We need to learn by doing: The case for Simulation Based Learning

Abstract

Simulation is a technique for practice and learning that can be applied to many different disciplines and trainees. It is a technique (not a technology) to replace and amplify real experiences with guided ones, often “immersive” in nature, that evoke or replicate substantial aspects of the real world in a fully interactive fashion. Simulation-based learning can be the way to develop health professionals’ knowledge, skills, and attitudes, whilst protecting patients from unnecessary risks. Simulation-based medical education can be a platform which provides a valuable tool in learning to mitigate ethical tensions and resolve practical dilemmas. Simulation-based training techniques, tools, and strategies can be applied in designing structured learning experiences, as well as be used as a measurement tool linked to targeted teamwork competencies and learning objectives. It has been widely applied in fields such aviation and the military. In medicine, simulation offers good scope for training of interdisciplinary medical teams. The realistic scenarios and equipment allows for retraining and practice till one can master the procedure or skill. An increasing number of health care institutions and medical schools are now turning to simulation-based learning. Teamwork training conducted in the simulated environment may offer an additive benefit to the traditional didactic instruction, enhance performance, and possibly also help reduce errors.


Christine Haskell, PHD has built her practice on credible, published research and data. In the Research Series, you’ll find highlights, shareable statistics, and links to the full source material.


Mental Models: Anchoring & Adjustment

When making decisions, we rely too heavily—or anchor—on one trait or piece of information.

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How might this apply to great teams and cultures?
In unfamiliar situation, we tend to evaluate things based on a single data point, or known anchor. From here we draw conclusions and  make relative adjustments. These anchors are often a numeric value, such as one’s review score or a promotion ratio.

How might this apply to great products?
The original price or a single attribute such as the amount of memory on a laptop or cell phone. Oddly enough, even the suggestion of a completely irreverent number can influence subsequent numeric predictions.

What anchors are you intentionally—or unintentionally—providing people?

Consider
What challenges — tied to desired behaviors — do you have in place?

See Also
Priming, Conceptual Metaphor, Framing

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In the whirl of our day-to-day interactions, it’s all too easy to forget the nuances that distinguish great teams, great cultures, and great products/services.

Mental Model Flash Cards bring together insights from psychology into an easy reference and brainstorming tool. Each card describes one insight into human behavior and suggests ways to apply this to your teams as well as the design of your products and services.

Mental Models: Contrast Effect

WHEN SCANNING NEW VISUAL INFORMATION, WE ARE UNCONSCIOUSLY DRAWN TO THINGS THAT STAND OUT AGAINST THEIR SURROUNDINGS.

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How might this apply to great teams and cultures?

We enhance or diminish others in relation to our perception of normal. It shows up in how we interact with, partner with, or seek others out.

How might this apply to great products or services?

Colors, size, shapes and other design elements are used to create visual contrast. Subtle movements on an otherwise static page catch people’s attention. Contrast can also be felt over time (an irregular e-mail notification vs. a daily notification) or through unusual and unexpected content or experiences.

Consider

Think about what qualities you want people to focus on for talent, for culture, for cultivating creativity, etc.--and, how you are willing to support those qualities to succeed.

See Also

Chunking, Juxtaposition, Proximity, Uniform Connectedness

   

Mental Models: Authority Principle

We want to follow the lead and advice of a legitimate authority.

How might this apply to great teams and cultures?

When communicating an idea that you want to see taken up by others, demonstrating authority in some way will give you more credibility in the eyes of your audience, and enable them to make a decision much more easily as the decision will feel less risky. Remember the reverse — if a figure of authority is stating that your idea is not the way to go, your audience is likely to listen to that statement. You need to be aware of this before communicating your message, so do your research and try to understand what authority positions in the market are saying. ​

How might this apply to great products?

To some extent, we all look for guidance and direction. Following a perceived leader has real benefits as it means you don’t have to spend time and energy figuring things out for yourself — you can just copy, learn from them, or obey and get the benefits. First to market gives authority. So does best quality.

Consider

How well does your product, service or organization lead people through an experience? Does that experience communicate confidence, quality and assurance? Are there options in your application that could be made at a design level on behalf of users? In an uncertain or new space, is there the presence of a formal authority figure (or brand) to reassure people?

See Also

Social Proof, Contrast, Limited Choice, Autonomy, Sequencing

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In the whirl of our day-to-day interactions, it’s all too easy to forget the nuances that distinguish great teams, great cultures, and great products/services.

Mental Model Flash Cards bring together insights from psychology into an easy reference and brainstorming tool. Each card describes one insight into human behavior and suggests ways to apply this to your teams as well as the design of your products and services.

