The Clinical Reasoning Conference: A Flipped‐Classroom, Case‐Based Approach to Teaching and Learning in the Pre‐Clerkship Medical Curriculum
Authors: Sullivan Rebecca Petre , Karras David J , Schwartz Daniel R. , Sterling Gerald 
Published: November 2023

The Lewis Katz School of Medicine at Temple University (LKSOM) annually welcomes a class of 210 students from a variety of cultural, socioeconomic, and geographic backgrounds to the MD program. Our goal is to create an interactive and collaborative experience to promote deeper levels of learning for large groups of students, while offering the attention, guidance and expertise of our faculty.

Medical schools nationally are expected to transition from traditional, passive didactic educational models to active, self‐directed learning models. Typical “flipped classroom” activities, however, require small class sizes and low learner/faculty ratios. This is difficult to execute in medical schools, where relatively few expert teaching faculty are available. The Clinical Reasoning Conference (CRC), added to all blocks in the first two years of the curriculum, is a case‐based learning activity developed at LKSOM to address this need by providing a format for independent, self‐directed learning, while encouraging engagement in experiences which expand upon and apply previously learned material to a case‐based problem. A core group of basic science and clinical educators (Core Educators) has been selected to develop and facilitate CRCs across the curriculum.

One week prior to each session, students are assigned a case with preparatory materials, including video lectures, journal articles, and/or textbook readings, tailored to their level of learning. As the CRC begins, students are given a series of questions exploring basic science concepts, clinical questions, and curricular threads. Students work on the case in teams of 6 students. Throughout the conference, faculty‐selected teams lead the class discussion on a subset of the questions. Additional teams document the discussion, which is compiled and reviewed by faculty before dissemination to the class. Core Educators and content experts facilitate the CRC, and assess student presentations and discussion using a rubric designed to provide both quantitative and narrative feedback.

The CRC model allows for the connection of the first year (Normal Structure, Function and Development) and second year (Causes, Mechanisms, Identification and Treatment of Major Human Diseases) curricula. One example is our Heart Failure CRC series; the first year CRC explores basic science mechanisms contributing to both normal physiology and pathophysiology, whereas the second year CRC further explores the development and mechanisms of disease, diagnosis, treatment, and prognosis.

The CRC model allows students to integrate material learned throughout their pre‐clerkship coursework and to build a conceptual framework on which to connect new material. CRCs promote student engagement, encourage higher orders of thinking as per Bloom's taxonomy, and provide value to the pre‐ clerkship curriculum. Small, diverse groups are pre‐designated to promote development in interpersonal and communication skills and professionalism. CRCs help bridge the transition from pre‐clerkship coursework to clinical clerkships in the third year.