EIGHT

Enhancing Cultural Competence: Face-to-Face Classrooms, Hybrid, and Online Courses

with contributions from Theresa M. Adams and Kathleen M. Nevel

Challenges of new learning environments and efforts to meet the diverse learning needs of culturally, academically, linguistically, generationally, and geographically diverse learners necessitate an array of learner-centered strategies and knowledge of learner characteristics. Nurse educators are also challenged to prepare critical-thinking, creative nurses to meet the expanding health care needs of diverse populations.

SNAPSHOT SCENARIO

Professor Change introduces the topic of enhancing cultural competence in face-to-face (f2f) classrooms, hybrid, and online courses by sharing a recent experience: I used to think that my traditional f2f course was full of engaging activities that provided students with enough transcultural knowledge, skills, and values needed for cultural competence. I thought my course instilled immediate confidence and lifelong commitment to ongoing learning about cultural competence. Last week, I participated in an interactive workshop at Nearby University called “Enhancing Cultural Competence: Systematic Inquiry at the Course Level.” During the workshop, we utilized several assessment and planning tools.

First, after completing the Self-Assessment Tool (see Toolkit Item 15), I discovered and rediscovered my strengths, areas for further development, and cultural values and expectations concerning students, learning, and cultural competence development. Next, after completing the Active Promoter Assessment Tool (see Toolkit Item 18), I discovered the importance of some of my actions with students that actively promote cultural competence development; but I also discovered that there were many other effective strategies that I could easily implement. Then, using my course syllabus and the Systematic Inquiry Tool (see Toolkit Item 20), I systematically appraised my course and course components in relation to my typical students. I realized I could do so much more. The small and large group activities throughout the interactive workshop validated some of what I currently implement but also identified that all workshop participants had strengths as well as areas for further development and innovation. Quiet, individualized self-reflection followed by a sequence of small group activities and two large group discussions permitted a collaborative sharing of ideas and prioritized action plan for all types of courses—including f2f, hybrid, online, and other distance education modalities. I highly recommend systematic appraisal and an action plan for enhancing cultural competence in all our courses.

Consider the following faculty thoughts and their potential impact on optimal cultural competence development in self and for culturally, linguistically, academically, and generationally diverse students (and possible impact on patient care and multicultural workplace harmony):

Professor Constants: Why should I appraise my course? Why should I make any changes? I’ve been teaching for 20 years and don’t plan to move out of the classroom setting. My student evaluations don’t indicate I should change anything.

Professor Cave: I’m not going to take time away from transferring my f2f course into a totally online course to undergo any of those assessment appraisals for cultural competence. The national guidelines mandate that the online learning experience should achieve the same or better outcomes as a traditional f2f course. Online students will have the same four optional cultural case study exemplars in weeks 6, 9, 11, and 12 and will be asked if they have any questions about them. Students can click on the “yes” or “no” bubble and post any questions in the blog if they respond yes.

Professor Winger: I’m just going to wing it and let the textbook provide the cultural case examples and issues. Students in the f2f, hybrid, and online sections all use the same textbook. No students have asked any questions so far but if they do, I’ll just wing it by reading the textbook examples and providing them with a reasonable answer in relation to the medical problem presented so they can answer my test questions correctly. Besides, my multiple-choice questions and essay questions are pretty generic so students who know about the disease should be able to wing the correct answer.

Professor Five: I updated my course from a strictly f2f course to one that utilizes our university’s learning management system (LMS) for storing documents. It contains a link to the Office of Minority Health website. Every 5 weeks, I post five optional journal articles dealing with culture concerning pediatric problems. Each student is assigned one of the journal articles for the semester and is expected to pick out the five main facts for other students to remember when dealing with patients and parents of that ethnic/racial group and a pediatric problem. They post the five facts in the discussion board so that other students can read and print out if they want to save it for later. At the end of the semester, students have the five main facts about five ethnic groups and 50 different pediatric problems. Students who don’t post their cultural facts lose five points from their total course grade. That’s enough to make a student drop down a letter grade and so it seems good enough to leave the course unchanged.

