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GME Best Practices: Using better brainstorming from Harvard Business Review

The traditional model of using a SWOT analysis (strengths, weaknesses, opportunities and threats) for the annual Program Evaluation Committee (PEC) review left Penn State Health’s Family and Community Medicine Residency in State College with the same ideas and approaches to the residency.

Dr. Joseph Wiedemer, program director, set a goal to improve that and keep the process as simple as possible, but not too simple.

Instead of the usual PEC approach of asking for answers, Wiedemer and the group utilized a technique from Harvard Business review, Better Brainstorming: Focus on questions, not answers, for breakthrough insights, to generate questions. The research found that using questions opens up creativity. Applying this method to the PEC was enjoyable and enlightening.

When the residency met for its PEC, the group did two SWOT analyses: One on resident performance and one on the residency. Wiedemer asked how everyone felt about the “Strengths of Resident Performance” and recorded their feelings. Then, a timer was set for four minutes. Everyone had to ask questions that began with the words “what” or “how,” and they could not explain their questions. No one was allowed to provide answers. No one could criticize another’s question. The questions had to be brief and discrete.

When the timer went off, Wiedemer asked how everyone felt. All responded more positively. The group generated at least 20 questions. They repeated the exercise for weaknesses, opportunities and threats, and again for the residency as a whole. The entire process took 90 minutes for both SWOT analyses.

The approach to PEC by using the Better Brainstorming model with questions yielded some interesting observations. This clearly broke down to demonstrate a classic gap analysis:

A ——————-> B

In this case, “A” represents questions about the current state. “B” represents the future/goal. The dashed line represents the strategy and metrics that bridge that gap.

As part of the inquiry process, the group created questions that asked “Where are we now?” (A). They created questions that asked “Where do we want to go?” (B). And they created questions that asked “What do we do to get there and measure what we are doing?” (gap).

Wiedemer divided the questions into those areas, and provided his own answers based on NI and ACGME surveys, as well as his own thoughts.

Finally, the group did its last exercise that only asked for answers, and it only demonstrated current (A) points. Wiedemer commented that, to him, that exercise yielded little/no direction for strategy or goals. The PEC Committee feelings were the same or worse after just providing answers.

Internal users can view a PowerPoint on the exercise in the GME Best Practices folder on the network drive.

With questions, contact Dr. Joseph Wiedemer at

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