AEDs available today only require the user to turn the AED on and follow audio instructions when prompted.

Research Finds Big Benefits in Blended Learning

In-class instruction twinned with simulation learning allows learners to "debrief" with instructors after simulations in order to understand their mistakes, ask questions, and then re-try scenarios online.

New research sponsored by the American Red Cross shows that simulation learning in combination with traditional classroom experience is more efficient and effective in preparing people to act in a crisis than traditional classroom learning or online learning alone. The Red Cross, a go-to source for training in how to prepare for emergencies, undertook the research to assess whether incorporating simulation learning into its online curriculum could improve training products and ensure learners were better prepared to respond to emergencies.

Released in November 2014, the research contains an extensive review of the scientific literature on the benefits of simulation learning, including a meta-analysis of dozens of studies by the U.S. Department of Education. The paper also includes the results of 15 interviews with cognitive experts and first responder trainers.

Simulation learning refers to a method of training in which learners test their knowledge using online interactive, scenario-based simulations. Generally, these programs offer learners multiple scenarios in which to test a concept or skill. In any given scenario, learners may select from a number of possible actions, each of which results in further situations and possibilities based on the learner's choice.

According to research cited and amplified by the Red Cross, simulation learning offers four key training advantages in health and safety training:

A no-risk experience: Virtual interaction offers a safe environment in which learners can test their knowledge of training concepts and procedures with no fear of harming the sick or injured subject. As a result, learners are free to practice skills, make decisions and commit errors--without real-world consequences. The research shows that self-paced, no-risk environments allowing for unlimited attempts at mastering knowledge and decision-making results in greater learner confidence.

"The value for me," said one paramedic interviewed for the research, "is being able to make mistakes in a low-pressure environment and then learning from your mistakes, and then doing that repetitive action. So that when you do have the pressure on you and you know you have to perform with that pressure, you are able to do it because you have seen it done and felt it before."

Real-world scenarios: Researchers also have found that simulation learning is effective because virtual scenarios can be designed with engaging psychological realism. Realism allows for the introduction of real-world variables, including common and unusual events. These offer greater challenges and training dimensions for learners when compared to non-interactive, text-based problems. Put another way, simulation learning can bridge the gap between classroom exercises and the real world.

Psychological realism is also important because stimulated learners retain information more efficiently and effectively than those who are less compelled by the subject matter. In fact, researchers have found that it is more important for simulations to be psychologically realistic than physically realistic. Beyond a certain point, increasing degrees of immersion in the environment adds nothing to the effectiveness of the learning experience.

One of the most frequently reported benefits of simulation learning is "a realistic portrayal of a community and what students believed would be the issues faced in resolving a real-world health problem," said Dr. Elio Spinello, MPH, EdD, who was interviewed as part of the research. Spinello, a faculty member in the Department of Health Sciences at California State University Northridge, is an expert in health-based training involving the use of technology.

A new way to train: Simulation learning can be more engaging and effective than classroom learning alone. Although simulation learning is not intended to be a game, many learners find the video-game aspects of the interactions engaging for the same reasons people are attracted to gaming.

"Scenario-based methods are very engaging," according to one simulation training researcher quoted in the new research. "That is how adults like to learn. They like to apply information that they already know or new information to situations that they are likely to experience or that they have experienced in the past."

At issue is that a learner who experiences an emotional connection to his/her training, as is found in simulation learning scenarios, is more likely to retain the knowledge gleaned from the training. Dr. Spinello said that during a simulation learning experience, "one can actually observe what happens when you make that mistake. And from a learning standpoint, you are tying something emotional to that decision, so it is something that is likely to be remembered, and it tends to, I think, deepen the learning process."

A 2011 study published in Personnel Psychology discussed the instructional effectiveness of computer-based simulation games. It found that trainees taught through interactive simulation tested higher in key measures when compared to other trainees. Specifically, the simulation learners' self-efficacy (confidence) was 20 percent higher, declarative knowledge was 11 percent higher, procedural knowledge was 14 percent higher, and retention was 9 percent higher than the non-interactive learners. The study authors attributed these gains to the ability of interactive simulations to simultaneously engage trainees' affective and cognitive processes.

Practice makes perfect: Because practice increases the retention of knowledge, simulation learning has another advantage over classroom instruction alone. Simulation learning programs allow learners to repeatedly test their skills and knowledge at their own pace and in a variety of scenarios and roles. Learners can train anytime and anywhere they have access to a computer.

Studies also show that learners using interactive simulations in which they control the interactions and can repeat them as needed are more likely to develop the kinds of automatic responses and confidence essential in first responders faced with an emergency. When given control over their interactive simulation learning, researchers found that learners had more positive attitudes, better cognitive outcomes, and "invested more and attempted more complex strategies than when they had no control."

Sim Learning is Optimal When Teamed with Traditional Classroom
The new research sponsored by the Red Cross uncovered several practical advantages of simulation learning, including cost savings, ease of implementation, overall satisfaction of trainers and trainees, and the ease of tracking learner progress through the training materials.

Many studies reviewed in the new research show that simulation learning is best when combined with in-class training. In-class instruction twinned with simulation learning, also known as "a blended learning format," allows learners to "debrief" with instructors after simulations in order to understand their mistakes, ask questions, and then re-try scenarios online.

The endorsement of simulation learning comes on the heels of a 2014 survey by Northwestern University's Kellogg School of Management in which 4,888 Red Cross trainers were asked their views on simulation training. The majority of respondents said that simulation learning is a good addition to current teaching methods and are willing to use it in their training.

In light of the significant evidence in favor of simulation learning, the Red Cross is introducing online interactive simulation learning into its workplace safety and first responder courses and then others down the road. It also plans to retain an in-class component to all training where simulation learning is offered. By augmenting in-person instruction with online simulation learning, the Red Cross believes that more people will receive an enhanced training experience–one that will help prepare them to perform the correct actions, should they face a real-world medical crisis.

By the first quarter of 2015, simulation learning is expected to be incorporated into all Red Cross First Aid, CPR, and AED training, as well as training for first responders. Simulation learning has already been incorporated into Red Cross water safety instruction and advanced child care training.

This article originally appeared in the December 2014 issue of Occupational Health & Safety.

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