[Clinical reasoning learning (CRL) sessions. An example of a contextualized teaching activity adapted to clinical...

Clinical reasoning learning (CRL) sessions stem from an educational reform brought about since 1987 at the Faculty of Medicine of the Université de Sherbrooke. This reform is student-centered and based on situated learning and teaching. The objective of the CRL sessions, designed and implemented at the clerkship level, is to help students develop problem solving competencies through the use of effective general clinical reasoning strategies and the development of a highly organized network of specific knowledge. These sessions also strive to offset the difficulties of random clinical exposure and often highly complex cases encountered by trainees during clinical rotations in teaching hospitals. Formed of small groups, sessions recreate a clinical consultation setting focused on a specific priority problem and clinical condition identified among the mandatory objectives of the rotation. Emphasis is placed on early generation and subsequent testing of diagnostic hypothesis, and the active search and gradual disclosure of clinical data using hypothesis-driven inquiry strategy. Students are asked to verbalize their reasoning process under the close supervision of a clinical expert in the field under discussion. Implemented in 5 different clinical disciplines since 1990 in Sherbrooke, assessment data are now available and support the relevance and usefulness of CRL sessions.