Fostering collaboration in simulations: How advanced learners benefit from collaboration scripts and reflection

Background

Individual reflection and interdisciplinary collaboration can be critical for high-quality diagnostic outcomes. However, empirical findings on using instructional approaches to facilitate reflection and collaboration in collaborative diagnostic reasoning are inconclusive and limited. Previous studies on structured reflection and collaboration scripts have failed to consider learners’ prior knowledge, but the benefits of different types of instructional support, which offer varying levels of external guidance, tend to differ across prior knowledge levels.

Aims

We aim to investigate individual and synergistic effects of structured reflection and collaboration scripts on collaborative diagnostic reasoning while considering knowledge in a simulation and to explore how individual reflection and collaborative engagement contribute to diagnostic outcomes.

Sample

Participants were 151 advanced medical students.

Methods

Participants received structured reflection, collaboration scripts, both, or no support while diagnosing fictitious patient cases with an agent-based radiologist.

Results

Structured reflection improved collaborative diagnostic reasoning performance for learners with extensive prior knowledge but impeded performance for learners with little prior knowledge. The opposite was found for collaboration scripts. Furthermore, learners with extensive prior knowledge benefited more from a combination of both kinds of support than learners with little prior knowledge. Whereas no main effect of instructional support on the diagnostic outcome was found, simply working with the collaborator had a positive effect.

Conclusions

Different types of instructional support in simulations are differentially effective for learners with little and extensive prior knowledge. Extensive knowledge is needed for effective learning through reflection. But for high-quality diagnostic outcomes in simulated collaborative settings, collaborative engagement is more important than individual reflection.