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

• Applicant: Professor Dr. Martin R. Fischer
• Subject Area: General and Domain-Specific Teaching and Learning
• Term: from 2016 to 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 274698440

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.

• DFG Programme: Research Units
• Subproject of: FOR 2385: Facilitation of Diagnostic Competences in Simulation-Based Learning Environments in Higher Education
• Co-Investigators: Professor Dr. Frank Fischer; Privatdozent Dr. Matthias Siebeck