Creating good out of bad

Last week I attended the Virtual Patients Symposium, “We Are Our Choices” in London. This brought together participants across Europe and the world involved in a number of projects regarding online learning in the medical sector. The latest of these is called WAVES (Widening Access to Virtual Educational Scenarios), a project I am involved with. It brings together academic and enterprise partners to make scenario based learning more accessible for a wide range of professions. You can find out more about the WAVES project at

The symposium covered a range of topics with a number of interesting speakers across the medical spectrum. This posting is my reflections on the main theme of the symposium, scenario based learning, and on some of the issues that could prevent it happening.

What is scenario based learning?

Scenario based learning presents the learner with a simulation of a real life experience to allow them to gain the relevant skills and information which they can use when they are presented with the same or similar situations in their work. The learning could be delivered in a number of ways, for example in a classroom or online (the focus of the WAVES project), and is placed in context to make it easier to engage with and to commit to memory for future use.

Scenario based learning techniques are widely recognised as a key tool in the educational toolkit, for safe training in competency and decision-making.

The Elearning industry website has a great introductory blog on the subject (

Error based learning

Scenario based learning is learning from your mistakes

Another definition of scenario based learning is to think of it as error based learning – learning from your mistakes – this was a key theme of the conference. One of the speakers gave a stark insight into the medical world. Doctors will kill patients. Throughout her working day a doctor has to make numerous decisions on the cases she sees. These will branch ever outwards into different directions. Some of those directions could lead to the death of a patient. So scenario based learning, allowing people to make errors in a safe environment such as a classroom or online and learn from them, can be crucial. This is the case not just for the medical profession but for other fields as well.

Barriers to Scenario Based Learning

However, with error comes failure which can be hard to come to terms with. Some people are more likely to fear failure than others.

As part of the WAVES project I interviewed a number of people about their experiences of scenario based learning. I was struck by a comment made by one interviewee that he felt younger people had a greater acceptance of failure than older people. It was just a hunch on his part and I have no data to prove it or otherwise. However, it was raised again during the conference. A YouTube video was shown of a five-year-old child playing a shoot ’em up game. He is momentarily distraught when he loses a life but soon bounces back to start “killing” again. It could be that younger people, more used to gaming, are happier to fail in virtual environments.

One of the reasons for fearing failure is the shame they will experience as a result. This may be an age issue but it could also be cultural, whether at a country level (with some delegates suggesting this was a particular problem in their country) or at an organisational level. One delegate from a corporation suggested this was an issue where he worked. In healthcare, the focus of this conference, it was suggested there has been a culture of not admitting that errors occur. This could make it harder to implement scenario based learning which has at its heart, permission to fail in a safe environment.


So, given the challenges, how do we embed scenario based learning into an organization? Over the next two to three years, the WAVES project will research the field and come up with some ideas that will be helpful for the learner, the trainer or educator, and the technologist implementing the solutions. In the meantime, the conference looked at cultural changes that needed to happen so that error could be seen as normal, to be learned from and moved on from.

Encouraging people to recycle their errors and make good out of bad

One suggestion was to provide regular opportunities for people to reflect on their day to day work and any mistakes made, to encourage them how to “recycle” errors, and, as one speaker said, to make good out of bad.

It is a big ask but it is something that needs to happen in critical fields such as the medical and health sector.

More about the WAVES project

If you would like to know more about the WAVES project please visit or get in touch with me.

We have also been collecting data about people’s experiences about scenario based learning (and MOOCs – another focus of the project). The survey is still open for a short while if you would like to add your views (