Simulation-based learning offers a wide range of opportunities to practice complex skills in higher education and to implement different types of scaffolding to facilitate effective learning. This meta-analysis includes 145 empirical studies and investigates the effectiveness of different scaffolding types and technology in simulation-based learning environments to facilitate complex skills. The simulations had a large positive overall effect: g = 0.85, SE = 0.08; CIs [0.69, 1.02]. Technology use and scaffolding had positive effects on learning. Learners with high prior knowledge benefited more from reflection phases; learners with low prior knowledge learned better when supported by examples. Findings were robust across different higher education domains (e.g., medical and teacher education, management). We conclude that (1) simulations are among the most effective means to facilitate learning of complex skills across domains and (2) different scaffolding types can facilitate simulation-based learning during different phases of the development of knowledge and skills.

We propose a conceptual framework which may guide research on fostering diagnostic competences in simulations in higher education. We first review and link research perspectives on the components and the development of diagnostic competences, taken from medical and teacher education. Applying conceptual knowledge in diagnostic activities is considered necessary for developing diagnostic competences in both fields. Simulations are considered promising in providing opportunities for knowledge application when real experience is overwhelming or not feasible for ethical, organizational or economic reasons. To help learners benefit from simulations, we then propose a systematic investigation of different types of instructional support in such simulations. We particularly focus on different forms of scaffolding during problemsolving and on the possibly complementary roles of the direct presentation of information in these kinds of environments. Two sets of possibly moderating factors, individual learning prerequisites (such as executive functions) or epistemic emotions and contextual factors (such as the nature of the diagnostic situation or the domain) are viewed as groups of potential moderators of the instructional effects. Finally, we outline an interdisciplinary research agenda concerning the instructional design of simulations for advancing diagnostic competences in medical and teacher education.

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.

Purpose To advance the learning of professional practices in teacher education and medical education, this conceptual paper aims to introduce the idea of representational scaffolding for digital simulations in higher education. Design/methodology/approach This study outlines the ideas of core practices in two important fields of higher education, namely, teacher and medical education. To facilitate future professionals’ learning of relevant practices, using digital simulations for the approximation of practice offers multiple options for selecting and adjusting representations of practice situations. Adjusting the demands of the learning task in simulations by selecting and modifying representations of practice to match relevant learner characteristics can be characterized as representational scaffolding. Building on research on problem-solving and scientific reasoning, this article identifies leverage points for employing representational scaffolding. Findings The four suggested sets of representational scaffolds that target relevant features of practice situations in simulations are: informational complexity, typicality, required agency and situation dynamics. Representational scaffolds might be implemented in a strategy for approximating practice that involves the media design, sequencing and adaptation of representational scaffolding. Originality/value The outlined conceptualization of representational scaffolding can systematize the design and adaptation of digital simulations in higher education and might contribute to the advancement of future professionals’ learning to further engage in professional practices. This conceptual paper offers a necessary foundation and terminology for approaching related future research.

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