Decision-Making in the Backcountry and Its Clinical Applications in Medical Education—a Pilot Experiential Learning Workshop

Wilderness and Environmental Medicine · 2025-05-05 · 3 citations

Introduction— Decision-making in clinical environments is often impacted by cognitive biases and exacerbated by high stakes, time pressures, and unreliable feedback—characteristics of a “wicked learning environment,” as defined by Robin Hogarth. 1,2 Traditional medical education inadequately addresses these biases, relying primarily on passive, lecture-based instruction. Objective— To bridge this gap, we designed and piloted an experiential learning workshop for first-year medical students, integrating backcountry skiing as a parallel wicked learning environment to teach decision-making biases, fallacies, and heuristics. Methods— The study employed a qualitative questionnaire to better understand student experience and measured learning outcomes. Results — Twenty-six students participated in the classroom-based components, and of those 26, 8 participated in the experiential learning component. Qualitative questionnaire responses suggest an elevated understanding of how backcountry decision-making informs clinical decision-making and the importance of decision-making within patient care. Discussion — There is clear potential for the programming to be expanded and applied to other forms of the outdoor recreation experience. Results suggest that applying the experiential learning model provides an additional and broader understanding of how decision-making biases may intersect with practical applications in medical settings. Despite limitations, including a low response rate, the results suggest that this novel approach enhances the understanding of cognitive biases and decision-making in clinical settings. Future iterations will aim to scale participation, include quantitative assessments, and explore alternative wicked learning environments. Conclusion— This pilot program demonstrates the potential of combining outdoor experiential learning with medical education to address critical gaps in teaching decision-making biases and improve clinical practice.

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

BMC Medical Education · 2025-08-14

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.

Getting Lost to Find Insights - A Prospective Cohort Evaluation of Outdoor Experiential Learning as a Method to Teach Clinical Decision-Making and Decision Science Concepts

Research Square · 2025-04-28

Natural landscape in the formation of historical city Saratov

Vestnik Tomskogo gosudarstvennogo arkhitekturno-stroitel nogo universiteta JOURNAL of Construction and Architecture · 2024-04-22

Purpose: The aim of this work is to determine the structural components of the natural landscape of Saratov and comprehend its role and place in the formation of this historical city. Research findings: Based on the analysis of related research results, the forwarded statements determine further research. The detected key elements of the landscape provide the expressiveness and interrelation of natural and anthropogenic subsystems in the city. Two levels of the city formation are distinguished together with their structure and influence on the city of Saratov. Research findings: Based on the analysis of related research results, the forwarded statements determine further research. The detected key elements of the landscape provide the expressiveness and interrelation of natural and anthropogenic subsystems in the city. Two levels of the city formation are distinguished together with their structure and influence on the city of Saratov.

Architectural and landscape revitalization of urbanized landscape as a method of formation of urban-ecological framework of Saratov city

2023-01-01

The article deals with the problem of formation of urban-ecological framework of a large historical city, including two subsystems: natural-ecological framework (or natural framework) and urban-ecological framework (system of green areas of the city). Architectural and landscape revitalization of destructive urban landscapes is considered as one of the ways to solve the problem. Expansion of the system of green areas of the city through architectural and landscape transformation of postindustrial, post-railroad, post-communal warehouse, etc. territories is an effective way to form a sustainable urban environment. For the city of Saratov, this method is the only possible way to increase the area of greenery in the historic center, characterized by high density of buildings and "sealed" soil cover. The lack of landscape and recreational spaces in the city center can be compensated by the formation of a linear system of parks in the coastal zone, the communication framework of which will be a new embankment being built along the entire historic city center. The formation of park territories of the planned recreational zone is carried out on the following principles: environmental sustainability, social justice and economic efficiency.

