Abstract

The acquisition of diagnostic competence is seen as a major goal during the course of study in medicine. One
innovative method to foster this goal is problem-based learning with erroneous worked examples provided in a
computer learning environment. The present study explores the relationship of attitudinal, emotional and
cognitive factors for learning with erroneous worked examples. 72 medical students from a German university
worked with six case-based examples in the domain of arterial hypertension. Domain-specific conceptual prior
knowledge, anxiety of making errors, attitudes towards errors, and ambiguity tolerance were measured as
independent variables before the students worked with the examples. Diagnostic competence was
operationalized by measuring conceptual, strategic, and conditional knowledge, which were assessed as
dependent variables after working with the learning environment. A cluster analytic approach yielded three
clusters. For each, the relationship with the learning outcome was analysed. Cluster membership significantly
influenced the learning outcome in strategic, but not in conditional knowledge. Furthermore, cluster membership
had a significant effect on conceptual knowledge; there was also an increase in conceptual knowledge for all
clusters when conceptual knowledge measured after the treatment was compared to prior conceptual knowledge.
The results clearly indicate the importance of a certain pattern of psychological factors for learning with
erroneous worked examples.

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