Consider the following faculty dialogue during the meeting and the potential impact on optimal cultural competence development in self and for culturally, linguistically, academically, and generationally diverse students (and its possible impact on patient care and multicultural workplace harmony):

Professor Button: Now that patient-teaching information is accessible at the push of a button, my advanced practice nursing (APN) students can easily tell patients about their medications, treatments, diets, and so on. The information can also be translated into other written languages at the push of a button. The non-English-speaking patients seem to like this and understand, because when I ask them if they understand, they just nod their heads up and down and smile.

Professor Light: I thought that this was great too until I discovered that culturally inclusive, appropriate, and relevant photos, illustrations, and examples were equally important. I guess translating a pamphlet into another language is not good enough unless it matches up with cultural values, beliefs, and practices along with practicalities and feasibility considerations such as geographic location, economics, lifestyle, and so on. I also learned that nonverbal gestures and saying “yes” does not always mean the same in every language or culture.

Professor Connect: After completing some continuing education programs, reviewing the literature, and networking with experts in cultural competence and distance education, I created a totally online course that connects multiple technologies such as podcasting, videoconferencing, online streaming, video clips, and narrated electronic slides that exposes students to many different transcultural issues and diverse populations locally and around the world. I’m contemplating use of social media, such as LinkedIn, to connect students with clinical and transcultural experts and scholars. I’m also open to exploring new technologies when they are invented and available.

Professor Narrow: I thought distance education only involved online learning like posting of reading assignments and weekly discussions with students answering a choice of 5 out of 20 or more questions.

Professor Broad: Distance education may involve various separate and/or combined teaching–learning strategies and has the potential to tap into each of the three learning domains and enhance learning if carefully coordinated. Learning environments today contain a diversity of diverse learners, each bringing unique perspectives and prior learning experiences into the interactive, learner-centered environment.

Professor Earnest: I was also at the workshop with Professor Change. The easy-to-use rating scale on the Systematic Inquiry tool (see Toolkit Item 20) made it evident that cultural competence was visible and consistently integrated in parts of my course; however, in some areas it was inconsistent or barely visible. If cultural competence is barely visible, inconsistent, or disconnected when I review my own course, how will it appear to students and/or to other full-time or part-time faculty whose courses should be complementing or building upon cultural competence values, skills, and knowledge?

Professor Piece: During the classroom component of my hybrid course, I show a few videos about cultural diversity and health disparities. I never thought about how I could or whether I should integrate cultural competence throughout various distance education modalities or the LMS as a repository for course materials and resources concerning cultural competence. Until now, I didn’t think about how students might perceive the cultural concepts and the course components to be disconnected. The course should present a purposely planned sequence of teaching–learning strategies, topics, and concepts that complement and scaffold learning and bring students to higher and deeper levels of cognitive, psychomotor, and affective learning.

Professor Frank: In my advanced practice nursing program, I never took any courses that addressed curriculum, principles of teaching, cultural competence, diverse learners, various teaching technologies, testing, or evaluation. Even if I did, it sounds like so much has changed even within the past 3 years concerning nursing students, technology, licensing exams, and accreditation mandates within academia and health care institutions that I would benefit from workshops aimed at updating teaching–learning modalities and evaluation as well as enhancing cultural competence.

Professor Ponder: Yes, I’m wondering how to become a better teacher for our diverse student population. How can I enhance cultural competence throughout my course and connect with other courses and activities in the curriculum to help students develop optimal cultural competence? How can I systematically appraise my existing course and make cultural competence optimally visible, integrated, and connected to all course components and program outcomes?

Each individual faculty member is empowered to make a positive difference in optimal cultural competence development; however, the greatest impact will be achieved through a coordinated, holistic group effort that thoughtfully weaves together nursing course components, nursing curriculum, and supplementary resources. Chapter 7 presented a general overview of inquiry, action, and innovation for optimal cultural competence development. Major emphasis was on faculty self-assessment and systematic inquiry at the curricular level via a holistic, team approach. The team approach both empowers and expects every nurse educator to contribute to the process by introducing, fostering, and nurturing cultural competence development within all aspects of his or her course(s). Amid the explosion of new technology, varied teaching–learning strategies, exponentially increasing scholarly literature, a fast-paced changing society, and recent widespread global endorsement of the Guidelines for Implementing Culturally Competent Nursing Care (1–3), nurse educators may feel overwhelmed about where and how to begin. Enhancing cultural competence via f2f classrooms, hybrid, and online courses requires systematic inquiry, action, and innovation but begins with faculty self-assessment (see Chapter 7 and Jeffreys 2016 Toolkit Items 15 and 18).