A Reverence for Time: Mindful Approaches to Land-based Travel Calculations

Journal of Outdoor Recreation Education and Leadership · 2022-08-09

How long will it take to get from “Point A” to “Point B”? Estimating the answer to this question is essential for outdoor leaders to accurately and safely manage their outdoor adventure education course. By being able to carefully estimate the amount of time needed to travel a particular route, over the course of a day or an entire expedition, outdoor leaders will be able to avoid unnecessary risk and provide ample time for other curricula and experiences. This paper describes several land-based travel calculation methods (including the less known Munter system recently added to www.caltopo.com’smapping functionality), and notes why they are essential for leading successful outdoor expeditions. Along the way the paper articulates the pedagogical relevance of time calculation models to leadership curriculum and anticipates critiques related to the “McDonaldization” of outdoor adventure education.

The self-governance challenges facing climbers, with examples from Utah, Colorado, &amp; Ontario

Journal of Outdoor Recreation and Tourism · 2020 · 8 citations

• Political Science
• Sociology
• Public relations

Implications of Shortening Outdoor Adventure Education Courses: Identifying Prioritized Outcomes and Effective Processes

Journal of Outdoor Recreation Education and Leadership · 2020 · 7 citations

• Computer Science
• Medical education
• Psychology

Across the nation, many outdoor adventure education programs are becoming shorter in duration. The purpose of this study was to determine if instructors alter targeted course outcomes and course processes because of shorter amounts of student field time. Data collection involved interviews with staff from the Colorado Outward Bound School. Results of this study identify the course outcomes and processes instructors reported to be most affected by course length, as well as the processes instructors identified as most important to best achieve desired course outcomes. This study concludes with a discussion for integration of results into current course design models and offers a revised model for maximizing short course program design.Subscribe to JOREL

Supporting Public Lands in an Uncertain Age: The Wasatch Front Urban Ranger Program

Journal of Park and Recreation Administration · 2019-01-01 · 4 citations

Open space and parks in urban and urban-proximate areas provide vital social, economic, and health benefits to people and communities. Specific benefits include offering opportunities for people to connect with nature, improving air quality, supporting wildlife habitat, and improving community identity and attachment. Management and maintenance of these areas can be expensive and challenging, particularly when multiple agencies oversee different components of the same resource. In the Salt Lake Valley in Utah, the Jordan River Parkway (JRP) and the Bonneville Shoreline Trail (BST) provide recreation opportunities to local citizens. Multiple agencies and private land owners are charged with managing elements of each entity, resulting in inconsistent application of management plans including patrols and maintenance. Subsequently, there are aspects of these outdoor recreation spaces that need increased support, maintenance, and overall stewardship. In 2015, the Department of Parks, Recreation, and Tourism at the University of Utah and the National Park Service’s Rivers, Trails, and Conservation Assistance Program (RTCA) created the Wasatch Front Urban Ranger Program (WFURP), a trail ambassador program featuring student volunteers from the University of Utah. Each Urban Ranger has three primary duties: public engagement, performing light maintenance, and collecting data on various aspects of trail use. During daily patrols, Rangers inform the public of land management issues and direct them to appropriate resources. They perform trail maintenance, including removing litter, cleaning dog waste, and plucking noxious weeds. They collect data about visitor use and conditions in each area, and regularly report the data to respective management agencies and/or law enforcement and health officials. Rangers recruit a student volunteer for each patrol, which helps increase engagement and enhance knowledge about public lands issues among University students. The program is funded through a number of small grants and the majority of the funding supports a graduate student to coordinate the program. Program partners include the National Park Service (NPS), Bureau of Land Management (BLM), Jordan River Commission (JRC), and Utah Department of Natural Resources (DNR). Support from additional local and national agencies help train the Rangers, including personnel the Salt Lake City Open Space District, the U.S. Fish and Wildlife Service, the USDA Forest Service (USFS), and local law enforcement agencies. Subscribe to JPRA

Wilderness With Honors: Assessing an Extended-Duration Outdoor Orientation Program

Journal of Outdoor Recreation Education and Leadership · 2018-01-01 · 1 citations

Incoming college students are faced with a host of new tasks, environments, and challenges. College orientation programs help prepare students for life after high school by raising awareness of university resources and tools, but the limited time available for traditional orientation and the transactional nature of information exchange curb the amount of preparedness students achieve. One specific type of orientation program, the outdoor orientation program, seeks to augment traditional orientation programs.Subscribe to JOREL