentistry, University of Nebraska Medical Center; she was an M.S.D.H. student at Idaho State University at the time this project was conducted; Dr. Rogo is Associate Professor of Dental Hygiene, Department of Dental Hygiene, Idaho State University; and Dr. Howlett is Associate Professor/ Research Coordinator in the Physician Assistant Program, Idaho State University. Direct correspondence and requests for reprints to Ms. Heather Hessheimer, University of Nebraska Medical Center, College of Dentistry, Department of Den- tal Hygiene, Room 2111, 40 th and Holdrege Streets, Lincoln, NE 68583-0740; 402-472-1957 phone; 402-472-5290 fax; hhessheimer@unmc.edu. Keywords: Bloom’s taxonomy, active learning, student perceptions, interactive lecture, dental hygiene education, questioning Submitted for publication 9/16/10; accepted 1/18/11 E ducators in the health professions have the unique responsibility of preparing graduates both to be successful on licensing examina- tions and to provide a high quality of patient care to the public. The means of achieving this dual mis- sion are a focus on student learning and learning outcomes deined as competencies, goals, and ob- jectives. Health professions faculty members create goals or objectives that state the intended outcomes of their courses and guide student learning. These outcomes express the learning students are expected to achieve by the end of the course as they participate in class sessions and complete assignments. When designing a course, student learning outcomes need to be aligned with the teaching strategies and assess- ment mechanisms to ensure consistency among the educational methodologies. 1 To support the current interest in promoting active learning in dental hygiene education, the purpose of our quasi-experimental, one-group crossover study was to determine the ef- fect of questioning during lectures on low-level and high-level learning as well as to evaluate student perceptions of questioning use. Active Learning as a Part of Instructional Design In the instructional design process, the educator irst must make decisions as to the level of learning the content of the course requires. The notion of higher level thinking was introduced in the seminal work of Bloom, 2 who created a taxonomy of cognitive processes with a hierarchy of low and high levels of learning. 3 His six levels from lowest to highest were knowledge, comprehension, application, analysis, synthesis, and evaluation. Educators began to use those levels of learning to organize their instruction, making sure to include the highest levels in order to maximize student achievement. In 2001, Anderson and Krathwohl published a revised version of Bloom’s taxonomy that divided knowledge into four categories: factual, conceptual, procedural, and metacognitive. 1 Factual knowledge includes discrete facts and terms, whereas conceptual knowledge consists of more organized knowledge articulated in concepts, principles, or theories. Pro-