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基于案例的范例有效地培养，其中包括教学错误(例如，Stark，Kopp，&Fischer，2011)。概述的项目旨在深化和拓宽案例学习的知识，但存在教学错误。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)，只有当它们与详细的反馈相结合时，指导错误才是有益的。当诊断决定只被认定为错误时，指导错误甚至会对诊断能力的获得产生负面影响。在不同的医学领域(甲状腺功能亢进症)，诊断能力的获得是通过精心设计的反馈来培养的；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外，不同类型的教学错误可能解释了这些结果，因为在这两个领域，教学错误以部分不同的方式操作。要回答这个问题，需要通过实验改变教学错误的范围和类型。这个项目的一个重要目标是分析不同类型的教学错误和领域特定因素对诊断能力的影响。第二个开放问题集中在教学错误学习的工作机制上。在以前的工作中，有迹象表明，教学错误会提高信息处理的质量。本项目旨在确定教学错误所支持的流程。此外，我们还考察了不同类型的错误和领域特定因素对学习过程的影响。第三个问题涉及对有教学错误的学习的教学支持问题。在以前的工作中，通过提供详细的反馈来实现教学支持。然而，这种方法可能会导致对学习的消极态度。因此，本研究将考察提示诱导的自我解释的有效性。到目前为止，还没有系统地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，或者特定于所实施的错误。此外，提示的特殊性如何影响学习过程仍是一个悬而未决的问题。我们认为自我解释提示的有效性受到学习者特征的影响。先前诊断能力的影响，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地研究。此外，还必须分析我们的教学方法产生的效果在多大程度上被证明是稳定的。此外，计划进行一项实地研究，以回答这些影响能在多大程度上促进医学教育的问题。

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.