Nurse educators are also challenged to (a) meet the learning needs of academically, generationally, linguistically, culturally (and sometimes geographically distant) diverse learners; and (b) prepare critical-thinking, creative nurses to meet the expanding health care needs of diverse populations. Certain factors within the academic setting may support cultural competence development, while yet other factors may restrict its development. This chapter aims to (a) uncover, discover, and explore educational opportunities (within academia at the course level) for promoting cultural competency; (b) describe action-focused strategies for educational innovation; and (c) present ideas for evaluation (and reevaluation) of educational innovation implementation. Major emphasis is placed on individual instructor appraisal, course-level appraisal, and innovations within classroom, hybrid, and online course components. For the purposes of this chapter, f2f refers to teaching and learning where teacher and learners are in the same classroom, online learning uses Internet technology to engage learners, and hybrid courses incorporate varying percentages of f2f and online components. (4) (It is beyond the scope of this book to detail online learning or other forms of distance education. Readers are referred to other sources in the literature.)

Close scrutiny at the course level (undergraduate and graduate) should assess whether cultural competency development is emphasized substantially, equally, and symmetrically in all dimensions and course components. This can begin by examining all components of the course syllabus: course description, course objectives, course topics, student learning outcomes, learning activities, course assignments, and methods of evaluation. Using the general questions depicted in Figure 7.3 and the Jeffreys Toolkit 2016 Item 20, nurse educators can conduct a systematic inquiry, make a decision, choose an action, and then develop innovations. For example, if a nurse educator decides that “care of culturally diverse clients” mentioned in the course description is “barely visible” in the other course syllabus components, the action chosen should be to make major revisions, develop innovations, and reevaluate within a specified time period. Collaboration with other faculty teaching in the nursing program and outside experts will be essential to the overall curricular goals and process. As a second example, a nurse educator may decide that the course topics present cultural competence as an “add-on” or “disconnected attachment.” Thereafter, the chosen action will be to connect together—or better still, to integrate—as a visible, horizontal thread.

Inquiry at the course level also includes all instructional media (e.g., textbooks, films, videos, movies, computer-based learning, journal articles, web pages, and PowerPoint), course components (e.g., classroom, nursing skills laboratory, simulation, clinical, service learning, and/or immersion experience), teaching–learning activities, and methods of evaluation (e.g., written assignments, presentations, and examination questions). Each of the following sections will highlight several select course-level components, providing examples of course-specific innovations. It is beyond the scope of this chapter to detail all elements. Readers are encouraged to critique the innovations presented, then modify, adapt, and create new innovations for the teaching and learning of cultural competence. Figures, “Innovation in Cultural Competence” exhibits, and the “Educator-in-Action” vignette provide supplementary information to expand upon narrative text features. TSET Research Exhibit 8.1 illustrates how the TSET (Transcultural Self-Efficacy Tool) can be used to evaluate the effectiveness of educational interventions implemented within a course. (See Chapter 9 for enhancing cultural competence in clinical settings, immersion experiences, service-learning, simulation, and nursing skills laboratory and Chapters 10 to 12 for spotlights on combination and multidimensional approaches. TSET Research Exhibits 7.2 and 7.3 present cross-curricular examples.)

TEXTBOOKS AND READING ASSIGNMENTS

Appraising textbooks carefully using preset criteria provides a systematic evaluation of textbook options (5). Although evaluation of content areas, supplementary features, cost, date of publication, and usability are important considerations, nurse educators must consider other aspects, especially if the needs of academically diverse and culturally diverse students are to be met. Textbook selection must be guided by learner characteristics, type of course, intended purpose of reading assignments, textbook features, coordination with other course components, and connection with other courses (prerequisite, co-requisite, and subsequent).

It is important to remember that it is not only the textbook that can make a difference in the learning process and the achievement of learning outcomes, but rather how the textbook is used (or not used). Accurate knowledge and comprehension about learner characteristics is a necessary precursor to textbook selection and the preparation of reading assignments. Exhibit 7.2 presents an overview of learner characteristics helpful in developing a profile of learner characteristics. For example, if many nursing students are financially challenged, it is unrealistic to expect that a supplementary textbook will be purchased to complete two required class readings. In fact, such expectations may cause undue stress on financially challenged students. A better approach may be to supplement one main textbook with select journal articles available online with full-text access or on reserve in the library. Several brief journal articles, featuring select cultural topics, can be used to enhance cultural competence development by creatively integrating the articles with other course activities. Optional readings concerning culture (or any topic) send a mixed message to students. For example, students may perceive that cultural considerations in nursing care are optional rather than an expected, integral component in providing quality nursing care and/or never complete the reading.

