Facilitating diagnostic competences is an important objective of higher education for many professions. This meta-analysis of 35 empirical studies builds on a conceptual framework and investigates the role of problem-solving, scaffolding, and context to foster diagnostic competences in learners with lower and higher professional knowledge bases. A moderator analysis investigates which type of scaffolding is effective for different levels of learners' knowledge bases, as well as the role of the diagnostic context. Instructional support has a moderate positive effect (g = .39; CI [.22; .56]; p = .001). Diagnostic competences are facilitated effectively through problem-solving independent of the learners' knowledge base. Scaffolding types providing high levels of guidance are more effective for less advanced learners, whereas scaffolding types relying on high levels of self-regulation are more effective for advanced learners.
This work introduces a process to develop a tool-independent, high-fidelity, ray tracing-based light detection and ranging (LiDAR) model. This virtual LiDAR sensor includes accurate modeling of the scan pattern and a complete signal processing toolchain of a LiDAR sensor. It is developed as a functional mock-up unit (FMU) by using the standardized open simulation interface (OSI) 3.0.2, and functional mock-up interface (FMI) 2.0. Subsequently, it was integrated into two commercial software virtual environment frameworks to demonstrate its exchangeability. Furthermore, the accuracy of the LiDAR sensor model is validated by comparing the simulation and real measurement data on the time domain and on the point cloud level. The validation results show that the mean absolute percentage error (MAPE) of simulated and measured time domain signal amplitude is 1.7%. In addition, the MAPE of the number of points Npoints and mean intensity Imean values received from the virtual and real targets are 8.5% and 9.3%, respectively. To the author’s knowledge, these are the smallest errors reported for the number of received points Npoints and mean intensity Imean values up until now. Moreover, the distance error derror is below the range accuracy of the actual LiDAR sensor, which is 2 cm for this use case. In addition, the proving ground measurement results are compared with the state-of-the-art LiDAR model provided by commercial software and the proposed LiDAR model to measure the presented model fidelity. The results show that the complete signal processing steps and imperfections of real LiDAR sensors need to be considered in the virtual LiDAR to obtain simulation results close to the actual sensor. Such considerable imperfections are optical losses, inherent detector effects, effects generated by the electrical amplification, and noise produced by the sunlight.
Background Standardized patients (SPs) have been one of the popular assessment methods in clinical teaching for decades, although they are resource intensive. Nowadays, simulated virtual patients (VPs) are increasingly used because they are permanently available and fully scalable to a large audience. However, empirical studies comparing the differential effects of these assessment methods are lacking. Similarly, the relationships between key variables associated with diagnostic competences (ie, diagnostic accuracy and evidence generation) in these assessment methods still require further research. Objective The aim of this study is to compare perceived authenticity, cognitive load, and diagnostic competences in performance-based assessment using SPs and VPs. This study also aims to examine the relationships of perceived authenticity, cognitive load, and quality of evidence generation with diagnostic accuracy. Methods We conducted an experimental study with 86 medical students (mean 26.03 years, SD 4.71) focusing on history taking in dyspnea cases. Participants solved three cases with SPs and three cases with VPs in this repeated measures study. After each case, students provided a diagnosis and rated perceived authenticity and cognitive load. The provided diagnosis was scored in terms of diagnostic accuracy; the questions asked by the medical students were rated with respect to their quality of evidence generation. In addition to regular null hypothesis testing, this study used equivalence testing to investigate the absence of meaningful effects. Results Perceived authenticity (1-tailed t81=11.12; P<.001) was higher for SPs than for VPs. The correlation between diagnostic accuracy and perceived authenticity was very small (r=0.05) and neither equivalent (P=.09) nor statistically significant (P=.32). Cognitive load was equivalent in both assessment methods (t82=2.81; P=.003). Intrinsic cognitive load (1-tailed r=−0.30; P=.003) and extraneous load (1-tailed r=−0.29; P=.003) correlated negatively with the combined score for diagnostic accuracy. The quality of evidence generation was positively related to diagnostic accuracy for VPs (1-tailed r=0.38; P<.001); this finding did not hold for SPs (1-tailed r=0.05; P=.32). Comparing both assessment methods with each other, diagnostic accuracy was higher for SPs than for VPs (2-tailed t85=2.49; P=.01). Conclusions The results on perceived authenticity demonstrate that learners experience SPs as more authentic than VPs. As higher amounts of intrinsic and extraneous cognitive loads are detrimental to performance, both types of cognitive load must be monitored and manipulated systematically in the assessment. Diagnostic accuracy was higher for SPs than for VPs, which could potentially negatively affect students’ grades with VPs. We identify and discuss possible reasons for this performance difference between both assessment methods.
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