Reflection plays an important role in medical students’ ability to develop diagnostic competence through practice with clinical cases. However, it is not easy for students to develop expert-like performance through self-reflection alone; conversely, seeking feedback from experts constantly in practice is impractical. This study investigates the design and effects of computer-based cognitive feedback in practice-oriented learning in an online system. The system allows learners to work with simulated cases and self-review and reflect on their diagnostic processes that the system captures visually. Moreover, the system provides learners with feedback about the gap between their performance and expert performance on a set of key components of the diagnostic task, i.e., selecting clinical examinations, making intermediate judgements, and reaching diagnostic conclusions. The findings show that cognitive feedback on task performance can reduce learners’ anxiety and frustration while working with complex tasks. Moreover, by providing feedback on learners’ performance on a set of key components of the task, the proposed approach has shown promising effects on improving learners’ diagnostic performance. Compared with its effects on learners’ diagnostic conclusions, the approach is more effective in enhancing learners’ performance when selecting clinical examinations and making intermediate judgements, both of which may improve learners’ understanding of the mechanism underlying the diagnostic process.

中文翻译：

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研究认知反馈在面向实践的临床诊断学习中的作用

反思在医学生通过实践临床病例发展诊断能力的能力中起着重要作用。然而，要让学生仅靠自我反思就很难发展出专家般的表现。相反，在实践中不断寻求专家的反馈是不切实际的。这项研究调查了在线系统中面向实践的学习中基于计算机的认知反馈的设计和影响。该系统允许学习者处理模拟案例并进行自我检查，并反思系统可视化捕获的诊断过程。此外，该系统还针对学习任务的一组关键要素，即选择临床检查，进行中间判断，并得出诊断结论。研究结果表明，对任务绩效的认知反馈可以减少学习者在处理复杂任务时的焦虑和沮丧感。此外，通过在任务的一组关键要素上提供有关学习者表现的反馈，所提出的方法已显示出对改善学习者的诊断表现的有希望的效果。与它对学习者诊断结论的影响相比，该方法在选择临床检查和做出中间判断时更有效地提高了学习者的表现，这两种方法都可以增进学习者对诊断过程背后机制的理解。通过在一组关键任务上提供有关学习者表现的反馈，所提出的方法已显示出对改善学习者的诊断表现的有希望的效果。与它对学习者诊断结论的影响相比，该方法在选择临床检查和做出中间判断时更有效地提高了学习者的表现，这两种方法都可以增进学习者对诊断过程背后机制的理解。通过在一组关键任务上提供有关学习者表现的反馈，所提出的方法已显示出对改善学习者的诊断表现的有希望的效果。与它对学习者诊断结论的影响相比，该方法在选择临床检查和做出中间判断时更有效地提高了学习者的表现，这两种方法都可以增进学习者对诊断过程背后机制的理解。