Formative feedback in a virtual patient simulator for clinical audiology training

The aim of this study was to examine the effectiveness of different types of feedback on learning pure-tone audiometry using a simulator. Participants were 51 undergraduate students in the Department of Communication Disorders. Participants were randomly allocated to one of two groups whilst undertaking pure-tone audiometry training with the Clinical Audiology Simulator (CAS). One group received summative feedback during the learning task while the second group received formative feedback. Probes were administered to examine participants’ knowledge of pure-tone audiometry following training. In addition, a subjective workload analysis was used to measure perceived cognitive load during training and assessment. Between-groups analysis was conducted to establish the effect of feedback on learning and cognitive load. Data regarding how much time each student spent training on the simulator was also collected, and a regression analysis was conducted to evaluate the relationship between time and learning. Formative feedback was found to have a large positive effect on learning in comparison to summative feedback. Cognitive load was perceived as being higher for students receiving formative feedback during training compared to those receiving summative feedback. In subsequent assessment, the formative feedback group reported a lower cognitive load than the summative feedback group. No relationship was observed between time spent training on the simulator and probes outcome. The formative feedback training mode of the CAS proved to be effective in supporting learning and cognitive load in novice students. The findings suggest that the type of feedback employed when using simulators affects learning outcomes for users