Publication: Journal of Applied Psychology (SEP 2009)
Article: Active learning: When is more better? The case of resident physicians’ medical errors.
Authors: T. Katz-Navon, E. Nevah, and Z. Stern
Reviewed By: Benjamin Granger
Active learning refers to a broad spectrum of training strategies in which individual trainees are encouraged to explore the learning environment, experiment with strategies, ask questions, and make many of the administrative decisions usually made by instructors in passive learning approaches (i.e., traditional classroom instruction). Active learning places trainees in the driver’s seat of their own learning. Sounds great, right? But what if I told you that active learning strategies usually facilitate trainee errors?
Now, errors are not inherently “bad”. In fact, encouraging trainees to make errors during training actually leads to improved learning and transfer of training. Errors are considered “bad” when their consequences are bad (e.g., injury, death). Should we then even consider active learning when such consequences are likely?
Katz-Navon, Nevah and Stern’s (2009) study of resident physicians suggests that even though healthcare errors can be disastrous, resident physicians often use active learning approaches. Much of their training occurs on-the-job and in “high-stakes” situations (i.e., surgeries). Thus, we arrive at a very serious dilemma: effective learning via active learning vs. safety.
Katz-Navon et al. surveyed 123 resident physicians from various departments of two hospitals. As expected, active learning climates seem to facilitate more treatment errors (can you say scarrryyyy!?).
Presumably, however, departments that place a high priority on safety should not see such spikes in errors when active learning is used. However, Kat-Navon and colleagues found that when active learning climates are high, having too low and even too high a safety-first climate acts to increase treatment errors. Low active learning climates, on the other hand, do not provide physicians with as many opportunities to err (and perhaps learn) and thus promote fewer treatment errors.
Katz-Navon et al.’s results point out that for professions in which the costs of errors are high (e.g., physicians, surgeons, pilots) active learning strategies can pose very serious problems. But, professionals in these fields also need opportunities for true learning and active learning is an excellent way to promote learning and transfer. In the end, organizations in such industries must consider whether the benefits of active learning are worth the risks.