Mental Models: Set Completion

THE CLOSER A COLLECTION IS TO BEING COMPLETE, THE MORE WE DESIRE COLLECTING ALL THE PIECES.

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How might this apply to great teams and cultures?

When something is certain and known then we feel comfortable and in control. When something is not complete, we cannot close that item in our mind as we have to keep thinking about it. This maintenance activity adds effort and leads to predictions that might give us cause for concern. This is the basis for the need for completion, and we will, therefore, seek to close off things that we do so we can forget them and move on to the next item of interest.

Some people have a particular need for completion and in teams will be the person who makes sure all jobs are done (often doing the jobs themselves). People who compulsively tidy up are "completer-finishers" as they see untidiness as a step before the completion of tidiness. Contrast this with people who are not completer-finishers and who will happily start something but will be unlikely to see things through to the end.

How might this apply to your business?

What can people collect in your system? How can these be organized into discrete sets to provide easier, achievable goals (and the motivation to continue completing the larger collection)? This principle also applies to incomplete puzzles or pictures—we desire to see the whole image completed. Look for logical groupings (like kinds of information) that can suggest set completion.

Consider

Are you a completer or a starter? What gaps do you seek to close? How do you leave things for people to complete. Start a sentence and see if they will complete it for you -- if they do, you have put the other person into the completer-finisher position. This can be a powerful tool in changing minds.Even if they do not verbally complete the sentence, they will do so in their minds. Watch their body language for signs of what they might be thinking.Likewise, you can use completion in physical tasks. Start something and give it to another to complete. Give rewards for completion, particularly if you have no completer-finishers who will end the job for you.

See Also

Chunking, Curiosity, Achievements, Collecting, Variable Rewards, Pattern Recognition, Status, Gifting, Reputation

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In the whirl of our day-to-day interactions, it’s all too easy to forget the nuances that distinguish great teams, great cultures, and great products/services.

Mental Model Flash Cards bring together insights from psychology into an easy reference and brainstorming tool. Each card describes one insight into human behavior and suggests ways to apply this to your teams as well as the design of your products and services.

 

Why Learning to Learn Well Is Fundamental to Our Survival

NUMBERS & NERVES

Thought Series provides actionable ideas and anchors for reflection on your life or your work.

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You can’t blink now without seeing articles on the pace of change, exponential growth, or the need to innovate. Over 60% of all executives now believe disruption will hit their industries hard in the next year. Artificial Intelligence will only accelerate this momentum. The majority of organizations have recognized that company culture, as it impacts decision making and strategic integration, is a major driver of successful transformation. People know change is coming, but do not have the skills and support to drive the transformation. It doesn't matter the industry - management consultingfinancial serviceseducation. Everyone's at risk.Then, there are these old chestnuts...

  • The only constant is change.

  • People don't resist change; they resist being changed.

  • Change before you have to.

The problem is that organizations of all sizes can be challenged on how to cope with change. All wrestle with their reality and go through denial about the need to change.Enter the field of change management.Change management has its origins in the 1960's when business was much more predictable. As a formal discipline, it has been around since the 1990’s. However, references to change and change management can be found in the psychological literature more than 40 years earlier. Psychologists described “change” as the unfreezing, moving, and refreezing of thoughts or behaviors. These developments described how people internalized change and their experience with it, though the researchers did not apply these concepts to an organizational setting.In the 1990s the topic of change and change management was applied to organizations, and managers and leaders took notice of the new groundswell of articles and books such as John Kotter’s “Leading Change”, and Spencer Johnson’s “Who Moved My Cheese”.Most change models are still based on old-school thinking, tools, and techniques. No wonder 70% of all change efforts fail. In the past, leaders had months and years to implement change. Now, change needs to be understood and addressed at the moment while it is occurring. The response to change needs to be implemented in days and weeks.Three Barriers to Learning to Learn Well That Impact Our Ability to Respond to ChangeHere are three barriers to learning, common behaviors that lead to beliefs we all succumb, that I believe account for the failure of our ability to contend with change:

Barrier: We are biologically wired to be afraid of uncertainty.  

Belief: Change is bad.

When confronted with the choice to continue with the status quo or accept change, few us will opt for change. We like to stick with what we believe works.

Behavioral psychology explains why we think change is bad:

  • Change is a threat.

  • Threat leads to a loss of food.

  • Loss of food leads to death.

So you notice things changing in the world (the robots are coming, the politics are more polarized than ever) and you're one step to it all being all over.So we learn a trick or two that works and we use those tricks over and over.

