TY - JOUR AU - Fernandez, Nicolas AU - Foucault, Amélie AU - Dubé, Serge AU - Robert, Diane AU - Lafond, Chantal AU - Vincent, Anne-Marie AU - Kassis, Jeannine AU - Kazitani, Driss AU - Charlin, Bernard PY - 2016/10/18 Y2 - 2024/03/29 TI - Learning-by-Concordance (LbC): introducing undergraduate students to the complexity and uncertainty of clinical practice JF - Canadian Medical Education Journal JA - Can. Med. Ed. J VL - 7 IS - 2 SE - Original Research DO - 10.36834/cmej.36690 UR - https://journalhosting.ucalgary.ca/index.php/cmej/article/view/36690 SP - e104-113 AB - <p><strong>Background: </strong>A current challenge in medical education is the steep exposure to the complexity and uncertainty of clinical practice in early clerkship. The gap between pre-clinical courses and the reality of clinical decision-making can be overwhelming for undergraduate students. The Learning-by-Concordance (LbC) approach aims to bridge this gap by embedding complexity and uncertainty by relying on real-life situations and exposure to expert reasoning processes to support learning. LbC provides three forms of support: 1) expert responses that students compare with their own, 2) expert explanations and 3) recognized scholars’ key-messages.</p><p><strong>Method: </strong>Three different LbC inspired learning tools were used by 900 undergraduate medical students in three courses: Concordance-of-Reasoning in a 1<sup>st</sup>-year hematology course; Concordance-of-Perception in a 2nd-year pulmonary physio-pathology course, and; Concordance-of-Professional-Judgment with 3rd-year clerkship students. Thematic analysis was conducted on freely volunteered qualitative comments provided by 404 students.</p><p><strong>Results:  </strong>Absence of a right answer was challenging for 1<sup>st</sup> year concordance-of-reasoning group; the 2<sup>nd</sup> year visual concordance group found radiology images initially difficult and unnerving and the 3<sup>rd</sup> year concordance-of-judgment group recognized the importance of divergent expert opinion.</p><strong>Conclusions: </strong>Expert panel answers and explanations constitute an example of “cognitive apprenticeship” that could contribute to the development of appropriate professional reasoning processes. ER -