Impact of an online learning by concordance program on reflection
Abstract Background Learning by concordance (LbC) is a recent approach that introduces learners to the complexity and uncertainty of clinical practice. Some data on LbC suggest that it stimulates reflection in future clinicians. We developed an online LbC training program on electrocardiogram (ECG)...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12909-023-04799-9 |
| _version_ | 1797636793730859008 |
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| author | Léa Charton Abdelkader Lahmar Elodie Hernandez Fabien Rougerie Mathieu Lorenzo |
| author_facet | Léa Charton Abdelkader Lahmar Elodie Hernandez Fabien Rougerie Mathieu Lorenzo |
| author_sort | Léa Charton |
| collection | DOAJ |
| description | Abstract Background Learning by concordance (LbC) is a recent approach that introduces learners to the complexity and uncertainty of clinical practice. Some data on LbC suggest that it stimulates reflection in future clinicians. We developed an online LbC training program on electrocardiogram (ECG) interpretation in general practice at the University of Strasbourg, France, and conducted an exploratory qualitative study to document the impact of this ECG learning-by-concordance training program on reflection in participants. Methods We created 18 clinical vignettes on ECG interpretation based on a review of the literature on frequent and serious cardiovascular diseases that can be identified using an ECG in general practice. The training program was delivered online to postgraduate general practice students in two faculties of medicine. We conducted a qualitative study based on thematic analysis of two focus groups and six individual interviews. Inductive and deductive coding were performed. The five major components of reflection in the Nguyen model were used in the deductive coding: (i) thoughts and actions, (ii) attentive, critical, exploratory, and iterative processes (ACEI), (iii) underlying conceptual frame, (iv) change and (v) self. Results Two focus groups and six individual interviews were conducted. The qualitative analysis indicated 203 codes in the focus groups and 206 codes in the individual interviews, which were divided into five groups based on the components of reflection in the Nguyen model: (i) the self; (ii) attentive, critical, exploratory, and iterative interactions with (iii) one’s thoughts and actions; and (iv) a view on both the change itself and (v) the underlying conceptual frame. Inductive coding revealed interesting insights into the impact of the identity of the panel members, the absence of a scoring system and the question of uncertainty in ECG reading. Conclusions This study supports the claim that the use of LbC in the context of ECG interpretation could foster reflection in future general practitioners. We discuss future research avenues on instructional design of LbC and reflection. |
| first_indexed | 2024-03-11T12:39:15Z |
| format | Article |
| id | doaj.art-049dfb92c2674ac68985e5ffc8b2dcc7 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-03-11T12:39:15Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-049dfb92c2674ac68985e5ffc8b2dcc72023-11-05T12:21:34ZengBMCBMC Medical Education1472-69202023-11-012311910.1186/s12909-023-04799-9Impact of an online learning by concordance program on reflectionLéa Charton0Abdelkader Lahmar1Elodie Hernandez2Fabien Rougerie3Mathieu Lorenzo4Département de Médecine Générale et de la Formation Territoriale, Faculté de Médecine, Maïeutique et Sciences de la SantéDépartement de Médecine Générale et de la Formation Territoriale, Faculté de Médecine, Maïeutique et Sciences de la SantéDépartement de Médecine Générale, Faculté de MédecineDépartement de Médecine Générale et de la Formation Territoriale, Faculté de Médecine, Maïeutique et Sciences de la SantéDépartement de Médecine Générale et de la Formation Territoriale, Faculté de Médecine, Maïeutique et Sciences de la SantéAbstract Background Learning by concordance (LbC) is a recent approach that introduces learners to the complexity and uncertainty of clinical practice. Some data on LbC suggest that it stimulates reflection in future clinicians. We developed an online LbC training program on electrocardiogram (ECG) interpretation in general practice at the University of Strasbourg, France, and conducted an exploratory qualitative study to document the impact of this ECG learning-by-concordance training program on reflection in participants. Methods We created 18 clinical vignettes on ECG interpretation based on a review of the literature on frequent and serious cardiovascular diseases that can be identified using an ECG in general practice. The training program was delivered online to postgraduate general practice students in two faculties of medicine. We conducted a qualitative study based on thematic analysis of two focus groups and six individual interviews. Inductive and deductive coding were performed. The five major components of reflection in the Nguyen model were used in the deductive coding: (i) thoughts and actions, (ii) attentive, critical, exploratory, and iterative processes (ACEI), (iii) underlying conceptual frame, (iv) change and (v) self. Results Two focus groups and six individual interviews were conducted. The qualitative analysis indicated 203 codes in the focus groups and 206 codes in the individual interviews, which were divided into five groups based on the components of reflection in the Nguyen model: (i) the self; (ii) attentive, critical, exploratory, and iterative interactions with (iii) one’s thoughts and actions; and (iv) a view on both the change itself and (v) the underlying conceptual frame. Inductive coding revealed interesting insights into the impact of the identity of the panel members, the absence of a scoring system and the question of uncertainty in ECG reading. Conclusions This study supports the claim that the use of LbC in the context of ECG interpretation could foster reflection in future general practitioners. We discuss future research avenues on instructional design of LbC and reflection.https://doi.org/10.1186/s12909-023-04799-9ReflectionLearning by concordanceClinical reasoningAssessmentECG interpretation |
| spellingShingle | Léa Charton Abdelkader Lahmar Elodie Hernandez Fabien Rougerie Mathieu Lorenzo Impact of an online learning by concordance program on reflection BMC Medical Education Reflection Learning by concordance Clinical reasoning Assessment ECG interpretation |
| title | Impact of an online learning by concordance program on reflection |
| title_full | Impact of an online learning by concordance program on reflection |
| title_fullStr | Impact of an online learning by concordance program on reflection |
| title_full_unstemmed | Impact of an online learning by concordance program on reflection |
| title_short | Impact of an online learning by concordance program on reflection |
| title_sort | impact of an online learning by concordance program on reflection |
| topic | Reflection Learning by concordance Clinical reasoning Assessment ECG interpretation |
| url | https://doi.org/10.1186/s12909-023-04799-9 |
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