Or, as another example, if ancillary digital resources require an extra charge, some students may opt not to purchase them because of interpreting the term ancillary as meaning “optional.” Even with textbooks whose ancillary digital resources are a “package deal” that all students are expected to purchase, it does not necessarily mean that students will utilize ancillary resources optimally. Especially with an academically, culturally, technologically, economically, and generationally diverse student population, guidance with how, when, and why to effectively incorporate such digital ancillary resources to best enhance learning requires faculty expertise, time, and commitment.

As another example, an academically diverse student group will need much guidance with how to become active readers, use tables and graphs effectively, analyze and synthesize material, formulate questions, and highlight important information (6–12). A new student orientation or course orientation that customizes prereading strategies, time management, active reading strategies, note-taking, and study skills to the nursing course will be most beneficial in enhancing success. Without reinforced guidance, students may not see the importance of textbook case studies, research briefs, clinical snapshots, digital ancillary learning resources, or other textbook chapter features concerning culturally diverse clients. As a result, students may neglect to read these sections and/or to optimally utilize accompanying ancillary digital learning resources. Consistent with trends in higher education, the numbers of academically diverse undergraduate nursing students, such as students whose first language is different from the language used in the academic setting, has increased. In addition, the number of students who completed remedial courses has also increased. Nurse educators can further assist diverse students by:

Examining the textbook (and its ancillary digital resources) for the age, gender, and cultural diversity of registered nurses and other health professionals depicted in illustrations, photos, or case exemplars is another important consideration to promote inclusion and foster cultural competence development. Identifying gaps between learner characteristics and textbook case studies provides the opportunity for nurse educators to supplement readings with other examples featuring cultures both similar and different from those of learners. Such supplements are valuable whether the course is an undergraduate medical–surgical nursing course, a required core course in the master’s degree curriculum, or any other course at any degree level. After some basic, introductory foundational material and case examples regarding cultural diversity and cultural competence, educators can creatively involve learners in critically appraising assigned readings and creating assignments whereby students find and share an article, and/or a published case study, or any other reliable resource to expand upon a class topic aimed at enhancing cultural competence.

FILMS, MOVIES, OR VIDEOS

Films, movies, or videos provide unique opportunities to enhance student cognitive, psychomotor, and affective learning. For the purposes of this chapter, “films, movies, and videos” will be referred to simply as “videos.” Through videos, students are exposed to a combined audio and visual medium that can enhance learning, especially among visual learners. If used appropriately, videos can expose students to a wide variety of new situations and cultural groups in a short amount of time that, ordinarily, they may not have the opportunity to encounter at all or for some time. Unfortunately, videos also have the potential to perpetrate stereotypes unless students are properly guided.

The best learning can take place if students are appropriately guided toward what to focus on in the video. A set of guided objectives, expected outcomes, and/or preset discussion questions can direct students’ attention toward achieving the desired learning outcomes. Pausing the video at strategic points is beneficial to maximize active learning (9, 13). For example, the nurse educator can elaborate upon key components, ask probing questions to stimulate further inquiry, direct learners to reflect upon the last segment viewed, and provide opportunity for guided class questions and/or discussion before proceeding with film. Pauses permit self-reflection, class dialogue, synthesis, clarification, and organized compartmentalization of learning “chunks” before proceeding to new learning. New questions or areas of guided focus can assist learners (especially novices) about what to look for, thereby serving as a jumpstart for critical thinking about cultural competence.

