Every day, thousands of people die as a result of bad decisions. From the halls of hospitals to streets across America, health care providers, pharmacists, police officers, military members and public officials hold the power to save or take a life.

Training such individuals to make good decisions demands a disruptive approach to learning that goes beyond imparting information and improving skills. It must recognize that the individuals in these positions often make critical choices under intense stress and that consequences frequently result from a series of decisions by different people.

For example, according to a 2014 Centers for Disease Control and Prevention (CDC) study, “on any given day, approximately one in 25 U.S. patients has at least one infection contracted during the course of their hospital care.” In 2016, U.S. News and World Report reported that there is growing concern about the frightening prevalence of bacteria that are resistant to antibiotics.

Is the problem that health care professionals simply do not know the precautions necessary to prevent these tragedies? Or do other factors contribute to them?

To confront these and similar challenges, training must be capable of portraying complex realistic events, recognizing the individual and interpersonal dynamics that affect outcomes, and enabling learners to practice decision-making.

To see how this process works, view the opening scene in a video-based simulation from the U.S. Department of Health and Human Services that is helping to reduce health care-associated infections.

While watching the video, were you engaged, thinking about what each of these people could have done differently to prevent this outcome? Did you contemplate how burnout, team-building, commitment, communication and standing up to superiors influenced this chain of events? Did you consider the role organizational culture played in this situation?

As training experts, we recognize that there is a narrative inherent in any teachable topic. We also realize the power of immersing learners in virtual experiences that mirror real life and provide opportunities to rehearse decision-making in safe settings. These experiences are especially crucial when lives are on the line.

If you are like most people, you have become emotionally involved in this story. You empathize with what the characters are feeling, especially if you have worked in a hospital. You want to see more and figure out how to change the outcome. You share the universal human desire to “win.”

At this point, the simulation allows learners to “become” the characters, climb into their skins and see what happens if they make different choices. The learner is in active mode, not simply the passive recipient of content.

Let’s see watch this solution in action. Return to the video, choose Dena (the nurse character) and play until you reach the first decision screen.

This decision point is a clear example of how knowing what to do may not translate into doing it. Action is affected by context, timing, previous experiences, priorities, state of mind and the perception of consequences. Of course, these factors are not limited to decisions made by medical personnel.

For a very different example, we can look at how police officers are trained to make split-second decisions in tense situations. When are shootings of citizens justified in the interest of public safety? How can relations be improved between law enforcement and the communities they serve? What role, if any, does implicit bias play in the actions officers take? Policies and procedures can be taught, but this knowledge must then be applied with sound judgment in the heat of the moment.

Critical choices are made daily on battlefields, in manufacturing plants, aboard cruise ships, in secure buildings and at other locations where human decisions affect lives. To be effective, simulations that address topically sensitive learning needs must be research-based and grounded in the principles of neuroscience. They should integrate solid instructional design, great storytelling, high-quality production, meaningful interactivity and leading-edge gaming elements. These tools should be developed for delivery asynchronously online and on mobile devices, as well as synchronously in live facilitated sessions. When well-built and properly deployed, such training can actually save lives.

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