Is making errors beneficial for learning and applying skills after severe traumatic brain injury?

What is it about?

After severe traumatic brain injury (TBI) people often need to relearn skills they had previously mastered. There are mixed views on the best strategy for relearning these skills; however, one method that has been found to be successful for people with severe cognitive impairment is ‘errorless learning’. Errorless learning refers to teaching the skill without ever allowing for errors to occur. The training session is designed in a way that requires the trainer to prompt with the correct response, rather than allowing the trainee to guess, and therefore risk laying down the memory of the error response. Learning in this method is often very specific and skills do not often generalise to other situations where the skill is needed outside of the training session. Error-based learning on the other hand involves structured feedback on performance (e.g., use of videos), graded prompts, and post-task reflection to teach people how to anticipate errors, check for and correct errors, and generate strategies for overcoming those errors. This ‘metacognitive’ method has previously been shown to reduce errors on trained tasks, increase self-regulation and self-awareness, however, it was previously not known if this approach would promote greater generalisation of skills than errorless learning. Fifty-four individuals with a severe traumatic brain injury were randomised either to the errorless learning group OR to the error-based learning group. They received 8 x 1.5 hour individual training sessions focused on meal preparation. The success of training was measured by total errors made during the Cooking Task (a measure of 'near transfer' or skills generalisation), as well as measure of broader generalisation (Zoo map test) and a number of other secondary outcome measures. After accounting for initial performance and level of pre-injury education, individuals in the error-based learning group demonstrated significantly fewer errors on the Cooking Task following training when compared to those in the errorless learning group. Those who received the error-based training strategies also demonstrated greater gains in self-awareness and behavioural competency after the intervention.

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Why is it important?

Results from this NHMRC funded study demonstrate that having structured opportunities to make errors and learn to correct these is important to support people to apply new skills to situations outside of rehabilitation.

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