Learning-by-Concordance to Enhance Clinical Reasoning Skills in Student Pharmacists

To assess the impact of a Learning-by-Concordance (LbC) activity within second professional year (P2) and third professional year (P3) capstone courses on student perceptions of learning, and to compare student group clinical reasoning responses to the responses of a faculty expert.

An LbC module with 3 clinical vignettes focused on type 2 diabetes mellitus pharmacotherapy was created and implemented in P2 and P3 capstone courses. Student groups provided Likert-based responses to the clinical vignettes and completed a perceptions survey following completion of the LbC module.

A total of 129 P2 and 100 P3 students were enrolled in the capstone courses and participated in the LbC module. Student group responses to each therapeutic option in vignettes 1 and 2 did not differ significantly between P2 and P3 student groups. Alignment between student and faculty expert response was high for both vignettes. Most students agreed or strongly agreed that the LbC module increased their perceived knowledge, challenged them to think critically, and facilitated discussion within their team-based learning (TBL) group. When compared with P3 students, significantly more P2 students noted that the LbC activity helped with application of the Pharmacists' Patient Care Process (PPCP) and desired to have more LbC activities in their coursework.

The LbC teaching methodology is an available tool to support clinical reasoning in uncertainty or complexity in the didactic setting that mimics real-world practice. Students perceived that LbC enhanced their knowledge, encouraged critical thinking, and facilitated collaboration.