Inertia makes it hard to turn. What gives us this momentum, gives us power: that's the power of scale. Scale is a force. When we have committed our lives to going in a straight line, and a revolution comes along requiring us to take a turn, we don't understand the new strategy and paradigms it's creating, or the tactics it requires, we get left behind.CONSIDER: What is shifting in our culture is the death of the industrial age. That is at the heart of all the shifts going on. Having a solid understanding of strategy (understanding the systems in play), tactics (the skills and capabilities required to manipulate strategy), and emotional labor (caring enough to really fail at something) are how we make a difference in the world. There's so much confusion now in the business world, a world that 50 years ago had virtually no confusion, about these three concepts, but we rarely separate them into these three different groups of problems and work them together

Barrier: We accept artificial replacements for actual experiences  

Belief: Change Is Fixed and Linear

In order to make sense of complex concepts, we use models to simplify our understanding. We seek templates, models, and prototypes versus gaining direct involvement with the problems we are trying to solve. In doing so, we give up proximity to the particulars in favor of distance and simplification.

When describing complexity, most change management frameworks assume that the process of change is linear.

Here are several examples.

They all have a beginning, middle, and end because that is how we understand things.

Losing proximity to the nuances of the problem we are trying to solve and the need for simplicity in how we think run counter to the ongoing learning that needs to occur when reckoning with change. We can no longer give up proximity to the particulars of these issues in favor of distance and simplification.CONSIDER: We need to remind ourselves to engage with the actual substance of a problem, not just a model. This requires us to revisit goals and strategies based on the learning that occurs from the process of intervening in the change itself. Moving fast requires creating feedback loops so you can adjust as needed based on what you see and experience - not by following a step by step approach with little flexibility. Like Design Thinking, it may be useful to jump back to a previous step and do it over based on what's been learned. 

Barrier: The values of formal education, advancing technology, and limitless expansion of global corporations stand between us and the learner’s mind

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Belief: Change Has Clear End States

The values within the structures we embrace emphasize efficiency, mechanization, standardization, and automation—enabling powerful forces that drive production, convenience, and reliability. They seek the ‘right answer’ to a prescribed question. The inertia behind these values drives towards homogenization.

Values of standardization tend to generate problems with relatively clear end states. If something isn’t efficient, troubleshooting persists until the wrinkle is smooth and systems run according to plan.We have a bias to concluding what we start.

We need closure

. This bias runs counter to truly gaining the intimacy needed with complex problems.

While the systems designed to support us have enhanced our lives, they are breaking down. Systems of scale allow more of us to do more than any one of us could do alone. And, they also block. With convenience, we have less need to master feeling, judgment, and sensing. We don’t even see it happening. Slowly we lose the capacity to troubleshoot the machines that support us. Process replaces feel; rules replace judgment; policy replaces our need to think critically. When ambiguous questions arise, we have less practice with the struggle of finding solutions. In the name of stability and convenience, we lose the opportunity to engage the problem with any meaningful intimacy.CONSIDER: When we address change, we typically focus on assessing the current state, defining the desired end state, and then bridging the gaps between the two via a gap analysis. This approach offers a logical end state. The ideal future is defined at the start of the change process and everything done from that point on hammers it home. But how often do people, or organizations, or economies freeze for the time you are working on your solution? In short, there is no closure. The environment you operate in is not fixed, but an emerging ecology that needs to be tended and responded to. Neither the pace of change nor disruptive technology will wait for you to implement your change. Customers don’t wait around either. Change processes that myopically focus on a pre-defined future risk having that future disrupted before it arrives. 

CONCLUSION

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Embracing the emotional labor of change, gaining proximity to the nuances of the problem we are trying to solve, and questioning the explicit and implicit values that guide the structures in which we reckon with tension, are the forces we need to embrace in order to learn to learn well. Change, real change, demands that we really integrate the idea of ongoing learning. Superbugs, homelessness, inequality, and global warming are all examples of ongoing, complex problems that can’t be solved without changing our beliefs:OPPORTUNITY v Threat: We can learn to respond and not react. We can learn to reframe threats into challenges and opportunities. The threat-challenge idea and its effects may rest on the assumption that people are prone to consistently interpret situations as a threat or a challenge based on their life experiences. But that doesn’t mean that this tendency is a life sentence that we always think this way. If you actively re-frame stressful situations as challenges and your elevated heart rate as excitement, you can improve your health, well-being, and performance level, all at the same time.ADAPTIVE v Fixed. Business as ‘unusual’ will not feel natural at first. At some point, we might even need new words to describe it. Eventually, we will need to reinvent what it means to lead or to work in an organization. To be as close to creative problem solving as possible you must learn to improvise and adapt. You can no longer pay lip service to these terms. To improvise means "to work with what is available." It is the antithesis to preparation. To adapt means "to adjust to new conditions." Both infer the need to respond to a shift in the environment around you. The opportunity for you is to be that agent of evolution. Waiting for the DNA to evolve will take too long. A random feature that is created when a strand of DNA, or an idea, is altered and then transferred creates a mutation. Seeking or creating positive mutations can increase an organization’s resilience to change.INFINITE v FINITE:  Complexity needs to be managed, not solved. That means we need to get adept at managing and leveraging tension between two opposing forces: open/closed; stability/innovation, etc.  Leveraging is about getting more with less. When you go too far to one side, you lose out on the benefits of the other.James Carse summarizes his argument in Finite and Infinite Games,