Cautioning viewers about the dangers of stereotyping based on the scenarios depicted in the video recognizes limitations but permits a partial insight into a different, emic (insider’s) view. An outsider from a different culture may gain a new viewpoint. Through organized class discussion, a student who is an “insider” in the depicted culture may also gain a new perspective on how outsiders (classmates) view certain cultural values and beliefs (CVB) while also being able to add his or her perspective on CVB presented in the video. Every video should be evaluated as to how it potentially perpetuates misperceptions, inaccuracies, and biases within nursing, health care, and particular cultural groups. The instructor is empowered to make a significant difference by developing cultural competence in students concerning every topic. Stopping the video to describe application to various cultural groups emphasizes the importance of culture and effectively links culture with other course components. When comparing and contrasting cultures, focused questions can assist students in recognizing subtle differences in various cultures (9). (In the online environment, “pause” moments with reflective or critical thinking questions interspersed via video-streaming, screen pop-ups, subtitles, written handouts with pause times and questions, or other technological strategies can be incorporated.)

Whether or not videos viewed outside of class are required or supplemental can have a tremendous impact upon learning outcomes. For example, if a video on “Chinese healing” is supplemental rather than required, then the perception is that it is (a) unnecessary, (b) less important than “required” assignments, and/or (c) optional. It may also give the perception that Chinese healing (and other non-Western and folk medicine healing modalities) are “alternative.” “complementary,” or “less valued” than Western medicine approaches. Similarly, if a video is “required” but it is not connected to the other course components, assignments, or discussions, it is really a disconnected attachment that needs to be connected or integrated effectively throughout the course (or ideally the curriculum). (See Chapter 10 for an innovative strategy that integrates video within a multidimensional strategy design.)

Educational course videos may focus on varied topics such as (a) general transcultural nursing principles, (b) a particular cultural group, (c) comparison between several cultural groups, (d) multidisciplinary health care, (e) clinical topics with cultural competence addressed, (f) clinical topics without cultural competence addressed, (g) patient-centered teaching, or (h) conferences and meetings. Creatively selecting fiction and/or nonfiction TV movies/clips and/or cinema films/clips can effectively complement and enhance course topics. Clinical topic videos should be critically appraised for relevance within and between cultural groups. For example, videos that include skin assessment should take into account differences based on physical appearance (e.g., variations in skin pigmentation, healing, and scar formation), cultural practices (e.g., tattoos, body-piercing, male and female circumcision), and cultural values (taboos, modesty in exposing skin to examiners of different genders, ages, cultures, and religions). Although the film may not address this, or may address these issues minimally, the nurse educator has the potential to make a difference by asking students to reflect on different client situations, asking questions, storytelling about actual clinical incidents, and presenting case studies (see Exhibit 8.1). Pauses, reflective feelings and thoughts, expression, journaling, and dialogue can facilitate heightened attention, awareness, skills, and knowledge concerning cultural considerations via f2f, hybrid, online, or other distance education environments. Nurse educators have the unique opportunity to incorporate various teaching–learning strategies that tap into cognitive, practical, and affective learning in order to achieve optimal outcomes among diverse learners (see “Educator-in-Action” vignette).

COMPUTER-BASED LEARNING: SOFTWARE PROGRAMS

Preparing computer-literate graduates of nursing programs who exercise critical thinking, clinical decision making, and reflection is an absolute necessity presently and in the future (9–12; 14–16). In particular, the future demands that nurses exercise critical thinking and clinical decision making that consider clients’ cultural values, beliefs, and practices. Empirical evidence supports that computer-assisted instruction (CAI) or computer-based learning (CBL) can enhance self-efficacy in clinical decision making and create a link between theoretical and clinical learning without the fear of jeopardizing client safety (4, 6, 9, 17–21). Many software programs feature unfolding case studies or spotlight various aspects of health assessment, nursing interventions and treatment, clinical procedures, pathophysiology, discharge planning, and so on. Within the context of cultural competence development, this means that students can potentially interact with a wide sampling of clients and case studies who are culturally different from the student without fear of making cultural mistakes. Students may have guided practice without the instructor present (22), thereby decreasing the anxiety of being observed, judged, or graded. Especially for adult learners who are self-directed and desire immediate feedback for performance, such programs offer a forum for independent learning, immediate feedback, clinical decision making, and critical thinking in a nonthreatening environment; transcultural self-efficacy (TSE) perceptions will be positively influenced. In addition, computer-based learning tools can emphasize lifelong learning (23–26), a quality necessary to keep pace with the ever-changing client populations and cultures.

