Healthcare students' perceptions and experiences of making errors in simulation: an integrative review

Background: Research literature suggests that learning from mistakes facilitates news insights and leads to professional development. The significant growth in the use of simulation-based learning is premised on the understanding that in this context learners can make and learn from their errors without negatively impacting real patients. However, studies also suggest that making errors can be emotionally detrimental to learners. Given these contradictory findings, this literature review explores learners' views about this phenomenon. Objective: The objective of this integrated review was to explore healthcare students' perceptions of making errors during simulation-based learning experiences. Design: Whittemore and Knafl's framework for integrated reviews was used to structure this review. Data sources: Five electronic databases MEDLINE, CINAHL, PsycINFO, ProQuest, and SCOPUS and the search engine Google Scholar were searched. The initial terms used were nursing students, medical students, health professionals, error*, mistake*, and simulation. Methods: The original search resulted in 2317 potential records. After screening against the inclusion/exclusion criteria, 11 articles were critically appraised using The Critical Appraisal Skills Program (CASP) checklist and were included in the review. Results: The two overarching themes to emerge from the analysis were the impact of errors on learners and the impact of errors on learning. Conclusion: Despite the negative feelings experienced by some students regarding making mistakes in simulation, there were key factors that moderated the impact of these feelings and transformed the errors into learning opportunities. These included: the provision of a safe learning environment where constructive feedback was provided by skilled educators, and where students were supported to take responsibility for their mistakes. Although the findings suggest that making mistakes in simulation-based learning can be beneficial, optimising learning from mistakes requires a deliberate and thoughtful approach in which educators plan for and support learners to recognise, acknowledge and respond effectively to errors.