ViA-ScAn - Fostering of diagnostic competences in medical history taking: Effects of adaptation of scaffolds in video simulations

DFG研究股Cosima的项目4侧重于不同类型的支架对诊断活动(学习过程)的影响以及在医学模拟学习中获得诊断能力的问题。在第一个项目阶段，在现场模拟、视频模拟和角色扮演中考察了结构化反思和角色扮演对诊断能力获得的影响。创建了知识测试和对患有呼吸困难的患者进行病史记录的真实模拟，并成功地进行了验证。一项验证研究的结果表明，诊断能力可以在视频和现场模拟病史记录中可靠和有效地测量。在模拟中，战略知识被证明是诊断质量的预测因子。正在进行的第一个供资阶段的干预研究中采用了略微改进的模拟。关于诊断能力的获得，最近对研究单位进行的一项元分析的结果表明，先前知识较低的学习者更多地受益于需要较低自我调节技能的样例。然而，具有较高先前知识的学习者更多地受益于需要高度自我调节技能的反思阶段。TP 4第二个资助阶段的研究1将调查不同类型的支架，即工作实例和反思阶段，对诊断活动的影响，以及对学习典型案例的学生在视频模拟中获得诊断能力的影响。将根据研究参与者在学习阶段(宏观适应)开始时对他们的先验知识的评估，为他们分配支架的类型。在研究2中，TP 4和TP 7将对第一个资助阶段的数据进行联合重新分析，以比较不同领域中角色扮演的学习过程和结构化反思的内容。研究3将重点放在病例典型性作为获得医学诊断能力的关键背景因素上。与研究1类似，将考察样例和反思阶段对诊断活动和诊断能力获得的影响。脚手架的类型将再次根据先前的知识进行分配，但这次学生将学习非典型案例。最后，将对研究1和研究3的数据进行汇总和分析，以比较案例典型性对诊断活动的影响，以及对具有不同先前知识水平的学习者在不同类型支架支持下获得诊断能力的影响。总而言之，TP 4努力为适应不同类型的支架在基于模拟的学习环境中获得诊断能力的有效性提供证据。这个项目将第一次调查背景因素对案例典型性的影响，这取决于先验知识。

Project 4 of the DFG Research Unit COSIMA focuses on the effects of different types of scaffolding on diagnostic activities (learning processes) and on the acquisition of diagnostic competences in simulation-based learning in medicine. In the first project phase, effects of structured reflection and role-taking on the acquisition of diagnostic competences were examined in live simulations, video simulations, and role-plays. Knowledge tests and realistic simulations of history-taking with patients suffering from dyspnea were created and successfully validated. Results from a validation study indicate that diagnostic competences can be measured reliably and validly in video and live simulations of medical history-taking. Strategic knowledge turned out to be a predictor of diagnostic quality in the simulations. A slightly enhanced simulation is being applied in the ongoing intervention studies of the first funding phase. Regarding the acquisition of diagnostic competences, findings from a recent meta-analysis of the research unit suggest that learners with low prior knowledge benefit more from worked examples that require low self-regulation skills. Learners with high prior knowledge, however, benefit more from reflection phases that require high self-regulation skills. Study 1 of the second funding phase of TP 4 will investigate effects of different types of scaffolds, namely worked examples and reflection phases, on diagnostic activities and on the acquisition of diagnostic competences in students learning with typical cases in video simulations. The type of scaffold will be assigned to study participants based on the assessment of their prior knowledge at the beginning of the learning phase (macro-adaptation). In study 2, TP 4 and TP 7 will conduct a joint reanalyis of data from the first funding phase to compare learning processes and contents of structured reflection from role-plays in different domains. Study 3 will focus on case typicality as a crucial context factor for the acquisition of diagnostic competences in medicine. Analogously to study 1, effects of worked examples and reflection phases on diagnostic activities and the acquisition of diagnostic competences will be examined. The type of scaffold will again be assigned based on prior knowledge, but students will learn with atypical cases this time. Finally, data from studies 1 and 3 will be aggregated and analysed to compare effects of case typicality on diagnostic activities and on the acquisition of diagnostic competences in learners with different levels of prior knowledge who were supported with different types of scaffolds. In summary, TP 4 strives to generate evidence for the effectiveness of the adaptation of different types of scaffolds for the acquisition of diagnostic competences in simulation-based learning environments. This project will be the first to investigate the effects of the context factor case typicality depending on prior knowledge.