Modelling learning from errors in daily work

Abstract

This study explores error situations and learning activities of nurses after the experience of an error episode. We assume that errors – although undesirable events – are a natural part of work processes and can lead to individual learning and organizational change. The importance of dealing with errors in an open and learning orientated way has been emphasized in applied works on quality and safety management. Furthermore, research on work‐place learning and professional development has indicated that learning from errors is an important way of developing professional competence. Until now, little is known about how and under which conditions individual learning from errors takes place at work. For the purpose of empirical investigation, a process model was developed which conceptualizes learning from errors in terms of the engagement in self‐regulated learning activities after the experience of an error episode. This model was further developed in an exploratory interview study with 10 experts in the field of hospital nursing. We found that especially non‐formal learning activities that incorporate social exchange were considered to be important. The results of the study guide the further development of research instruments and studies aiming to investigate learning from errors.

How Nurses Experience Their Work as a Learning Environment

“…In accordance with previous research, this study concurs with the finding that interpersonal relations and processes have a major influence on learning and job mastery in nursing practice (Bauer and Mulder 2007;Berings et al 2007;Estabrooks et al 2005;Eraut 2007;Aamodt and Havnes 2008). In addition, this study underscores the personal role in collective learning processes (Billett 2001b(Billett , 2008 and the importance of nurses' engagement in learning as part of their professional work (Jensen 2007).…”

“…They consulted other professionals whom they knew had the appropriate experience or special knowledge to solve a particular problem or task (Bauer and Mulder 2007;Estabrooks et al 2005). However, access to this special knowledge depended on the activities in which the nurses engaged and how their particular workplaces were structured.…”

“…In addition, the nurses wished to discuss and reflect with peers, thus sharing their strong points as well as their limitations (Bauer and Mulder 2007). They seemed to be aware that guidance was a learning activity that helped them gain insight into what types of knowledge were available and required in their particular workplaces (Billett 2001a).…”

“…Hence, learning plays a key role in their professional development, job satisfaction and the continuous improvement of patient care. Nurses have been shown to envision themselves as lifelong learners (Gerrish 2000;Jensen 2007), and to actively seek socially oriented learning activities, including exchanging, sharing, and confirming knowledge with co-workers in situations of uncertainty (Estabrooks et al 2005), when seeking to improve their technical nursing skills (Berings et al 2007), and when dealing with errors in their work (Bauer and Mulder 2007). Consequently, it is important to understand the factors that shape nurses' ongoing learning and as how to most effectively sustain this learning in the dynamic and demanding work environments in which they practise.…”

Negative Knowledge: Understanding Professional Learning and Expertise

“…Furthermore, Oser and Spychiger (2005) propose that also regret and correction are required for building negative knowledge from an error. On the basis of the experiential learning theory by Kolb (1984), Bauer and Mulder (2007) suggest a framework of errorrelated learning activities, involving: (1) cause analysis, (2) the development of new strategies in order to avoid the error in future, and (3) experimentation with and implementation of these new strategies to the work context. This framework can be interpreted in terms of the creation, application, and further modification of knowledge that is focused on what is wrong, but relevant.…”