Imperfect practice makes perfect: error management training improves transfer of learning.
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| Title: | Imperfect practice makes perfect: error management training improves transfer of learning. |
|---|---|
| Authors: | Dyre, Liv, Tabor, Ann, Ringsted, Charlotte, Tolsgaard, Martin G |
| Source: | Medical Education. Feb2017, Vol. 51 Issue 2, p196-206. 11p. 1 Diagram, 2 Charts, 2 Graphs. |
| Subjects: | Prevention of medical errors, Training of medical students, Simulation methods in higher education, Ultrasonic imaging, Transfer of training, Young adults, Adults, Higher education, Professional education, Diagnostic errors, Analysis of variance, Confidence intervals, Statistical correlation, Experimental design, Fetal ultrasonic imaging, Study & teaching of medicine, Rating of students, T-test (Statistics), Video recording, Effect sizes (Statistics), Pre-tests & post-tests, Repeated measures design, Human research subjects, Patient selection, Descriptive statistics, Prevention |
| Geographic Terms: | Denmark |
| Abstract: | Context Traditionally, trainees are instructed to practise with as few errors as possible during simulation-based training. However, transfer of learning may improve if trainees are encouraged to commit errors. The aim of this study was to assess the effects of error management instructions compared with error avoidance instructions during simulation-based ultrasound training. Methods Medical students ( n = 60) with no prior ultrasound experience were randomised to error management training ( EMT) ( n = 32) or error avoidance training ( EAT) ( n = 28). The EMT group was instructed to deliberately make errors during training. The EAT group was instructed to follow the simulator instructions and to commit as few errors as possible. Training consisted of 3 hours of simulation-based ultrasound training focusing on fetal weight estimation. Simulation-based tests were administered before and after training. Transfer tests were performed on real patients 7-10 days after the completion of training. Primary outcomes were transfer test performance scores and diagnostic accuracy. Secondary outcomes included performance scores and diagnostic accuracy during the simulation-based pre- and post-tests. Results A total of 56 participants completed the study. On the transfer test, EMT group participants attained higher performance scores (mean score: 67.7%, 95% confidence interval [ CI]: 62.4-72.9%) than EAT group members (mean score: 51.7%, 95% CI: 45.8-57.6%) (p < 0.001; Cohen's d = 1.1, 95% CI: 0.5-1.7). There was a moderate improvement in diagnostic accuracy in the EMT group compared with the EAT group (16.7%, 95% CI: 10.2-23.3% weight deviation versus 26.6%, 95% CI: 16.5-36.7% weight deviation [p = 0.082; Cohen's d = 0.46, 95% CI: −0.06 to 1.0]). No significant interaction effects between group and performance improvements between the pre- and post-tests were found in either performance scores (p = 0.25) or diagnostic accuracy (p = 0.09). Conclusions The provision of error management instructions during simulation-based training improves the transfer of learning to the clinical setting compared with error avoidance instructions. Rather than teaching to avoid errors, the use of errors for learning should be explored further in medical education theory and practice. [ABSTRACT FROM AUTHOR] |
| Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 120689569 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Imperfect practice makes perfect: error management training improves transfer of learning. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Dyre%2C+Liv%22">Dyre, Liv</searchLink><br /><searchLink fieldCode="AR" term="%22Tabor%2C+Ann%22">Tabor, Ann</searchLink><br /><searchLink fieldCode="AR" term="%22Ringsted%2C+Charlotte%22">Ringsted, Charlotte</searchLink><br /><searchLink fieldCode="AR" term="%22Tolsgaard%2C+Martin+G%22">Tolsgaard, Martin G</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Medical+Education%22">Medical Education</searchLink>. Feb2017, Vol. 51 Issue 2, p196-206. 11p. 1 Diagram, 2 Charts, 2 Graphs. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Prevention+of+medical+errors%22">Prevention of medical errors</searchLink><br /><searchLink fieldCode="DE" term="%22Training+of+medical+students%22">Training of medical students</searchLink><br /><searchLink fieldCode="DE" term="%22Simulation+methods+in+higher+education%22">Simulation methods in higher education</searchLink><br /><searchLink fieldCode="DE" term="%22Ultrasonic+imaging%22">Ultrasonic imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Transfer+of+training%22">Transfer of training</searchLink><br /><searchLink fieldCode="DE" term="%22Young+adults%22">Young adults</searchLink><br /><searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Higher+education%22">Higher education</searchLink><br /><searchLink fieldCode="DE" term="%22Professional+education%22">Professional education</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnostic+errors%22">Diagnostic errors</searchLink><br /><searchLink fieldCode="DE" term="%22Analysis+of+variance%22">Analysis of variance</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+correlation%22">Statistical correlation</searchLink><br /><searchLink fieldCode="DE" term="%22Experimental+design%22">Experimental design</searchLink><br /><searchLink fieldCode="DE" term="%22Fetal+ultrasonic+imaging%22">Fetal ultrasonic imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Study+%26+teaching+of+medicine%22">Study & teaching of medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Rating+of+students%22">Rating of students</searchLink><br /><searchLink fieldCode="DE" term="%22T-test+%28Statistics%29%22">T-test (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Video+recording%22">Video recording</searchLink><br /><searchLink fieldCode="DE" term="%22Effect+sizes+%28Statistics%29%22">Effect sizes (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Pre-tests+%26+post-tests%22">Pre-tests & post-tests</searchLink><br /><searchLink fieldCode="DE" term="%22Repeated+measures+design%22">Repeated measures design</searchLink><br /><searchLink fieldCode="DE" term="%22Human+research+subjects%22">Human research subjects</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+selection%22">Patient selection</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Prevention%22">Prevention</searchLink> – Name: SubjectGeographic Label: Geographic Terms Group: Su Data: <searchLink fieldCode="DE" term="%22Denmark%22">Denmark</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Context Traditionally, trainees are instructed to practise with as few errors as possible during simulation-based training. However, transfer of learning may improve if trainees are encouraged to commit errors. The aim of this study was to assess the effects of error management instructions compared with error avoidance instructions during simulation-based ultrasound training. Methods Medical students ( n = 60) with no prior ultrasound experience were randomised to error management training ( EMT) ( n = 32) or error avoidance training ( EAT) ( n = 28). The EMT group was instructed to deliberately make errors during training. The EAT group was instructed to follow the simulator instructions and to commit as few errors as possible. Training consisted of 3 hours of simulation-based ultrasound training focusing on fetal weight estimation. Simulation-based tests were administered before and after training. Transfer tests were performed on real patients 7-10 days after the completion of training. Primary outcomes were transfer test performance scores and diagnostic accuracy. Secondary outcomes included performance scores and diagnostic accuracy during the simulation-based pre- and post-tests. Results A total of 56 participants completed the study. On the transfer test, EMT group participants attained higher performance scores (mean score: 67.7%, 95% confidence interval [ CI]: 62.4-72.9%) than EAT group members (mean score: 51.7%, 95% CI: 45.8-57.6%) (p < 0.001; Cohen's d = 1.1, 95% CI: 0.5-1.7). There was a moderate improvement in diagnostic accuracy in the EMT group compared with the EAT group (16.7%, 95% CI: 10.2-23.3% weight deviation versus 26.6%, 95% CI: 16.5-36.7% weight deviation [p = 0.082; Cohen's d = 0.46, 95% CI: −0.06 to 1.0]). No significant interaction effects between group and performance improvements between the pre- and post-tests were found in either performance scores (p = 0.25) or diagnostic accuracy (p = 0.09). Conclusions The provision of error management instructions during simulation-based training improves the transfer of learning to the clinical setting compared with error avoidance instructions. Rather than teaching to avoid errors, the use of errors for learning should be explored further in medical education theory and practice. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/medu.13208 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 11 StartPage: 196 Subjects: – SubjectFull: Prevention of medical errors Type: general – SubjectFull: Training of medical students Type: general – SubjectFull: Simulation methods in higher education Type: general – SubjectFull: Ultrasonic imaging Type: general – SubjectFull: Transfer of training Type: general – SubjectFull: Young adults Type: general – SubjectFull: Adults Type: general – SubjectFull: Higher education Type: general – SubjectFull: Professional education Type: general – SubjectFull: Diagnostic errors Type: general – SubjectFull: Analysis of variance Type: general – SubjectFull: Confidence intervals Type: general – SubjectFull: Statistical correlation Type: general – SubjectFull: Experimental design Type: general – SubjectFull: Fetal ultrasonic imaging Type: general – SubjectFull: Study & teaching of medicine Type: general – SubjectFull: Rating of students Type: general – SubjectFull: T-test (Statistics) Type: general – SubjectFull: Video recording Type: general – SubjectFull: Effect sizes (Statistics) Type: general – SubjectFull: Pre-tests & post-tests Type: general – SubjectFull: Repeated measures design Type: general – SubjectFull: Human research subjects Type: general – SubjectFull: Patient selection Type: general – SubjectFull: Descriptive statistics Type: general – SubjectFull: Prevention Type: general – SubjectFull: Denmark Type: general Titles: – TitleFull: Imperfect practice makes perfect: error management training improves transfer of learning. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Dyre, Liv – PersonEntity: Name: NameFull: Tabor, Ann – PersonEntity: Name: NameFull: Ringsted, Charlotte – PersonEntity: Name: NameFull: Tolsgaard, Martin G IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 02 Text: Feb2017 Type: published Y: 2017 Identifiers: – Type: issn-print Value: 03080110 Numbering: – Type: volume Value: 51 – Type: issue Value: 2 Titles: – TitleFull: Medical Education Type: main |
| ResultId | 1 |
