A conceptual model to inform the design of healthcare simulations that promote errors as a catalyst for learning: A discussion paper.

BACKGROUND: Previous studies have demonstrated that students who are engaged in learning tasks and make errors before receiving instruction on how to complete them, achieve better learning outcomes than students who first receive instruction and then complete the learning activities with the aim of avoiding errors. Although simulation literature often refers to errors as learning opportunities, to date, there is limited understanding of how pedagogical approaches that promote learning from errors can guide the design of simulation-based learning in healthcare education. AIMS: To (a) present the Learning from Errors conceptual model; and (b) provide an example of how educators can use this model. DESIGN: The Learning from Errors model is drawn from critical elements of two pedagogical approaches, productive failure and error management training and pedagogical features of high-quality healthcare simulations. METHODS: We describe the Learning from Errors model, which emphasises the need for adopting pedagogical methods that explicitly use errors as learning opportunities and ultimately inform simulation design. We then illustrate the application of this model to a simulation example. RESULTS: The model includes the following elements: i) normalisation of errors, ii) challenging simulation scenarios, iii) self-directed learning, iv) collaborative teamwork and v) comparison with best practice. CONCLUSION: This discussion paper presents the Learning from Errors conceptual model, an evidence-based approach that can assist educators in the design of simulations that embrace errors as a catalyst for learning.

From Sensor Data to Educational Insights.

Technology is gradually becoming an integral part of learning at all levels of educational [...].

Transmission of SARS-CoV-2 in a primary school setting with and without public health measures using real-world contact data: A modelling study.

Background: Stringent public health measures have been shown to influence the transmission of SARS-CoV-2 within school environments. We investigated the potential transmission of SARS-CoV-2 in a primary school setting with and without public health measures, using fine-grained physical positioning traces captured before the COVID-19 pandemic. Methods: Approximately 172.63 million position data from 98 students and six teachers from an open-plan primary school were used to predict a potential transmission of SARS-CoV-2 in primary school settings. We first estimated the daily average number of contacts of students and teachers with an infected individual during the incubation period. We then used the Reed-Frost model to estimate the probability of transmission per contact for the SARS-CoV-2 Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron variant (B.1.1.529). Finally, we built a binomial distribution model to estimate the probability of onward transmission in schools with and without public health measures, including face masks and physical distancing. Results: An infectious student would have 49.1 (95% confidence interval (CI) = 46.1-52.1) contacts with their peers and 2.00 (95% CI = 1.82-2.18) contacts with teachers per day. An infectious teacher would have 47.6 (95% CI = 45.1-50.0) contacts with students and 1.70 (95% CI = 1.48-1.92) contacts with their colleague teachers per day. While the probability of onward SARS-CoV-2 transmission was relatively low for the Alpha and Delta variants, the risk increased for the Omicron variant, especially in the absence of public health measures. Onward teacher-to-student transmission (88.9%, 95% CI = 88.6%-89.1%) and teacher-to-teacher SARS-CoV-2 transmission (98.4%, 95% CI = 98.5%-98.6%) were significantly higher for the Omicron variant without public health measures in place. Conclusions: Our findings illustrate that, despite a lower frequency of close contacts, teacher-to-teacher close contacts demonstrated a higher risk of transmission per contact of SARS-CoV-2 compared to student-to-student close contacts. This was especially significant with the Omicron variant, with onward transmission more likely occurring from teacher index cases than student index cases. Public health measures (eg, face masks and physical distance) seem essential in reducing the risk of onward transmission within school environments.

Measuring the impact of productive failure on nursing students' learning in healthcare simulation: A quasi-experimental study.

