Facilitating Diagnostic Competences in Higher Education—a Meta-Analysis in Medical and Teacher Education

Chernikova, Olga; Heitzmann, Nicole; Fink, Maximilian; Timothy, Venance; Seidel, Tina; Fischer, Frank

doi:10.1007/s10648-019-09492-2

Cited by 93 publications

(134 citation statements)

References 92 publications

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“…Before including less advanced learners medical educators should consider how to ensure that learners profit from VPs. One way to make VPs profitable for less advanced students could be as reflection prompts with instructional support adapted to the prior knowledge of learners [20] or even to incorporate other instructional methods before working on the VPs. While parts of the design for VPs are important to foster clinical reasoning, we found that testing students' actual subject-specific prior knowledge levels is also of great value.…”

Section: Discussionmentioning

confidence: 99%

Learning clinical reasoning: how virtual patient case format and prior knowledge interact

Kiesewetter¹,

Sailer²,

Jung³

et al. 2020

BMC Med Educ

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Introduction: Clinical reasoning has been fostered with varying case formats including the use of virtual patients. Existing literature points to different conclusions regarding which format is most beneficial for learners with diverse levels of prior knowledge. We designed our study to better understand which case format affects clinical reasoning outcomes and cognitive load, dependent on medical students' prior knowledge. Methods: Overall, 142 medical students (3 rd to 6 th year) were randomly assigned to either a whole case or serial cue case format. Participants worked on eight virtual patients in their respective case format. Outcomes included diagnostic accuracy, knowledge, and cognitive load. Results: We found no effect of case format on strategic knowledge scores pre-vs post-test (whole case learning gain = 3, 95% CI.-.01 to .01, serial cue learning gain = 3, 95% CI.-.06 to .00 p = .50). In both case formats, students with high baseline knowledge (determined by median split on the pre-test in conceptual knowledge) benefitted from learning with virtual patients (learning gain in strategic knowledge = 5, 95% CI .03 to .09, p = .01) while students with low prior knowledge did not (learning gain = 0, 95%CI −.02 to .02). We found no difference in diagnostic accuracy between experimental conditions (difference = .44, 95% CI −.96 to .08, p = .22), but diagnostic accuracy was higher for students with high prior knowledge compared to those with low prior knowledge (difference = .8, 95% CI 0.31 to 1.35, p < .01). Students with low prior knowledge experienced higher extraneous cognitive load than students with high prior knowledge (multiple measurements, p < .01). Conclusions: The whole case and serial cue case formats alone did not affect students' knowledge gain or diagnostic accuracy. Students with lower knowledge experienced increased cognitive load and appear to have learned less from their interaction with virtual patients. Cognitive load should be taken into account when attempting to help students learn clinical reasoning with virtual patients, especially for students with lower knowledge.

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Section: Discussionmentioning

confidence: 99%

Learning clinical reasoning: how virtual patient case format and prior knowledge interact

Kiesewetter¹,

Sailer²,

Jung³

et al. 2020

BMC Med Educ

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“…The promotion of SRL is best combined with the teaching of learning content (school subject) and is not an extracurricular activity. Providing guidance and direct instruction might be most effective for less advanced self-regulated learners, while scaffolding and high levels of autonomy might be more beneficial for advanced self-regulated learners (van de Pol et al, 2010;Chernikova et al, 2020). Consequently, considering differences between students becomes crucial for teachers' SRL instruction and support (Peeters et al, 2016).…”

Section: Teaching Self-regulated Learningmentioning

confidence: 99%

“…This implies a transfer from an externally regulated form of learning to a co-regulated form finally moving toward students' selfregulated forms of learning (van de Pol et al, 2010;van Beek et al, 2014). This highlights the important role of continuously diagnosing students SRL competences, which is achieved by coaching students and providing SRL related feedback (Hamman et al, 2000;Klug et al, 2013;Chernikova et al, 2020;Vattøy, 2020). However, several studies reported that teachers rarely integrate SRL in their everyday classroom instruction, provide little direct instruction of strategies, and seldomly emphasize metacognitive aspects of SRL (Kistner et al, 2015;Spruce and Bol, 2015;Karlen, 2016b;Dignath and Büttner, 2018;Zepeda et al, 2019).…”

Section: Teaching Self-regulated Learningmentioning

confidence: 99%

Teachers’ Professional Competences in Self-Regulated Learning: An Approach to Integrate Teachers’ Competences as Self-Regulated Learners and as Agents of Self-Regulated Learning in a Holistic Manner

2020

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Competences in self-regulated learning (SRL) are important prerequisites for success in school and beyond. Teachers play a crucial role in students' development of SRL. When focusing on teachers' professional competences in SRL, their experiences as selfregulated learners and their competences as agents of SRL are important. At present, an integrative and holistic framework that combines these two important aspects of SRL with regard to teachers' professional competences in SRL is absent. First, this paper introduces a theoretical framework for teachers' professional competences and instructional practices in SRL that integrates teachers' competences as selfregulated learners with their competences as agents of SRL. This integrative approach allows for differentiated analyses of particular aspects of competences and creates the possibility to deeply understand the reasons why teachers do or do not promote SRL in classrooms. In the second part of this paper, the interplay of teachers' professional competences as self-regulated learners and agents of SRL, with their intention to implement SRL in classes and their self-reported SRL teaching practices, is examined using data provided by 106 in-service teachers from primary and secondary schools. We assessed teachers' professional knowledge about SRL (i.e., content knowledge about SRL [CK-SRL] and pedagogical content knowledge about SRL [PCK-SRL]) with two different knowledge tests. Teachers' beliefs (i.e., implicit theories about SRL and beliefs about promoting SRL) and their motivations (i.e., self-concept about one's SRL and self-efficacy to promote SRL) were assessed with self-report measures. We found that teachers had small to average amounts of CK-SRL and PCK-SRL. Teachers reported positive beliefs about and motivation toward SRL. Most importantly, the results highlight the significance of differentiating between teachers' competences as selfregulated learners and as agents of SRL when examining teachers' implementation of

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“…This meta-analysis summarizes the effects of scaffolding and technology use in simulation-based learning environments on facilitating a range of complex skills across domains (e.g., medical and teacher education, psychological counseling, care). In a previous meta-analysis, it has been found that the effects of instruction across domains of medical and teacher education have similar magnitude for a certain set of skills related to diagnosing; the effects increase in magnitude with the proper use of scaffolding (Chernikova et al, 2019). Other meta-analyses in the field of medical education (e.g., Cook, 2014) support the idea that simulations can be highly effective for advancing specific motor and technical skills.…”

mentioning

confidence: 99%

Simulation-Based Learning in Higher Education: A Meta-Analysis

Chernikova¹,

Heitzmann²,

Stadler

et al. 2020

Review of Educational Research

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442

275

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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.

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Facilitating Diagnostic Competences in Higher Education—a Meta-Analysis in Medical and Teacher Education

Cited by 93 publications

References 92 publications

Learning clinical reasoning: how virtual patient case format and prior knowledge interact

Learning clinical reasoning: how virtual patient case format and prior knowledge interact

Teachers’ Professional Competences in Self-Regulated Learning: An Approach to Integrate Teachers’ Competences as Self-Regulated Learners and as Agents of Self-Regulated Learning in a Holistic Manner

Simulation-Based Learning in Higher Education: A Meta-Analysis

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