0
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Assessment of Diagnostic Competences With Standardized Patients Versus Virtual Patients: Experimental Study in the Context of History Taking

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          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 t 81=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 ( t 82=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 t 85=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.

          Related collections

          Most cited references 51

          • Record: found
          • Abstract: not found
          • Article: not found

          A simple sequentially rejective multiple test procedure.

           S Holm,  SA Holm,  Holm (1979)
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            The Experience of Presence: Factor Analytic Insights

              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Expectancy-value theory of achievement motivation: A developmental perspective

                Bookmark

                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                March 2021
                4 March 2021
                : 23
                : 3
                Affiliations
                [1 ] Institute for Medical Education University Hospital, LMU Munich Munich Germany
                [2 ] Department of Psychology Ludwig-Maximilians-Universität München Munich Germany
                [3 ] Munich Center of the Learning Sciences Ludwig-Maximilians-Universität München Munich Germany
                Author notes
                Corresponding Author: Maximilian C Fink maximilian.fink@ 123456yahoo.com
                Article
                v23i3e21196
                10.2196/21196
                7974754
                33661122
                c3d23b39-b708-4675-a4d0-44ffdb3d08c8
                ©Maximilian C Fink, Victoria Reitmeier, Matthias Stadler, Matthias Siebeck, Frank Fischer, Martin R Fischer. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.03.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                Categories
                Original Paper
                Original Paper

                Comments

                Comment on this article