TY - BOOK

T1 - Interactive fiction and learning from failure in distance learning postgraduate clinical pharmacy education

AU - McKenna, Aileen

PY - 2025

Y1 - 2025

N2 - Formal postgraduate clinical pharmacy education is relatively common but underexplored in the literature, particularly in clinical decision-making and learning from errors – a source of anxiety and stress for pharmacists. Research shows interactive fiction (IF) has been beneficial to help undergraduate pharmacy students learn from their errors and gain confidence in their decision-making whilst developing their clinical knowledge. Its use at the postgraduate level however remains unexplored. This study explores how postgraduate distance-learning (DL) pharmacy students engage with IF as a pedagogical tool to learn from failure within their academic studies, as well as on the impact on their usual professional practice. Using Green and Jenkins' (2014) conceptual model of interactivity effects in interactive fiction, this research investigates how students' dual identities as learners and professionals shape their interactions with IF for their own academic and professional development.Anonymous online questionnaires and semi-structured interviews were used to gather quantitative and qualitative data in this mixed methods study. Participants were required to play through an IF story simulating a clinical scenario, making both sound and unsound choices in multiple playthroughs to explore the impact of error and failure. Findings suggest IF may be an enjoyable way to enhance clinical decision-making, knowledge retention, learning engagement, and confidence. Unlike undergraduate studies on IF, participants were able to draw on real world experiences and connections to practice which appears to have increased learning impact. Participants found the IF valuable overall, and noted that it encouraged reflection and changes in processes for some participants. Emotional responses to poor decisions did not reduce engagement but appeared to facilitate deeper reflection. This may have implications for long-term knowledge retention and enhanced decision-making. Whilst some found the IF time-consuming, all participants stated they would welcome more IF within their course, particularly in complex case discussions, ethical decision-making, and for experiencing other clinical specialties and pharmacy sectors. This research highlights IF’s potential use as an educational tool for PG pharmacists, particularly in learning from failure, the development of clinical decision-making skills and simply as a tool to foster engagement. It also contributes to the literature on interactive fiction, postgraduate pharmacy education and on the use of Green and Jenkins' conceptual framework within formal educational contexts. Limitations include a low response rate and a resultant small participant pool, all from one academic institution. Areas for future research include further applications in other healthcare professions, inter- and multi-disciplinary use, in longitudinal knowledge retention, and the use of IF in other subjects within the same context. Furthermore, comparisons of UG and PG engagement may reveal further insights into pharmacy education at both levels.

AB - Formal postgraduate clinical pharmacy education is relatively common but underexplored in the literature, particularly in clinical decision-making and learning from errors – a source of anxiety and stress for pharmacists. Research shows interactive fiction (IF) has been beneficial to help undergraduate pharmacy students learn from their errors and gain confidence in their decision-making whilst developing their clinical knowledge. Its use at the postgraduate level however remains unexplored. This study explores how postgraduate distance-learning (DL) pharmacy students engage with IF as a pedagogical tool to learn from failure within their academic studies, as well as on the impact on their usual professional practice. Using Green and Jenkins' (2014) conceptual model of interactivity effects in interactive fiction, this research investigates how students' dual identities as learners and professionals shape their interactions with IF for their own academic and professional development.Anonymous online questionnaires and semi-structured interviews were used to gather quantitative and qualitative data in this mixed methods study. Participants were required to play through an IF story simulating a clinical scenario, making both sound and unsound choices in multiple playthroughs to explore the impact of error and failure. Findings suggest IF may be an enjoyable way to enhance clinical decision-making, knowledge retention, learning engagement, and confidence. Unlike undergraduate studies on IF, participants were able to draw on real world experiences and connections to practice which appears to have increased learning impact. Participants found the IF valuable overall, and noted that it encouraged reflection and changes in processes for some participants. Emotional responses to poor decisions did not reduce engagement but appeared to facilitate deeper reflection. This may have implications for long-term knowledge retention and enhanced decision-making. Whilst some found the IF time-consuming, all participants stated they would welcome more IF within their course, particularly in complex case discussions, ethical decision-making, and for experiencing other clinical specialties and pharmacy sectors. This research highlights IF’s potential use as an educational tool for PG pharmacists, particularly in learning from failure, the development of clinical decision-making skills and simply as a tool to foster engagement. It also contributes to the literature on interactive fiction, postgraduate pharmacy education and on the use of Green and Jenkins' conceptual framework within formal educational contexts. Limitations include a low response rate and a resultant small participant pool, all from one academic institution. Areas for future research include further applications in other healthcare professions, inter- and multi-disciplinary use, in longitudinal knowledge retention, and the use of IF in other subjects within the same context. Furthermore, comparisons of UG and PG engagement may reveal further insights into pharmacy education at both levels.

KW - Distance learning

KW - Postgraduates

KW - clinical pharmacy

KW - learning from failure

KW - interactive fiction

KW - choose-your-own-adventure

U2 - 10.17635/lancaster/thesis/2868

DO - 10.17635/lancaster/thesis/2868

M3 - Doctoral Thesis

PB - Lancaster University

ER -