Work

Getting lost to find insights - a quasi-experimental evaluation of outdoor experiential learning as a method to teach clinical decision-making and decision science concepts

Year: 2025

Type: article

Abstract: BACKGROUND: There is a high prevalence of errors related to decision-making biases that results in medical errors. Despite this, there is limited teaching on decision-making biases in medical education. STUDY HYPOTHESIS OR OBJECTIVE: This study aimed to evaluate outdoor experiential learning as a mechanism to teach decision-making to first year medical students. METHODS: As a quasi-experimental study, the first year medical students at our institution were invited to participate in a brief workshop that included an introductory discussion followed by a guided hiking experience. During the hike, the guides were instructed to intentionally lead students off the outlined path and into a commonly experienced decision-making error, authoritative bias. This provided the students with a first-hand experience of the consequences of decision-making biases. Student experience was evaluated with a pre and post course test designed to evaluate participants' knowledge on the decision-making biases, and decision science concepts that were covered both in the experiential, and didactic portions of the workshop. RESULTS: Of the 120 students who participated in the workshop, 41 students completed the pre course and post course evaluation. The overall pre-quiz scores, and post-quiz scores were evaluated. Results of a paired sample t-test indicated a statistically significant improvement in scores [t(40) = 7.64, p < 0 0.001]. The Mean Pre-Quiz Score was 51.83% ± 18.40, the Mean Post-Quiz Score was 74.09 ± 18.40. This represents a 22.26% (95% CI: 16.37-28.14) score increase from pre-quiz to post-quiz (p < 0.001). CONCLUSIONS: The results suggest that this novel outdoor experiential learning workshop was an effective method of introducing decision-making biases and general decision science concepts to first year medical students. Future iterations of this work can investigate long-term retention of these concepts, comparison of this method to a traditional classroom method, and changes in clinical practice and decision-making behavior following completion of the course. CLINICAL TRIAL NUMBER: Not applicable.

Source: BMC Medical Education

DOI: 10.1186/s12909-025-07533-9