title: Comparison of error-based and errorless learning for people with severe traumatic brain injury: study protocol for a randomized control trial.
abstract: BACKGROUND
  Poor skills generalization poses a major barrier to successful outcomes of rehabilitation after traumatic brain injury (TBI). Error-based learning (EBL) is a relatively new intervention approach that aims to promote skills generalization by teaching people internal self-regulation skills, or how to anticipate, monitor and correct their own errors. This paper describes the protocol of a study that aims to compare the efficacy of EBL and errorless learning (ELL) for improving error self-regulation, behavioral competency, awareness of deficits and long-term outcomes after TBI.
  
  
  METHODS
  This randomized, controlled trial (RCT) has two arms (EBL and ELL); each arm entails 8 × 2 h training sessions conducted within the participants' homes. The first four sessions involve a meal preparation activity, and the final four sessions incorporate a multitasking errand activity. Based on a sample size estimate, 135 participants with severe TBI will be randomized into either the EBL or ELL condition. The primary outcome measure assesses error self-regulation skills on a task related to but distinct from training. Secondary outcomes include measures of self-monitoring and self-regulation, behavioral competency, awareness of deficits, role participation and supportive care needs. Assessments will be conducted at pre-intervention, post-intervention, and at 6-months post-intervention.
  
  
  CONCLUSIONS
  This study seeks to determine the efficacy and long-term impact of EBL for training internal self-regulation strategies following severe TBI. In doing so, the study will advance theoretical understanding of the role of errors in task learning and skills generalization. EBL has the potential to reduce the length and costs of rehabilitation and lifestyle support because the techniques could enhance generalization success and lifelong application of strategies after TBI.
  
  
  BACKGROUND
  ACTRN12613000585729.
authors.affiliation: School of Applied Psychology and Behavioural Basis of Health Program, Griffith Health Institute, Griffith University, Mt Gravatt 4122, Australia. t.ownsworth@griffith.edu.au.
authors.forename: Tamara
authors.initials: T
authors.lastname: Ownsworth
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fleming
authors.forename: Robyn
authors.initials: R
authors.lastname: Tate
authors.forename: David H K
authors.initials: DH
authors.lastname: Shum
authors.forename: Janelle
authors.initials: J
authors.lastname: Griffin
authors.forename: Julia
authors.initials: J
authors.lastname: Schmidt
authors.forename: Amanda
authors.initials: A
authors.lastname: Lane-Brown
authors.forename: Melissa
authors.initials: M
authors.lastname: Kendall
authors.forename: Mathilde
authors.initials: M
authors.lastname: Chevignard
mesh_terms: D001315:Australia; D001364:Awareness; D001930:Brain Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D002985:Clinical Protocols; D003071:Cognition; D030141:Feedback, Psychological; D005793:Generalization, Psychological; D006699:Home Care Services; D006801:Humans; D007858:Learning; D009048:Motor Skills; D020127:Recovery of Function; D012107:Research Design; D012927:Social Control, Informal; D013997:Time Factors; D016896:Treatment Outcome