Errorless Learning for Everyday Functioning in Adults With Brain Injury: A Scoping Review

Abstract

Background

Errorless learning is an intervention technique used in acquired brain injury (ABI) rehabilitation. To support the use of this intervention within occupational therapy practice, it is important to know how errorless learning has been applied to (re)train daily functions.

Objectives

To describe the empirical literature on errorless learning applied to everyday functioning in adults with ABI.

Method

A scoping review was conducted with systematic searching of four databases (i.e., AMED, CINAHL, MEDLINE, PsycINFO) and screening by independent reviewers.

Findings

41 experiments from 34 papers met eligibility criteria. Errorless learning has been heterogeneously delineated, described, and applied. Operationalization of everyday functioning has been poorly reported, and mostly applied to technology use and instrumental activities of daily living.

Implications

Greater clarity and detail of errorless learning interventions are required, and more research is needed on its applications to everyday functioning.

Plain Language Summary

A review of studies using a brain injury rehabilitation technique called errorless learning for improving how people perform daily activities

Errorless learning is a technique used by some occupational therapists to (re)teach skills to people with learning challenges from brain injury. Although errorless learning has existed since the 1960s, we do not know whether researchers have a similar understanding of the concept and method, or include relevance to how people function in the real world. A review of studies is needed so that progress can be made on improving success in rehabilitation. The purpose of this review is to “scope” the existing studies on errorless learning when it has been used for everyday functioning in people with brain injury. We wanted to learn how researchers have thought about errorless learning and used the technique in studies. We began this review by systematically searching four research article databases, then screening retrieved articles by independent reviewers to find studies meeting our inclusion criteria. We pulled the key information from included studies, then used descriptive statistics to summarize the findings and inductive content analysis to highlight features of errorless learning. Our search included 41 experiments from 34 papers. Papers varied in whether errorless learning was truly “errorless” and how errorless learning was carried out, often being combined with other rehabilitation techniques. There were many differences in how errorless learning was delivered, like amount of practice. Some important intervention elements were not described in the studies, so it is difficult to understand how the technique is carried out. Also, some types of everyday functioning activities were missing and the ones that were studied were mostly chosen by researchers. Future researchers should provide more details about errorless learning intervention designs and be consistent in their reporting. Everyday functioning activities should be chosen by people with brain injury so that these are personally meaningful and better improve their lives outside clinical settings.