Narrative Simulation Exercises and Farm Safety

Research from a number of fields demonstrates that critical thinking and decision-making skills make it possible for people in at-risk situations to recognize pre-event factors that lead to injury events and to act promptly to prevent an injury event or to lessen its severity. One way to teach these critical skills to at-risk populations involves using well-designed simulation exercises based on real-world cases.

Simulations are routinely used to teach individuals to prevent and to cope with emergency situations in civil and military aviation, in clinical medicine, and in high-risk occupations including mining, construction, hazardous materials handling, and firefighting (Cole, 1994; Cole, Vaught, Wiehagen et al., 1998; Cole, Lineberry, Wala et al., 1993). Simulation formats vary from very realistic, high-fidelity flight simulators (where a user is immersed in an environment nearly indistinguishable from an actual aircraft flight deck) to lower fidelity but engaging interactive table-top scenarios that provide challenges for recognizing patterns of potentially disastrous events and making decisions to prevent those events. More than 400,000 copies of 70 table-top paper and pencil simulation exercises that teach critical thinking and decision-making skills have been used in the U.S. mining industry to facilitate underground coal miners’ early recognition of problems and actions to prevent injury and disaster events (Cole, Wiehagen, Vaught, & Mills, 2001). Each simulation is based upon an actual mine emergency. The simulations serve two purposes: First, they assess the hazard recognition skills and knowledge needed to avoid injury events. Second, in the safety of a training room workers experience simulated emergency situations and make decisions to prevent pre-event conditions from progressing to the injury event stage (Cole, 1994, 1997, 2002).

Since the inception of the Southeast Center for Agricultural Health and Injury Prevention in 1992, Dr. Henry P. Cole and colleagues have completed a number of studies that apply simulation exercise methodology to the prevention of farming-related injuries. Products of this research activity include paper and pencil simulation exercises that are currently available as downloadable text files from the National Agricultural Safety Database (NASD). Two of these simulations promote the use of ROPS and seat belts to prevent injuries to tractor operators during overturns or roadway collisions. Two other simulations promote the use of approved helmets to prevent traumatic brain injuries to horse back riders and ATV operators.

Richardson (2004) observes that the simulation exercises target “the inner knowledge, attitudes, and beliefs of the population at risk of injury.” The exercises promote problem solving and critical thinking and thereby foster the early recognition and removal of risk factors for injury. Richardson adds, “Through the presentation of real life problem simulations, the target audience can develop the ‘foresight’ required to anticipate, prevent, and alter [otherwise] unpredictable occurrences that are characteristic of real life accidental injuries.” These observations are supported by the empirical results of studies by Cole et al.

In his comprehensive review of farm safety educational practices, Murphy (2003) states that the simulation exercises developed and field tested by Henry Cole and colleagues are unique in that these exercises are well-grounded in the theory of narrative psychology and its integration of behavioral, cognitive, and sociocultural approaches to behavior change. Most approaches to farm safety lack a strong theoretical and conceptual framework; farm safety has focused primarily on hazard recognition and safety rules (Murphy, 2003; Cole, 2002). Murphy states, “The attractiveness of Cole’s (1997) model for farm safety and health education is that it provides a method to capture the reality of at-risk and safe behavior of those we are attempting to help, and combines it with the insights provided by traditional behavioral and health behavior change models.”

A transdisciplinary team of University of Kentucky and NIOSH researchers developed and evaluated the simulation exercise titled The Kayles’ Difficult Decisions. The Kayles family is stressed by the need to harvest two crops before forecasted rain moves in within the next 12 hours. The stress and fatigue lead family members to engage in timesaving but risky shortcuts. The result is a severe and life threatening injury to a 14-year old boy who overturns a tractor that is not equipped with a rollover protective structure (ROPS). The costs of the youth’s injuries -- medical, non-medical, direct, and indirect, including lost labor and production -- create a large debt that threatens loss of the farm. The simulation exercise is atypical because it encompasses both the safety and economic aspects of the pre-event, event, and post-event stages of the injury incident.

The Partnerships for Preventing Farm Injuries to Rural Youth (PFIRY) study involved using a CD version of the Kayles program along with the Farm Planning Tool program available from the Web site of the Kentucky Farm Business Management Program of the University of Kentucky Agricultural Economics Department. The updated version of the Kayles simulation programmed in Asymmetric Toolbook is included on the Tractors, Farm Safety, and Economics CD available from the Southeast Center for Agricultural Health and Injury Prevention. Students who completed the Kayles CD received immediate feedback about the effects of their decisions at each key decision point in the simulation’s developing story about the Kayles family and its predicaments. When students finished the exercise, they printed out their answers and performance scores. The CD format allowed students to return multiple times to the Kayles program and its wealth of supplemental information and graphic displays. An added benefit was that, unlike the earlier consumable paper versions, the compact discs remained in the classroom to be reused repeatedly by other students and teachers in future classes.

References and Further Reading:

Cole, H.P. (1994). Embedded performance measures as teaching and assessment devices. Occ. Med: State of the Art Reviews, 9, 261-281.

