gms | German Medical Science

Simulations with standardized patients can foster knowledge acquisition in medical education. Often only one student can perform such simulations at a time. Offering students to observe the simulation and provide peer-feedback might enhance the effectiveness of the simulation. Collaboration scripts were used as instructional approach to support the learners. According to the Script Theory of Guidance (SToG), collaboration scripts specify, distribute and sequence activities of collaborative learners. In a study with N=66 medical students we varied an observation script (with vs. without) and a feedback script (with vs. without). We examined the effects on the competencies regarding the rectal exam. An observation script specified a list of important features the observer should focus on. A feedback script provided guidelines how to provide helpful feedback. The learning phase was segmented into three phases: First, the student in the examiner role performed the rectal exam while being observed by the observer. Second, while the examiner receives feedback from the standardised patient, the observer prepared feedback for the examiner. Finally, the examiner received feedback from the observer. Results show that the observation script (but not the feedback script) had a positive effect on performance of the observer. There was, however, a general effect of feedback: Despite the fact that students in the examiner role did not had direct contact with the observation script, a positive effect of the observation script on their competence was found. Post-hoc comparisons with students without an observation prior the simulation session showed that only dyads supported by the observation script outperformed learners without the opportunity to observe the rectal exam. This study shows that observation of simulations and giving feedback can enhance performance of learners in a context in which the observer will perform at a later time, but only if supported by an observation script.