Transforming Errors into Learning Opportunities in Simulation-Based Learning
- Publication Type:
- Thesis
- Issue Date:
- 2022
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This thesis explores how productive failure simulations influence nursing students’ learning, perceptions and satisfaction compared with traditional simulations. Simulation-based learning enables learners to make mistakes and learn from them without compromising real patients’ safety. Productive failure is a pedagogical approach that allows students to make mistakes as they solve novel learning tasks before receiving instruction. Productive failure simulations comprise a simulation followed by instruction, which contrasts with direct instruction simulations that begin with instruction followed by the simulation. Productive failure has facilitated meaningful learning outcomes in diverse educational settings, but no previous studies have examined the impact of productive failure in nursing simulation. To fill this research gap, an exploratory, sequential mixed-methods design with a three-stage approach was used.
The first stage of the study, an integrative literature review, explored healthcare students’ perceptions of making errors in simulation. It identified that supporting students to take responsibility for their mistakes is critical to moderating the negative impact of making errors and transforming them into learning opportunities.
The second stage of this study resulted in the Learning from Errors conceptual model. Building on productive failure and error management training approaches, the model was designed to inform healthcare simulations that explicitly embrace learning from errors. This model includes the following elements: normalisation of errors, challenging simulation scenarios, self-directed learning, collaborative teamwork, and comparison with best practice.
The third stage of this study evaluated nursing students’ learning from and satisfaction with productive failure simulations compared to direct instruction simulations and explored students’ perceptions of productive failure simulations. Participants were randomly allocated to either a productive failure group (n = 181) or a direct instruction group (n = 163). Quantitative data included knowledge tests measuring declarative knowledge, explanatory knowledge and transfer of learning, and the Satisfaction with Simulation Experience scale. Qualitative data involved interviews with students in the productive failure group.
For explanatory knowledge and transfer of learning, the productive failure group outperformed the direct instruction group. This group also scored significantly higher on the satisfaction items related to reflection on practice and clinical learning. The qualitative results identified the following themes: the benefits of simulation prior to instruction; the value of performing a second simulation; and the importance of normalising errors.
This doctoral study demonstrated that productive failure simulations improve nursing students’ learning, perceptions and satisfaction levels. The thesis concludes with implications for nursing education, directions for further research, and recommendations for future practice.
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