Creating learning in healthcare that changes outcomes requires a different set of principles and active learning from experiences.


5 Principles of Learning in Healthcare:

  1. Everything is about our patient(s) – and our patients see us as a team, not as individuals
  2. Education ≠ learning – just because a student participated in a training initiative does not mean they learned a thing
  3. Learning = changed outcomes – changing outcomes requires changes in the learner, experience and environment
  4. Learning is an expertise (that should be consulted by content experts) – content experts should be at the bedside
  5. Everyone is in learning – everyone, at all times is both a learner and a facilitator of learning


For more information about the 5 Principles of Learning in healthcare, see Learning Card 10:



Learning Outcomes Model


Changing outcomes in healthcare requires changing the Learner along with their Experience and Environment.  When initiatives fail, it is due to one of the three sections missing.  It is not enough to have a learner motivated, or have a great experience (or simulation), or just change a policy/equipment/environment, you need to do all three.  For example, if we help learners understand the importance of washing their hands, they won’t change behaviors if the sink is broken or the alcohol based product burns their hand.
For more information about the Learning Outcomes Model see Learning Card 1:





3D Model of Debriefing: Defusing, Discovering and Deepening


The 3D Model of Debriefing was created based upon the Theoretical Foundations of Learning in Simulation <link> specifically to embrace the Learning Outcomes Model and the principles of Experiential Learning.  As with many debriefing models it has three phases.  The first phase, Defusing, helps the learner to ‘vent’ their emotions from their experience (concrete experience), readying them for learning.  The second phase, Discovering, prompts reflection to identify existing mental models so that gaps can be addressed for future mental models (reflection and abstract conceptualization).  The third phase, Deepening, is an queue for the learner to mentally go through active experimentation to ‘cement’ their new mental model (if it cannot immediately occur in practice).


For more information about the Learning Outcomes Model see Learning Card 5:





Foundations of Experiential Learning Cards


The ‘Learning Cards’ are part of the Leadership Playbook for healthcare and provide a cognitive aid and framework for learning.  Each card has content on the front followed by a Diving Deeper, What to Watch For, Connections and References.  In the top left of the card there is a number (i.e. L-3).  Together with the cards for Teamwork, Trust, and Change, they make the leadership playbook for healthcare which includes over 100 action plans.




Teamwork Cards


The Teamwork Cards are based upon AHRQ’s TeamSTEPPS (adapted and reprinted with their permission) but have been expanded to include the content on the back and connected to content from Trust, Change and Learning.




To download the entire set of learning and/or TeamSTEPPS cards enter your information below:




Zigmont, J.J, Kappus, L, Sudikoff, S.N. (2011) Theoretical Foundations of Learning Through Simulation. Seminars in Perinatology, April, Vol 35, Issue 2, p. 47-51

Zigmont, J.J, Kappus, L, Sudikoff, S.N. (2011) The 3D Model of Debriefing:  Defusing, Discovering, and Deepening. Seminars in Perinatology, April 2011, Vol 35, Issue 2, p. 52-58