Cole, H.P. (1997). Stories to live by: A narrative approach to health-behavior research and injury prevention. In D. S. Gochman (Ed.), Handbook of health behavior research methods: Vol. 4. (pp. 325-349). New York: Plenum.

Cole, H.P. (2002). Cognitive-behavioral approaches to farm community safety education: A conceptual analysis. J Agric Saf Health, 8, 145-159. Cole, H.P. (2004a). Tractors, farm safety, and economics. An interactive multimedia CD-ROM. Lexington, KY: University of Kentucky, Southeast Center for Agricultural Health and Injury Prevention. [Included the electronic version of Kayles’ Difficult Decisions, a farm safety and economics simulation exercise case.]

Cole, H.P. (2004b). Partnerships for Preventing Farm Injuries to Rural Youth. CDC/NIOSH funded project 5-U50-OH07447-04. 9/04-9/06. Lexington, KY: University of Kentucky Southeast Center for Agricultural Health and Injury Prevention.

Cole, H.P., Kidd, P.S., Isaacs, S.G., Parshall, M. & Scharf, T. (1997). Difficult decisions: A simulation that illustrates cost effectiveness of farm safety behaviors. J Agromed, 4, (1 & 2), 117-124.

Cole, H.P., Lineberry, G. T., Wala, A. M., Haley, J. V., Berger, P. K. & Wasielewski, R.D. (1993). Simulation exercises for training and educating miners and mining engineers. Mining Eng., 44, 1397-1401.

Cole, H., Mazur, J., Kidd, P., Scharf, T., Westneat, S., Phillips, S., Bayer, S., Colligan, M., Chrislip, D. & Elliott, P. (2004). Promoting Tractor and Farm Safety Practices Among High School Social Studies Students and Adult Farmers in Rural Communities. J Rural Community Health, 24(2), 35-42.

Cole, H.P., Myers, M.L. & Westneat, S.C. (2006). Frequency and severity of injuries to operators during overturns of farm tractors. J Agric Saf Health, 12(2), 127-38.

Cole, H.P., Vaught, C., Wiehagen, W.J., Haley, J.V. & Brnich, M.J. (1998). Decision-making during a simulated mine fire escape. IEEE Tran Eng. Mgt., 45, 153-162.

Cole, H.P. & Westneat, S. (2001). The Kentucky ROPS Project. Final technical report for Partners in Prevention: Promoting ROPS and seat belts on family farm tractors. Technical report to CDC/NIOSH. Lexington, KY: Southeast Center for Agricultural Health and Safety, University of Kentucky.

Cole, H.P., Westneat, S., Mazur, J., Myers, M. & Piercy, L. (2004). Final Performance Summary Report for the NIOSH Community Partners for Healthy Farming Intervention Project: Further Dissemination and Evaluation of the Kentucky ROPS Project. Lexington, KY: University of Kentucky, Southeast Center for Agricultural Health and Injury Prevention.

Cole, H.P., Westneat, S.C. & Myers, M.L. (2006). Ratio of non-fatal to fatal operator injuries during overturns of farm tractors. Technical paper accepted for presentation at and publication in the proceedings of the Annual NIFS June 2006 Meeting.

Cole, H.P., Westneat, S., & Phillips, S. (2001). Evaluation of Two Delivery Formats for a Farm Safety Simulation Exercise: Final Report. Lexington, KY: University of Kentucky, Southeast Center for Agricultural Health and Injury Prevention.

Cole, H.P., Wiehagen, W.J., Vaught, C., & Mills, B.S. (2001). Use of simulation exercises for safety training in the U.S. mining industry. National Institute for Occupational Safety and Health, Information Circular, 9459.

Cole, H.P. et al. (2002). The Kentucky Community Partners for Healthy Farming ROPS Project: A program of materials and activities to preserve farmers’ health, way of life and money. Available online from the National Agricultural Safety Database.

Mazur, J. & Cole H. (2002). Integrating Farm Safety Information into Social Studies Classrooms in Rural Public Schools: A Report from the Field: 1998-2002.Paper presented at the annual conference of the International Commission on Occupational Health (ICOH), Baltimore, MD.

Mazur, J.M. & Cole, H.P. (2003). Integration of community-relevant public health materials into required public school curricula. Invited paper presented at the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health NIOSH Seminar Series. Cincinnati, OH: CDC/NIOSH Alice Hamilton Laboratory, January 29. (Broadcast nationally by the CDC/NIOSH interactive digital Envision system).

Mazur, J. (2004). Conversation Analysis for Educational Technologists: Theoretical and Methodological Issues for Researching the Structures, Processes and Meaning of On-line Talk. In D. Jonassen (Ed.) Handbook of Research for Educational Communications and Technology. New York: McMillian.

Murphy DJ. Looking beneath the surface of agricultural safety and health. ASAE Pub 801M0303. St. Joseph, MI: American Society of Agricultural Engineers; 2003.

Richardson, C. (2004). Community Partners for Health Farming (CPHF) Project/The Kentucky ROPS Project. In R. Volpe & J. Lewko (Eds.), Preventing Neurotrauma: A Casebook of Evidence Based Practices. Ontario: Neurotrauma Foundation.