Berndt Markus, Thomas Franziska, Bauer Daniel, Härtl Anja, Hege Inga, Kääb Stefan, Fischer Martin R, Heitzmann Nicole
University Hospital, LMU Munich, Institute for Medical Education, Munich, Germany.
Walden University, Richard W. Riley College of Education and Leadership, Minneapolis (MN), USA.
GMS J Med Educ. 2020 Feb 17;37(1):Doc11. doi: 10.3205/zma001304. eCollection 2020.
ECG interpretation is prone to errors that can lead to relevant misdiagnoses and incorrect treatment. Prompts are one way in lectures to encourage learning from one's own mistakes and to reduce error rates. Prompts are measures such as questions, hints, and suggestions of content-related or metacognitive nature, which can lead to self-explanation in the learner and thus to a deeper understanding of an issue. The aim of the study was therefore to investigate whether the use of prompts can reduce the error rate in ECG interpretation among students. In a 2x2 experimental test and control group design, =100 final year medical students carried out ECG interpretation tasks in the form of online case vignettes in CASUS. In these tasks, justification prompts (B) and error analysis prompts (F) were systematically varied in four groups and the learning success was measured using a knowledge test. In addition, prior knowledge in ECG interpretation, motivation, interest in the topic, subjective confidence in ECG interpretation, and cognitive load was collected. Neither error analysis prompts nor justification prompts had a significant effect on the correct ECG interpretation by students, (1,96)=1.03, =.31. Justification prompts seemed to have a positive effect on the confidence of answering the questions, (1,96)=10.15, =.002, =.10; and a negative effect on student motivation, (1,96)=8.13 , =.005, =.08; but both with comparable diagnostic accuracy. The present study could not confirm the positive effects of prompts on the error rate in ECG interpretation reported in the literature but showed significant effects on subjective confidence and motivation which should be investigated in further studies.
心电图解读容易出现错误，这些错误可能导致相关的误诊和不当治疗。在讲座中，提示是一种鼓励从自身错误中学习并降低错误率的方式。提示是诸如问题、提示以及与内容相关或元认知性质的建议等措施，这些措施可促使学习者进行自我解释，从而更深入地理解某个问题。因此，本研究的目的是调查使用提示是否能降低学生心电图解读中的错误率。在一个2×2实验性测试与对照组设计中，100名医学专业最后一年的学生以在线病例 vignettes 的形式在 CASUS 中进行心电图解读任务。在这些任务中，在四组中系统地改变了理由提示（B）和错误分析提示（F），并使用知识测试来衡量学习成果。此外，还收集了心电图解读方面的先验知识、动机、对该主题的兴趣、对心电图解读的主观信心以及认知负荷。错误分析提示和理由提示对学生正确解读心电图均无显著影响，（1,96）=1.03，P =.31。理由提示似乎对回答问题的信心有积极影响，（1,96）=10.15，P =.002，η² =.10；对学生动机有消极影响，（1,96）=8.13，P =.005，η² =.08；但两者的诊断准确性相当。本研究未能证实文献中报道的提示对心电图解读错误率的积极影响，但显示出对主观信心和动机有显著影响，这应在进一步研究中进行调查。