There are at least two kinds of games: finite and infinite. Finite games are those instrumental activities - from sports to politics to wars - in which the participants obey rules, recognize boundaries and announce winners and losers. The infinite game - there is only one - includes any authentic interaction, from touching to culture, that changes rules, plays with boundaries and exists solely for the purpose of continuing the game. A finite player seeks power; the infinite one displays self-sufficient strength. Finite games are theatrical, necessitating an audience; infinite ones are dramatic, involving participants.

We are slowly acknowledging that we are in an infinite game, playing by old rules. We will never solve the complex problems that plague us today with the tools that got is here. We have to build new tools, which require a different way of thinking.  

Best Practice Series: How to meditate

 
 

WHAT IS IT?

During the past two decades, mindfulness meditation has gone from being a fringe topic of scientific investigation to being an occasional replacement for psychotherapy, tool of corporate well-being, widely implemented educational practice, and “key to building more resilient soldiers.”  

KEY IDEAS

ATTENTION

Attention is what we are focusing on in the moment.  Attention is limited, selective, and a very basic component of our biological makeup.

META-ATTENTION

Meta-attention is attention of attention. It is, what we think and how we feel about what we are noticing. The ability to pay attention to attention itself raises our cognitive functioning and enables response over reactivity. For example, when you become bored, your attention wanders. Sometimes something clicks and you are reminded you need to be paying attention. You can catch yourself and bring your attention back to the task at hand. 

Meta-attention is the key to deep concentration and awareness. When your meta-attention becomes strong, you can keep your wandering mind on task. Rather than long periods of boredom of fidgeting, you can recover your attention quickly and often enough to experience continuity of your own experience, a more continuous attention, which is deep concentration.

MEDITATION

Neuroscientist Julie Brefczynski-Lewis suggests that meditation is about mental training practices. Meditation encapsulates many different kinds of practices. In Mindfulness Meditation, the goal is to distinguish between two specific mental process: Attention and Meta-attention.

MINDFULNESS

Mindfulness is a quality of being — the experience of being open and aware in the present moment, without reflexive judgment, automatic criticism or mind wandering.

 

BENEFITS

  • Reduced rumination, or “mental spinning.” 

  • Stress reduction. 

  • Boosts to working memory. 

  • Less emotional reactivity

  • More cognitive flexibility. 

  • Relationship satisfaction. 

  • Other benefits. Mindfulness has been shown to enhance self-insight, morality, intuition and fear modulation, all functions associated with the brain's middle prefrontal lobe area. Evidence also suggests that mindfulness meditation has numerous health benefits, including increased immune functioning, improvement to well-being and reduction in psychological distress. In addition, mindfulness meditation practice appears to increase information processing speed, as well as decrease task effort and having thoughts that are unrelated to the task at hand.

 

HOW TO MEDITATE

  1. Sit or lie comfortably. You may even want to invest in a meditation chair or cushion.

  2. Close your eyes. ...

  3. Make no effort to control the breath; simply breathe naturally. Notice that you are breathing in, and breathing out.

  4. Focus your attention on the breath and on how the body moves with each inhalation and exhalation.

  5. Notice your thoughts. 

  6. Keep your attention on your breath going in, and going out.

  7. Notice how your thoughts change.

Remember that your first thoughts are not your fault. Many find that comforting. 

The work is to choose an appropriate response.

 If you are looking for regular meditation prompts, check out the Meditations area.

 

RESOURCES

  • Davis, D. & Hayes, J. (2012). What are the benefits of mindfulness? Monitor on Psychology, July/August, 43 (7).

  • James W. (1980). The Principles of Psychology. In: Green CD, ed. Classics in the History of Psychology.

  • Gelles, D. How To Meditate. Retrieved April 12, 2015 from: https://www.nytimes.com/guides/well/how-to-meditate

Mental Models: Commitment & Consistency

WE DESIRE TO ACT IN A MANNER CONSISTENT WITH OUR STATED BELIEFS AND PRIOR ACTIONS.

