Learning Diagnostic Skills Online (German: Diagnostik Skills Online Lernen)

Study Overview
=================
Brief Summary
-----------------
Clinical psychologists give diagnoses to their patients everyday and these diagnoses determine if and how these patients will be treated. Misdiagnoses can have severely adverse effects. Therefore, teaching diagnostic skills to clinical psychologists is very important during their undergraduate, graduate and postgraduate training. One major problem in teaching diagnostics is that there are too few opportunities to practice with real patients due to legal and ethical restrictions. The aim of the DiSkO-project is, therefore, the development and evaluation of a blended learning course to teach diagnostic skills to (future) clinical psychologists. In order to make the diagnostic training more practical a series of video files of simulated diagnostic interviews will be presented in an online course. These video files will be divided in different segments and presented with questions and automatic feedback. In a second step, learners will make a transfer to a real face-to-face diagnostic situation with an actor simulating a patient. The DiSkO- course will be evaluated in a randomized-controlled trial at three universities in Germany (Ruhr-University of Bochum, Philipps University of Marburg, University of Cologne). To test whether students are equally good in administering a diagnostic interview after taking the DiSkO-course compared to students who took part in a traditional face-to-face university course a noninferiority-analysis will be conducted. Furthermore, diagnostic knowledge and attitudes toward evidence-based assessment after taking part in DiSkO vs. the face-to-face course will be compared. The investigators aim at disseminating the open source DiSkO-course to other universities or institutions of tertiary education in Germany with the aim of improving the diagnostic training for students, better prepare them for their clinical practice and thus improve patients' health care in Germany.

Official Title
-----------------
Learning Diagnostic Skills Online (German: Diagnostik Skills Online Lernen)

Conditions
-----------------
Diagnosis, Psychiatric

Intervention / Treatment
-----------------
* Behavioral: blended learning
* Behavioral: teaching format as usual


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Psychology bachelor students of a cooperating university (Ruhr-University of Bochum, University of Cologne, Philipps-University of Marburg) Exclusion Criteria: previous participation in a diagnostic seminar

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: intervention group vs. control group
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: intervention group<br>blended learning | Behavioral: blended learning<br>* The blended learning course consists of two parts. The first part is an online course with case studies and instructional videos providing basic clinical diagnostic knowledge and the ability to conduct structured clinical interviews. In the second part, learners get to discuss the course content with a teacher, practice their interviewing skills with other students and make a transfer to a real face-to-face diagnostic situation with an actor simulating a patient.<br>|
| Active Comparator: control group<br>Teaching format as usual | Behavioral: teaching format as usual<br>* The teaching format as usual represents the usual teaching of clinical diagnostic knowledge and the ability to conduct structured clinical interviews. Also in this intervention students also have the opportunity to discuss the course content with a teacher, practice their interviewing skills with other students and conduct a structured interview with an actor simulating a patient.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Behavioral Measure: Performance in a structured interview | Conducting a 15 minute section of a structured interview with a patient played by an actor. This interview is videotaped and then rated by independent evaluators regarding e.g. rules of correct implementation and clincial interviewing skills. | 13 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Knowledge Test A | A test of basic clinical diagnostic knowledge developed and previously piloted by the study authors. Using the data from the piloting, two parallel 15-Item versions (A and B) were created, which students answered before and after the intervention. | 1 week | 
| Knowledge Test B | A test of basic clinical diagnostic knowledge developed and previously piloted by the study authors. Using the data from the piloting, two parallel 15-Item versions (A and B) were created, which students answered before and after the intervention. | 14 weeks | 
| Münster Questionnaire for the Evaluation of Seminars - revised (MFE-Sr; Thielsch & Hirschfeld, 2010) | 7-point Likert scale (min.: 1, max.:7) The following 6 Items from the MFE-Sr were used: Item Number 14: The content of this course was too difficult for me. Item Number 15: The pace of teaching was too fast for me. Item Number 16: The time commitment associated with the course overwhelmed me. Item Number 25: I learned a lot in this course. Item Number 26: I would recommend this course to other students. Item 14-16: higher values indicate worse outcome, Item 25-26: higher values indicate better outcome | 14 weeks | 
| Website-Clarity, Likeability, Informativeness, and Credibility (Web-CLIC; Thielsch & Hirschfeld, 2019) | A 12-item questionnaire measuring a users' subjective view on web content, regarding its clarity, likeability, informativeness and credibility. The whole 12-item scale and one additionally created item regarding the credibility (I completely trusted the content in DiSkO) were used. 7-point Likert scale (min.: 1, max.:7) higher values indicate better outcome | 14 weeks | 
| Brief scale for teaching evaluation (Zumbach, Spinath, Schahn, Friedrich & Kögel, 2007) | The following 3 Items were used: Item Number 1: The subject matter was appropriately illustrated (e.g. by examples, visualizations, etc.). Item Number 2: The course was clearly structured. Item Number 3: The learning objectives of the course were clearly defined. 7-point Likert scale (min.: 1, max.:7) higher values indicate better outcome | 14 weeks | 
| Usability Metric for User Experience - Lite (UMUX-Lite; Lewis et al., 2013) | A 2-item scale assessing perceived usability. 7-point Likert scale (min.: 1, max.:7) higher values indicate better outcome | 14 weeks | 
| Visual Aesthetics of Websites Inventory - Short (VisAWI-S; Moshagen & Thielsch, 2013) | A 4-item scale measuring subjectively perceived aesthetics. The 4-item scale and one additionally created item (DiSkO is designed to be visually appealing) were used. 7-point Likert scale (min.: 1, max.:7) higher values indicate better outcome | 14 weeks | 
| Overall impression | One item using the german school grading system ranging from 1 (very good) to 6 (unsatisfactory): Overall: I give the course an overall grade of ... | 14 weeks | 
| Acceptance of structured interviews questionnaire (Bruchmüller et al., 2011) | A 11-item questionnaire measuring the estimated patient satisfaction with structured interviews. Item 1: visual analogue scale (0-100) higher values indicate better outcome Item 2-11: 4-point Likert scale (min.: 0, max.:3) Item 2,3,4,5 and 8 higher values indicate worse outcome Item 6,7,9,10 and 11 higher values indicate better outcome | 14 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
clinical interview, blended learning, diagnostic interview