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The way medical students learn anatomy is constantly evolving. Nowadays, technologies such as tablets support established learning methods like drawing. In this study, the effect of drawing on a tablet on medical students' anatomy learning was investigated compared to drawing or summarizing on paper. The quality of drawings or summaries was assessed as a measure of the quality of strategy implementation. Learning outcome was measured with an anatomy test, both immediately afterward and after 4-6 weeks to assess its sustainability. There were no significant group differences in learning outcome at both measurement points. For all groups, there was a significant medium strength correlation between the quality of the drawings or summaries and the learning outcome (p < 0.05). Further analysis revealed that the quality of strategy implementation moderated outcomes in the delayed test: When poorly implemented, drawing on a tablet (M = 48.81) was associated with lower learning outcome than drawing on paper (M = 58.95); The latter (M = 58.89) was related to higher learning outcome than writing summaries (M = 45.59). In case of high-quality strategy implementation, drawing on a tablet (M = 60.98) outperformed drawing on paper (M = 52.67), which in turn was outperformed by writing summaries (M = 62.62). To conclude, drawing on a tablet serves as a viable alternative to paper-based methods for learning anatomy if students can make adequate use of this strategy. Future research needs to identify how to support student drawing, for instance, by offering scaffolds with adaptive feedback to enhance learning.

Individual reflection and interdisciplinary collaboration can be critical for high-quality diagnostic outcomes. However, empirical findings on using instructional approaches to facilitate reflection and collaboration in collaborative diagnostic reasoning are inconclusive and limited. Previous studies on structured reflection and collaboration scripts have failed to consider learners' prior knowledge, but the benefits of different types of instructional support, which offer varying levels of external guidance, tend to differ across prior knowledge levels. We aim to investigate individual and synergistic effects of structured reflection and collaboration scripts on collaborative diagnostic reasoning while considering knowledge in a simulation and to explore how individual reflection and collaborative engagement contribute to diagnostic outcomes. Participants were 151 advanced medical students. Participants received structured reflection, collaboration scripts, both, or no support while diagnosing fictitious patient cases with an agent-based radiologist. Structured reflection improved collaborative diagnostic reasoning performance for learners with extensive prior knowledge but impeded performance for learners with little prior knowledge. The opposite was found for collaboration scripts. Furthermore , learners with extensive prior knowledge benefited more from a combination of both kinds of support than learners with little prior knowledge. Whereas no main effect of instructional support on the diagnostic outcome was found, simply working with the collaborator had a positive effect. Different types of instructional support in simulations are differentially effective for learners with little and extensive prior knowledge. Extensive knowledge is needed for effective learning through reflection. But for high-quality diagnostic outcomes in simulated collaborative settings, collaborative engagement is more important than individual reflection. • Prior knowledge is crucial for learning through reflection. • Collaboration scripts benefit learners with little prior knowledge. • Different instructional support types enhance collaboration, not diagnostic outcomes. • For changing individual representations, collaboration with a simulated agent is more influential than reflection. [ABSTRACT FROM AUTHOR]