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"Asking questions can be a means of establishing authority, fulfilling leadership functions, and ensuring effective learning. In fact, asking questions is probably the most subtle p

According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product

ower you have for controlling people. The person who asks questions always controls the conversation... if we could discipline our minds to ask questions instead, we could lead any

; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

Examples of combination products may in

onversation to wherever we wanted it because the other person would still be wrapped up in thinking what he or she wanted to say next...One of the rights you have as a trainer is to

lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

ask questions and expect answers. This is why question-asking is such a powerful tool. It challenges and avoids confrontation at the same time."

Mitchell, Garry, The Trainer's Hand

here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe

ook: The AMA Guide to Effective Training, Amacom, 1998, p 63.

If you deliver training, odds are you reduce participants' learning and enthusiasm through manipulative questions - li

d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

Combination pro

e the ones Garry is advocating for -and that you're unaware that you're doing this. I label Garry's approach to questions as manipulative because they require that the trainer ask q

ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc

estions for the purposes of guiding a conversation in a particular direction without disclosing that direction in advance and giving participants a choice about whether they want to

easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi

go there.

My colleague Sue McKinney and I explored this subject in detail in "The Facilitative Trainer" chapter of The Skilled Facilitator Fieldbook. Today I hope I can help you id

nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically

ntify how, if at all, this is happening for you, and offer a way of using questions that avoids the negative consequences above.

When I began my work as a trainer, I often resorted

and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ

to subtly manipulative questions to achieve my goals in a training session. For example, I'd ask questions I already felt I knew the answer to in hopes that participants would get t

ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi

e "right" "Ahas". Trouble was, this was significantly limiting learning for everyone in ways I couldn't see.

Chris Argyris' research and our client work lead me to believe that thi

ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

Following aspects would a

kind of questioning gets people defensive; they don't know why you're asking the questions, they guess, and their guesses often contain negative judgments about you or the training

dd to the challenges in developing combination products:

Which markets to tap where the combination products can do fairly well?
Which combination prod

design. All this reduces your credibility and their learning.

I used the following four methods to dramatically reduce this kind of manipulation and increase my effectiveness as a

cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin

rainer; I continue to use them with colleagues to improve our training work.

~ Identify whether and how you use questions manipulatively. Record and revisit your own training work

tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen

nd/or ask to be observed as you train. Assess where you were being transparent about your reasoning for asking your questions - and where you weren't.

~ Alone and with others, expl

t?

As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel

re what beliefs led you to do this. For example, do your questions indicate you believe that the learners won't "get it" without your "guidance"? Do your questions indicate that the

ping new procedures for reviewing their safety, efficacy and quality.

Professional from academic institutions, pharmaceutical industries, health care indust

e's only one "it" to get, and you know it in advance? These assumptions and beliefs won't be "nice" or "pretty", but until you discover them, you'll continue to act as if they were

y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products

rue, and get consequences you and your participants don't want.

~ Be transparent about the change you're trying to make. If you decide you want to change your approach, let clients

.

As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de

participants and colleagues know, and ask for their feedback- especially during the training.

This last step has turned out to be simply essential for us. When I've tried to avoid

elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

Companies that provide selfless information through particip

doing this, change has either taken much longer or didn't happen at all.

What are your reactions to my thoughts here? I invite you to email me with your thoughts.

© 2005 Matt Bean

tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

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I can't tell you about my success with vending routes, but you can learn what not to do.

Are you ready to compose your cover letter? Did you get the name and address of the hiring manager conducting the interviews? What? You just got the company address and you were planning to send it to To Whom It May Concern in the human resources department? (Why on earth would somebody give their child such a name?)

We all have a tough time Prospecting. It is especially difficult to begin a prospecting process when you aren't used to it. Persistence at the beginning of any prospecting program is critical tot the success of the program.

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