Previous computer experience and faculty promotion of software programs has a direct impact on student use (4, 9, 27). Previous computer experience may include a degree of comfort and familiarity with computer use, satisfaction with software programs, correlation of CBL material with course content and immediate goals, self-efficacy about computer skills, easy access, satisfaction, and support services associated with software use. For example, the quality of the software program can influence student learning, interest, and motivation. A high-quality program is one that is interactive, stimulating, uses a multimedia format, permits user control, and enables immediate and descriptive feedback in questioning (28). If software programs are to be perceived as user-friendly, programs must be promoted consistently by faculty throughout the curriculum, beginning students must be introduced to them early in the curriculum, and software programs must complement and enhance learning via other educational media (e.g., film, video, reading, and lecture). Using a standardized, reliable, and valid evaluation tool for appraising instructional software can enhance the probability that programs will meet overall curricular and course objectives (22). Adding several items that evaluate the capacity to enhance learning related to cultural competence development and accurate exposure to multicultural clients, families, communities, nurses, and health care professionals will provide comparative information. Such data will help with purchasing decisions, design of strategies to integrate programs systematically throughout the course (and curriculum), and development of supplementary materials as needed to further address cultural similarities and differences. Examples of strategy design innovations are presented in Exhibit 8.2.

“Students today include traditional college-age learners, first time adult learners, and second-degree students” (29, p. 348) and represent generational diversity (10–12, 25). Recently, researchers have begun to realize the need to explore expectations and preferred learning styles and values among different generations: baby boomers, generation X, and generation Y (30). The generation of the millennials challenges educators to keep pace with the social and educational technologies that these learners expect (31–36). For example, the net generation (1980 to 2004) expects technology, participates actively in the learning process, wants immediate response to learning, multitasks, prefers group work, and enjoys being mentored by older generations. In contrast, Generation Xers (1960 to 1980) are self-directed learners who are less technology proficient, can delay gratification, and seek learning with practical application. Baby boomers (1940 to 1960) are generally less technology proficient since technology is viewed as a new approach rather than an expected approach, are more familiar with passive learning styles, and expect a caring and connected work environment. (25, 35, 36)

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EXHIBIT 8.2

Innovations in Cultural Competence Development: Computer-Based Learning (Computer-Assisted Instruction)

 

Sample Programmed Instruction Guide

  1.  Click on the icon “Medical–Surgical Nursing.”

  2.  Click on the case study “Care of the Client with ______.”

  3.  Click on the CAI program option “Video With Tutorial” and view segment 1.

  4.  What assumptions did you make about the client’s cultural background in video segment 1? Why?

  5.  What assumptions did you make about the nurse’s cultural background in video segment 1? Why?

  6.  What are the dangers of making assumptions based on physical characteristics, age, and/or gender?

  7.  Proceed to the video segment and tutorial CAI in segments 2–7.

  8.  What verbal and nonverbal communication techniques does the client use?

  9.  What verbal and nonverbal communication techniques does the nurse use?

10.  Are the communication patterns used effective? Why or why not?

11.  What information concerning the client’s cultural values, beliefs, and practices were presented?

12.  How did the nurse incorporate the client’s cultural values, beliefs, and practices into the plan of care?

13.  To achieve cultural congruent care, what (else) should the nurse have done? Why?

14.  Reflect upon the traditional elderly Chinese client presented in last week’s class video. How would the nurse-client interaction and plan of care be the same (or different) to achieve cultural congruent care? Explain.

15.  Reflect upon the case study about the Mexican American migrant worker presented in this week’s assigned reading (Chapter 12). How would the nurse–client interaction and plan of care be the same to achieve cultural congruent care? Explain.

16.  Proceed to video segment and tutorial CAI number 8–15.

17.  To achieve cultural congruent care, how would the nurse’s discharge teaching and home care plan be the same (or different) if the client held the dominant (traditional) values, beliefs, and practices consistent with the ___________ culture? (examples: Egyptian, Filipino, Nigerian, Lakota, Jamaican, etc.) Explain.

18.  To achieve cultural congruent care, how would the nurse’s discharge teaching and home care plan be the same (or different) if the client in the previously listed ethnic groups were also ___________? (examples: female, Muslim, Jehovah Witness, Catholic, Jewish, Mormon, indigent, wealthy, illiterate, deaf, unemployed, unmarried, etc.) Explain.

19.  Proceed to complete the review questions and check your answers and rationale.

20.  Reflect on your experience completing this CAI and programmed instruction guide questions. What did you like best? Discuss.

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