Error-based Learning Project
Description
Self awareness and error self regulation are key predictors of whether people return to work and live independently after TBI. Poor skills generalisation poses one of the biggest barriers to successful outcomes of rehabilitation. For skills transfer to occur after training, individuals need to internalise self regulation strategies that will support them to adapt learned principles to different everyday situations, thus promoting lifelong application.
Errorless learning is a recommended method for teaching task-specific skills and knowledge to people with severe memory impairment after TBI. However, despite achieving favourable immediate outcomes, there is evidence that errorless learning does not elicit generalisation from the training task to a novel and untrained set of procedures.
A collaborative research team from Griffith University and the University of Queensland has developed and trialled a new rehabilitation approach called error-based learning, which has been found to promote these skills. An error-based learning approach uses systematic feedback techniques to internalise the strategy of stopping, checking, and correcting one’s own errors during task performance.
Both approaches are expected to promote functional gains on the specific training task. However, by training internal monitoring and regulation of errors, only error-based learning is predicted to increase people’s awareness of their deficits and promote generalisation of self regulation skills to non trained tasks.
Rationale
This study was one of the first to assess the efficacy of error-based learning for improving self awareness and error self regulation. It was also the first trial to determine whether an internal focus on teaching people to self monitor and correct their errors translates to greater role participation and lower support needs at six months post-treatment follow-up.
Participants
Individuals with traumatic brain injury
Key Features
The study aimed to compare the efficacy of error-based learning (i.e. making mistakes when learning) and errorless learning (preventing mistakes to promote error free performance) for improving awareness of deficits, skills generalisation and long term social outcomes. We also aimed to determine whether improvements in self awareness and self regulation following error-based learning were associated with long term gains in role participation and reduced support needs.
Funding
This project was funded by a National Health and Medical Research Council grant.
Research / Evaluation Strategies
The proposed methodology involved recruiting 54 adults (aged 18-65 years) with severe TBI from the Brain Injury Rehabilitation Unit of the Princess Alexandra Hospital, the Acquired Brain Injury Outreach Service (ABIOS) and a brain injury rehabilitation unit in Sydney. Participants were randomly allocated into either the error-based learning or the errorless learning group. Participants in each group will received eight sessions (90 minutes) of home based rehabilitation conducted by the project therapists focussed on training new skills in meal preparation and a home based functional activity or routine of the participants' own choosing (e.g., gardening, home maintenance) using either an error-based learning or errorless learning approach. Participants were assessed at baseline, post-intervention, and at 6 months post-intervention.
Outputs and Outcomes
EBL was found to be more effective than ELL for enhancing skills generalization on tasks related to training and improving self-awareness and behavioural competency.
Publications
Ownsworth, T., Fleming, J., Tate, R., Beadle, E., Griffin, J., Kendall, M., Schmidt, J., Lane-Brown, A., Chevignard, M., & Shum, D.H.K. (2017). Do people with severe traumatic brain injury benefit from making errors? A randomized controlled trial of error-based and errorless learning. Neurorehabilitation and Neural Repair, 31(12), 1072-1082.
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