Thinking About the Why: A Qualitative Study on Students' Perspectives of Paediatric Team-Based Learning Discussions

Clinical reasoning skills are essential to medical practice. Team-based learning (TBL) using key-feature questions provides students an opportunity to explicitly practice clinical reasoning skills with peers. Understanding student experiences with this learning strategy may provide insights into optimizing learning experiences that foster clinical reasoning in preparation for the care of future patients.

A descriptive qualitative design explored third-year medical students' experiences of a clinical reasoning-focused virtual TBL session. Six focus groups involving 26 third-year medical students were conducted; audio recordings were transcribed verbatim. Themes were generated from analysed codes, drawing connections between common thoughts, processes and conditions experienced by participants. Data were verified, upholding principles of qualitative rigour to assure methodological credibility, transferability, confirmability and reflexivity.

Data analysis revealed five themes: (a) self-confidence, including enabling and deterring factors and peer calibration; (b) co-learning with peers, with students identifying knowledge gaps and gaining experience establishing consensus; (c) trust, as related to sense and position of authority; (d) clinical reasoning strategies articulated by students and integrating peer feedback; and (e) clinical application, as a parallel to real-life patients involving choosing wisely and commitment to decisions.

Students' perspectives on the clinical reasoning process were greatly impacted by clinical experience, including lack thereof. Their peer-to-peer experience highlights the power of social learning and trusting relationships on students' professional identity formation. How students translate learning from the classroom to authentic clinical encounters requires further study.