Should learning be easy?

Is it possible for training to be too easy?

Does this sound counterintuitive? Well, learners need to expend mental effort in order to build new connections in their brains. In healthcare training, if they have practised new skills and received feedback during training, they are more likely to transfer learning to the workplace.

In this article, we use the term ‘Helpful’ to describe activities that build lasting mental connections.

Below are some examples of the three different types of activity discussed in the video.

Necessary (sandwich in the video)

Must know’ content, such as:

• The ratio of compressions to ventilation for CPR.
• How to add allergy information to a patient record.
• How to register child protection concerns.

Helpful (fruit and salad in the video)

Activities that aid understanding and retention:

• Practising ventilations and compressions on a mannikin.
• Finding allergy choices information on the drop-down menu and adding to the patient record.
• In groups, discuss actions when uncertain if a witnessed event was actually abuse.

Unhelpful (sugary snacks in the video)

Interesting items not needed for learning which use processing power:

• Discussing cardiac drugs at length on a Basic Life Support course.
• Describing a system restore process for which guides are available.
• Being told the names and telephone extensions of all the hospital safeguarding team.

Is ‘quick and easy’ learning good?

Training that is undertaken in a short time and with a minimal amount of activity may appear to be an efficient use of time.

However, we know that learning is more likely to be transferred to the workplace if learners practice skills and received feedback on their performance. Provision of opportunities for practice and formative feedback requires more time than a simple delivery of information, and it can be tempting to move on to the next element or ‘chunk’ without these steps.

But it is effort and supportive feedback which builds lasting mental connections.

A carefully planned degree of difficulty can be helpful to learning

One might expect training to offer new skills and information in a form that is easy to understand. But if we simply do this and move on, the mental connections that we saw in Week 1 may not have had sufficient opportunity to grow.

So, training provides further engagement to stimulate this growth. This is also known as ‘Desirable Difficulty’.

For example, an Assertiveness Course includes the skill of ‘fogging’. On a training course it might be explained like this:

‘Fogging is a technique which can help if you are confronted by someone who is being manipulative or aggressive. Instead of arguing back, fogging is the giving of a calm, placating response while not agreeing to meet demands. It involves agreeing with any truth contained within the person’s utterances, and showing a degree of understanding that they feel as they do. By not responding in the way they expect, the other person ceases to be confrontational because their desired effect is not being achieved. They are effectively fighting against a wall of ‘fog’ and their agression gradually dissipates’.

You probably understood the gist of fogging just by reading the above paragraph. However, if you were not aware of the technique before, reading that paragraph alone is unlikely to create a lasting mental model.

Training adds a degree of difficulty by requiring learners to practice this skill with someone who acts in a manipulative way. At first, it is not easy to ‘fog’, and learners receive feedback as their technique improves which allows them to develop a strong mental model.

As a result, they are more likely to use the technique when confronted by someone acting in such a manner.

How can relevant information be ‘Unhelpful’?

‘Unhelpful’ elements are so named because they tend to displace more important information that we wish learners to retain. However, it does not mean they are irrelevant or uninteresting.

Indeed, it may not even mean they are unimportant; just that they load too much information onto learners.

For example, when planning a Safeguarding session, a learning designer might decide that presenting the names and contact details of the senior team members could displace more important information which learners need to retain.

Items such as names and telephone numbers can be placed on an intranet page and learners only need to be aware of its existence. In this way, the learning includes only content which needs to be retained by the learners.

Does presenting the same material twice make learning easier or harder?

Learning material is sometimes presented in two modes simultaneously. In a commonly seen example, a trainer speaks while a summary of their words appears beside them on a screen. This is offered in the belief that when language is presented in two simultaneous modes it produces more retention than one.

There is a large amount of research that indicates the reverse is often true. The display of text which mimics the trainer’s words can actually result in a reduction in learning. This is due to an overload of working memory as learners attempt to listen to and read the same words which are provided at different speeds.

The cognitive load

If a trainer wishes to display text on a screen, cognitive load can be kept to an acceptable level by keeping the text brief and allowing learners time to read it for themselves. Once they have digested the text, the trainer can then expand on the meaning.

Learner overload of a similar kind may also be found in online courses if text and narration are provided simultaneously. There is reliable evidence to show this practice should also be avoided. If there is a need to include narration, aim to reduce the text to an absolute minimum so the learner can concentrate on the spoken language.

Note: Narrated text has a valuable function for learners who may have reading difficulties. In this context, there is not a clash as the learner will rely primarily on the narration.

Social distancing and ease of learning

Covid has made life harder for everyone and there is a natural inclination to make things easier for our colleagues when we can. So now is a good time to remove ‘Unhelpful’ content from learning as described in this step.

In addition, any non-essential content which can be removed from learning materials and placed online should be. It can then be used when required as a resource and accessed ‘just in time. But we should just be careful not to dilute learning in an effort to be kind, healthcare patients and service users trust us and their safety depend on the integrity of healthcare training.