January 3, 2020By Lance Baily

Healthcare Simulation: Triggering the Neuroscience of Learning

Today we take a small step back from medical simulation to look at the emerging methodology (and technology) from the lens of “professional development” opportunities from other high stakes communities. Today we consider ways other business professionals overcome skill barriers by “jumping out of their comfort zone” from the Harvard Business Review, and how the “neurological science behind learning from unknown situations” from Dr. Todd Maddox’s recent Cross Knowledge article. Both help us confirm our suspicions that simulation in healthcare has what it takes to take us all one step further.

First, we take a look at a recent Harvard Business Review article by Andy Molinsky entitled “If You’re Not Outside Your Comfort Zone, You Won’t Learn Anything“, which sounds like a perfect fit when taken under the added context of medical simulation. Andy writes:

Without the skill and courage to take the leap, we can miss out on important opportunities for advancement. How can we as professionals stop building our lives around avoiding these unpleasant, but professionally beneficial, tasks?


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First, be honest with yourself: When you didn’t confront that coworker who had been undermining you, was it really because you felt he would eventually stop, or was it because you were terrified of conflict?

Then, make the behavior your own: Recognize these opportunities and take advantage — don’t chalk this variability up to randomness.

Finally, take the plunge: In order to step outside your comfort zone, you have to do it, even if it’s uncomfortable. Put mechanisms in place that will force you to dive in, and you might discover that what you initially feared isn’t as bad as you thought.

You may stumble, but that’s OK. In fact, it’s the only way you’ll learn, especially if you can appreciate that missteps are an inevitable — and in fact essential — part of the learning process. In the end, even though we might feel powerless in situations outside our comfort zone, we have more power than we think.


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Clinical simulation was specifically designed to support momentary stumbles with professional, mature, and safe learning environments geared towards providing nonjudgemental critical feedback. Using the simulated learning space to become self aware of behaviors, especially via recording and debriefing systems where learners can see their own actions played back, is the essence of ‘taking the plunge’ out of comfort zones and into constructive practice.

Next, our good friend Dr. Todd Maddox, PhD, CEO of Cognitive Design & Statistical Consulting, learning scientist and research fellow at Amalgam Insights, shared in his recent CrossKnowledge.com article “The Neuroscience of Learning: Improving the Effectiveness of People Skills Training” that the brain relies on three different learning systems, cognitive, behavioral and emotional and each must be engaged to maximize training outcomes.

Todd starts by asking us “Did you know that 85% of job success depends on having well-developed people skills, while only 15% depends on technical skills? Recognizing their value, companies invest large sums of money (over $200 billion worldwide) in soft skills training solutions, yet they are not as effective as learning programs deployed for hard skills. Why? The answer can be found by examining the neuroscience of learning.”

He continues that “Microlearning, characterized by short bursts of learning, has revolutionized the L&D sector. When combined with testing and targeted retraining that is spaced over time, it is capable of transforming short-term memory into long-term memory. This is great for engaging the cognitive learning system and acquiring technical skills. However, it’s not so great for the development of people skills and situational awareness, and can even be detrimental.

The difficulty is that behavioral skills learning requires a more nuanced approach, one that focuses on training multiple behaviors in various settings. To induce long-term behavioral change, people need to be trained to think on their feet. This can only happen in situations where there is randomness and the uncertainty of what is coming next. A person becomes aware of a situation and decides how to behave in a matter of seconds. Microlearning does not allow learners to react quickly in a multi-faceted setting as it focuses on one topic, trains it, then focuses on another, and so on.”

What does allow for learners to experience uncertainty? Healthcare Simulation of course! While learning scenarios should themselves never be random for the educator and their educational plan, the experience learners receive from simulated healthcare should definitely remain unknown until the experience unfolds in real-time. Dr. Maddox explains that such learning puts “ourselves in the shoes of another building people skills like awareness and sensitivity, and this phenomenon happens in the amygdala and other limbic structures of the brain.”

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