Fallbasiertes Lernen mit fehlerhaften Lösungsbeispielen in der Medizin: Effektivität von unterschiedlichen instruktionalen Fehlern und Selbsterklärungsprompts

医学生的诊断能力学习可以通过包括教学错误在内的基于案例的工作实例来有效地培养（例如，Stark, Kopp, & Fischer, 2011）。该项目旨在加深和拓宽案例教学法的知识。到目前为止，我们的教学方法的效果部分不一致。在一个领域（动脉高血压），教学错误只有在与详细的反馈相结合时才有益。当诊断决策仅被定性为错误时，教学错误甚至对诊断能力的习得产生负面影响。在不同的医学领域（甲状腺机能亢进），诊断能力的获得是通过详细的反馈来促进的；这种影响在很大程度上独立于教学错误的提供。除了特定领域的解释之外，不同类型的教学错误可能会导致这些结果，因为在两个领域中，教学错误的操作方式部分不同。为了回答这个问题，教学错误的领域和类型需要通过实验来改变。该项目的一个重要目标是分析不同类型的教学错误和特定领域因素对诊断能力的影响。第二个开放的问题集中在教学错误学习的工作机制上。在先前的研究中，有迹象表明教学错误会提高信息处理的质量。这个项目试图识别由教学错误支持的过程。此外，研究了不同类型的误差和领域特定因素对学习过程的影响。第三个问题是关于对有教学错误的学习的教学支持问题。在以前的工作中，教学支持是通过提供详细的反馈来实现的。然而，这种方法会导致被动的学习态度。因此，我们将对提示诱导的自我解释的有效性进行研究。提示应该在多大程度上是一般性的，即独立于内容因素，或特定于所实施的错误，迄今尚未系统地进行调查。此外，提示的特异性如何影响学习过程的问题仍未解决。我们认为自我解释提示的有效性受到学习者特征的调节。先验诊断能力以及动机变量对诊断能力习得和自我解释提示有效性的影响需要更详细的研究。此外，还必须分析我们的教学方法所产生的效果在多大程度上是稳定的。此外，计划进行一项实地研究，以回答这些影响在多大程度上有助于加强医学教育的问题。

Learning of diagnostic competence in medical students can effectively be fostered through case-based worked examples which include instructional errors (e.g., Stark, Kopp, & Fischer, 2011). The project outlined is supposed to deepen and broaden the knowledge on case-based learning with instructional errors.So far the effects of our instructional approach were partly inconsistent. In one domain (arterial hypertension) instructional errors were only beneficial if they were combined with elaborated feedback. The instructional errors even had negative effects on the acquisition of diagnostic competence when diagnostic decisions were only qualified as wrong. In a different medical domain (hyperthyroidism), acquisition of diagnostic competence was fostered by elaborated feedback; this effect was largely independent from the provision of instructional errors. In addition to domain-specific explanations, different types of instructional errors may account for these results because in both domains instructional errors were operationalized in a partly different way. To answer this question, domain and type of instructional error need to be varied experimentally. An important goal of this project is to analyze the effects of different types of instructional errors and of domain-specific factors on diagnostic competences.A second open question focuses on the working mechanisms of learning with instructional errors. In prior work there were hints that instructional errors foster the quality of information processing. This project seeks to identify processes that are supported by instructional errors. In addition, effects of different types of errors and domain specific factors on learning processes are investigated.A third question concerns the issue of instructional support for learning with instructional errors. In prior work instructional support was realized by providing elaborated feedback. However, this method can contribute to a passive attitude towards learning. Therefore, the effectiveness of self-explanation induced by prompts will be investigated. The extent to which prompts should be general, that is independent from content factors, or specific to the errors implemented has not been investigated systematically so far. Moreover, the question remains open how the specificity of the prompts influences the learning process. We suppose that the effectiveness of self-explanation prompts is moderated by characteristics of the learner. The influence of prior diagnostic competence, and also of motivational variables on the acquisition of diagnostic competence and on the effectiveness of self-explanation prompts needs to be studied in more detail. In addition, it has to be analyzed to what extent the effects generated by our instructional approach prove stable. Furthermore, a field study is planned to answer the question how far these effects can contribute to enhance medical education.