BACKGROUND: Previous research suggests that making errors in a non-threatening simulated environment can facilitate learning. Productive failure, which combines problem-solving tasks followed by instruction, enables students to learn from making mistakes. This teaching approach has demonstrated improved learning outcomes such as explanatory knowledge and transfer of knowledge compared to a direct instruction approach where students receive instruction prior to problem-solving tasks. However, no previous studies have examined the impact of productive failure on nursing students' learning in manikin-based simulation. OBJECTIVE: To measure the impact of productive failure on nursing students' declarative knowledge, explanatory knowledge, and transfer of knowledge compared to a direct instruction approach in a paediatric closed head injury simulation. METHODS: Second year undergraduate nursing students (n = 349) from one Australian university were invited to participate in the study. Consenting participants (n = 344) were randomised into two groups: productive failure and direct instruction. The intervention consisted of two paediatric closed head injury simulations separated by a simulation debrief. Knowledge tests were administered before and immediately after the simulation. RESULTS: Data from 331 participants were analysed. The productive failure group outperformed the direct instruction group in the post-test (p < 0.001). Learning gains for participants in the productive failure group were significantly higher than the direct instruction group for both explanatory knowledge (p < 0.001) and the ability to apply learning to solve novel clinical problems (p < 0.001). The difference in the median scores for declarative knowledge was not significant (p = 0.096). CONCLUSION: This study demonstrated that a productive failure simulation that leads learners to make mistakes before receiving instruction can facilitate deeper levels of explanatory knowledge and enable the transfer of learning to new clinical situations. These results suggest the need for further exploration of pedagogies that foster learning from errors in simulation-based learning.

Basic Life Support Training for undergraduate nursing students: An integrative review.

The aim of this review was to identify the role of basic life support training interventions in international undergraduate nursing education, that support optimal acquisition and retention of knowledge, psychomotor skills and resuscitation self-efficacy. Twenty-four articles were identified and analysed using an integrative review approach. Studies were reviewed for quality using a Critical Appraisal Skills Programme checklist. Common objective and standardised methods of basic life support education practice were identified: instructor led, simulation experiences, self-directed learning, skills training combined with clinical practicum, and computer-based training. Evaluation of competency was collected primarily from multiple-choice questionnaires or researcher-designed checklists, with a lack of objective performance data noted. Importantly, current teaching approaches do not guarantee acquisition or retention of basic life support skills. Objective feedback from technologies supporting cardiopulmonary resuscitation training may be useful in acquisition and retention of psychomotor skills, and therefore requires further exploration. Development of robust, psychometrically sound instruments are needed to accurately and consistently measure nursing students' skills performance.

Healthcare students' perceptions and experiences of making errors in simulation: An integrative review.

BACKGROUND: Research literature suggests that learning from mistakes facilitates news insights and leads to professional development. The significant growth in the use of simulation-based learning is premised on the understanding that in this context learners can make and learn from their errors without negatively impacting real patients. However, studies also suggest that making errors can be emotionally detrimental to learners. Given these contradictory findings, this literature review explores learners' views about this phenomenon. OBJECTIVE: The objective of this integrated review was to explore healthcare students' perceptions of making errors during simulation-based learning experiences. DESIGN: Whittemore and Knafl's framework for integrated reviews was used to structure this review. DATA SOURCES: Five electronic databases MEDLINE, CINAHL, PsycINFO, ProQuest, and SCOPUS and the search engine Google Scholar were searched. The initial terms used were nursing students, medical students, health professionals, error*, mistake*, and simulation. METHODS: The original search resulted in 2317 potential records. After screening against the inclusion/exclusion criteria, 11 articles were critically appraised using The Critical Appraisal Skills Program (CASP) checklist and were included in the review. RESULTS: The two overarching themes to emerge from the analysis were the impact of errors on learners and the impact of errors on learning. CONCLUSION: Despite the negative feelings experienced by some students regarding making mistakes in simulation, there were key factors that moderated the impact of these feelings and transformed the errors into learning opportunities. These included: the provision of a safe learning environment where constructive feedback was provided by skilled educators, and where students were supported to take responsibility for their mistakes. Although the findings suggest that making mistakes in simulation-based learning can be beneficial, optimising learning from mistakes requires a deliberate and thoughtful approach in which educators plan for and support learners to recognise, acknowledge and respond effectively to errors.