Diagnosing Collaboratively: A Theoretical Model and a Simulation-Based Learning Environment

Abstract

In their daily practice, physicians with different professional backgrounds often diagnose a patient’s problem collaboratively. In those situations, physicians not only need to be able to diagnose individually, but also need additional collaborative competences such as information sharing and negotiation skills (Liu et al., 2015), which can influence the quality of the diagnostic outcome (Tschan et al., 2009). We introduce the CDR model, a process model for collaborative diagnostic reasoning processes by diagnosticians with different knowledge backgrounds. Building on this model, we develop a simulation in order to assess and facilitate collaborative diagnostic competences among advanced medical students. In the document-based simulation, learners sequentially diagnose five patients by inspecting a health record for symptoms. Then, learners request a radiological diagnostic procedure from a simulated radiologist. By interacting with the simulated radiologist, the learners elicit more evidence for their hypotheses. Finally, learners are asked to integrate all information and suggest a final diagnosis.

Who is on the right track? Behavior-based prediction of diagnostic success in a collaborative diagnostic reasoning simulation

“…The model can also be viewed as an integration and extension of Liu et al 's (2015) collaborative problem-solving framework and Klahr and Dunbar's (1988) scientific discovery as dual search (SDDS) model. More precisely, the collaborative diagnostic reasoning model combines individual and collaborative activities and integrates them Richters et al Large-scale Assessments in Education (2023) 11:3 into CDAs referred to as eliciting, sharing, negotiating, and coordinating evidence as well as hypotheses (Radkowitsch et al, 2022). During the diagnostic reasoning process, these activities help diagnosticians construct and maintain a shared conception of a problem (Roschelle & Teasley, 1995).…”

“…During the diagnostic reasoning process, these activities help diagnosticians construct and maintain a shared conception of a problem (Roschelle & Teasley, 1995). The quality of CDAs is assumed to be crucial for the success of the collaboration (Radkowitsch et al, 2022).…”

“…eu). For further information about the development, implementation, and validation of the simulation, see Radkowitsch et al (2022). The study was conducted in a laboratory setting.…”

“…Previous research on collaborative problem solving (e.g., Graesser et al, 2018) has highlighted the need for training in collaboration skills, which form a key competence of the twenty-first century. For example, in order to assess a student's learning status or to diagnose a patient's health problem accurately, teachers or physicians, respectively, must be able to generate, elicit, and share evidence as well as come up with and share hypotheses and draw conclusions (so-called collaborative diagnostic activities [CDAs]; Fischer et al, 2014;Radkowitsch et al, 2022). The improvement of such complex skills is related to a constant increase in learners' current zone of proximal development (Vygotsky, 1978), which describes what learners are currently not able to solve on their own but could certainly solve with external help.…”

Representational scaffolding in digital simulations – learning professional practices in higher education

“…A second example of a simulation, which was designed for medical education, aims at facilitating medical students’ collaboration as a member of an interprofessional team (core EPA 9) – more specifically the collaborative diagnosing of an internist and a radiologist (Radkowitsch et al , 2022). Within the simulation, learners take on the role of the internist and diagnose several simulated cases of patients having fever of unknown origin.…”