How might this apply to great teams and cultures?

When we are incented to and challenged to speak and act outside their normal belief boundaries, preferably in a public way. This encourages them to change their beliefs and to be consistent with their actions. This is how Brainwashing works.

We think of brainwashing as negative but it is actually a pretty neutral concept. It happens all the time. Think of the values and mission you adopted when you joined your last company. Each day you were asked to do some small thing that you agreed with (or not) and over time, it became your truth.

When our actions differ from our beliefs or values, we need to explain this gap to ourselves. We crave routine, so we do not generally want to change our beliefs or values. Our first move is to seek external reasons for the difference. For example, sometimes people can have a hard time letting go of strong cultures even once they've moved on in their career--expecting every other organization to adopt those same strong beliefs and ways of doing things.

Change has to be incremental or the actions people are asked to take will seem too overwhelming. When people aren't taking personal responsibility for their own actions, they claim that they were forced to act as they did. They blame authority (watch out, this might be you!). This is why it is so important to "get everyone on board", make values work an ongoing part of your business management, and make the change a daily/ongoing practice.

How might this apply to your business?

People have a general desire to be (and appear) consistent in their behavior. Ask someone to state a position, declare their intentions, or show a small gesture of support. Why? Generally, people will act in a manner consistent with these small requests, even it later asked to make a much larger (but consistent) commitment. Be careful: done poorly, these will be viewed as compliance tactics.

Consider

How did you react the last time new management came in with different ideas?

See Also

Story, Reputation, Status, Sequencing, Trigger, Social Proof, Positive Mimicry

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In the whirl of our day-to-day interactions, it’s all too easy to forget the nuances that distinguish great teams, great cultures, and great products/services.

Mental Model Flash Cards bring together insights from psychology into an easy reference and brainstorming tool. Each card describes one insight into human behavior and suggests ways to apply this to your teams as well as the design of your products and services.

 

Mental Models: Aesthetic-Usability Effect

AESTHETICALLY PLEASING DESIGNS ARE OFTEN PERCEIVED AS BEING EASIER TO USE.

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How might this apply to great teams and cultures?​​

In organizations, we can be forgive of personality flaws if someone is unusually talented. This aesthetic-usability effect can mask leadership problems and can prevent confrontation of a toxic climate if the lived values of the organization favor results above all else.

How might this apply to great products?

Attractive things work better—or at least we perceive them as being easier to use. Have you evaluated how attractive your application (or site) is to your users? We are more forgiving of attractive designs and assume they are (or should be) easier to use. The curious part? A well-designed site is often a more usable site.

Consider

Identify instances of the aesthetic-usability effect in your organization by watching how managers confront or don't confront bad behavior, we well as listening to what they say.

See Also

Affect Heuristic, Visual Imagery, Sensory Appeal

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In the whirl of our day-to-day interactions, it’s all too easy to forget the nuances that distinguish great teams, great cultures, and great products/services.

Mental Model Flash Cards bring together insights from psychology into an easy reference and brainstorming tool. Each card describes one insight into human behavior and suggests ways to apply this to your teams as well as the design of your products and services.

 

Mental Models: Status

WE CONSTANTLY ASSESS HOW INTERACTIONS EITHER ENHANCE OR DIMINISH OUR STANDING RELATIVE TO OTHERS AND OUR PERSONAL BEST.

How might this apply to great teams and cultures?

Fear of losing power, fear of losing status, fear of losing rewards, fear of the unknown; fear of undermining credibility, fear of our own ignorance and, fear of how people with different opinions will change the ways we do things around here.Further, dominant groups in an organization in relation to gender, race, nationality, as well as, dominant ways of working, are all motivated to maintain the status quo.

How might this apply to great products?

Are you providing feedback loops and measures to let people know how they are doing? Status is personal—an assessment of our standing relative t others (income, performance, etc.). Status can also be public (scoring, recognition, etc. ). However, studies show that a threat response kicks in when our status seems jeopardized; take care to measure only those things linked to desired behaviors. Also use status to reinforce new skills.

Consider

Dominance amounts to power. Why would you want to give your power away or even share some of it?

See Also

Competition, Reputation, Appropriate Challenges, Feedback Loops, Need for Achievement

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In the whirl of our day-to-day interactions, it’s all too easy to forget the nuances that distinguish great teams, great cultures, and great products/services.

Mental Model Flash Cards bring together insights from psychology into an easy reference and brainstorming tool. Each card describes one insight into human behavior and suggests ways to apply this to your teams as well as the design of your products and services.