Learning by concordance (LbC) to develop professional reasoning skills : AMEE guide no. 141

Abstract

Developing effective clinical reasoning is central to health professions education. Learning by concordance (LbC) is an on-line educational strategy that makes learners practice reasoning competency in case-based clinical situations. The questions asked are similar to those professionals ask themselves in their practice and participant answers are compared to those of a reference panel. When participants answer the questions, they receive an automated feedback that is two-fold as they see (1) how the panelists respond and (2) justifications each panelist gives for their answer. This provides rich contextual knowledge about the situation, supplemented by a synthesis summarizing crucial points. As many educators in the health sciences are engaging in introducing innovative approaches, many consider building LbC learning modules. Elaborating, designing and implementing a LbC tool remain a challenge. This AMEE Guide describes the steps and elements to be considered when designing a LbC tool, drawing on examples from distinct health professions: medicine, nursing, physiotherapy, and dentistry. Specifically, the following elements will be discussed: 1) LbC theoretical underpinnings; 2) principles of LbC questioning; 3) goals of the concordance-based activity; 4) nature of reasoning tasks; 5) content / levels of complexity; 6) reference panel; 7) feedback / synthesis messages; 8) on-line learning platforms.