Awareness Of Errors Research Articles

A retrospective study of pet owners' complaints against veterinary practices in Türkiye (2012-2021).

The objective of this study was to examine in detail the complaints against veterinarians submitted by pet owners and evaluated by the Turkish Veterinary Medical Association in Türkiye, with the aim to create awareness among Turkish veterinarians about the nature of the complaints and how they might reduce the risk of making medical errors. 127 files of complaints. A total of 127 written complaints from pet owners filed between January 2012 and December 2021 were analyzed. The pet owners' complaints were subjected to a conventional content analysis to identify the primary, secondary, and tertiary themes. Each case was evaluated by a 3-level complaint-coding taxonomy. The first level included 3 domains (themes), namely clinical, management, and relationship, while the second level was ordered in a total of 7 subcategories of complaint types. Thereafter, the third-level minor themes were grouped into related subcategories. From 127 file complaints, 296 specific issues were identified. Of these, 62% were in the clinical domain, 24% in the management domain, and 14% about poor behavior of the attending veterinarians. The most common (43%) complaint was medical errors. An increased awareness of common medical errors should be promoted among Turkish veterinarians in order to reduce the risk of negligence and malpractice.

Spelling Errors in Children With Mild to Moderate Hearing Loss: Relations to Linguistic and Audiologic Factors

The purpose of this study was to evaluate the types of spelling errors made by children with mild to moderate hearing loss (CMMHL) compared with children with typical hearing (TH) and to determine if types of spelling errors were related to linguistic or audiologic factors. CMMHL and TH completed measures of spelling, spoken language, speech production, and reading. Children's spellings were coded for linguistic-based spelling errors using the Multilinguistic Coding System. The relation of types of linguistic spelling errors and children's performance on standardized language assessments, as well as audiologic factors, was evaluated. CMMHL did not make more spelling errors than TH; however, they exhibited a higher proportion of phonological awareness errors and a lower proportion of mental grapheme representation errors in their spellings. Phonological awareness errors and mental grapheme representation errors were related to relevant linguistic performance. Better-ear pure-tone average was related to total frequency of spelling errors and phonological awareness spelling errors, and better-ear Speech Intelligibility Index (SII) was related to semantic knowledge spelling errors. This study supports the use of linguistic spelling error analysis with CMMHL and provides evidence of the relation of types of linguistic spelling errors to linguistic knowledge and audiologic factors.

Error logs in the second language classroom: Exploring the relationship between learner engagement with written corrective feedback and improvements in writing accuracy

This classroom-based study investigates how engagement with written corrective feedback (WCF) through the completion of error logs is related to improvements in linguistic accuracy in new pieces of writing. Conducted over eight weeks in a Hong Kong secondary school English as a foreign language (EFL) classroom with 20 student participants, the study involved learners completing error logs after receiving metalinguistic WCF on their written texts. The error logs required learners to record each error and type, their corrections, and explanations for each correction. Using a pre-test, post-test design, the study compared learners' linguistic accuracy before and after the error log intervention, and explored the relationship between accuracy gains and successful error log completion. Learners' attitudes towards using error logs were also assessed through questionnaires and interviews. The findings indicated that linguistic accuracy significantly improved from pre-test to post-test, there was a significant positive correlation between accuracy gains and level of success in explaining corrections, and that learners generally held positive attitudes towards using error logs. The positive perceptions stemmed mainly from learners’ recognition that the error logs raised their awareness of common errors and fostered their linguistic development.

Regulatory focus predicts individual differences in pragmatic versus grammatical awareness and sensitivity

The present study employs regulatory focus theory (Higgins, 1997) to investigate the effects of L2 speakers’ chronic regulatory focus on their L2 pragmatic versus grammatical awareness. It involved the participation of 121 Chinese students, who are English language learners, at a university in the United States. Haws et al.’s (2010) questionnaire was used to examine the participants’ regulatory dispositions, and a judgment task was adapted from Bardovi-Harlig and Dörnyei (1998) to assess participants’ awareness of grammatical and pragmatic errors, as well as the severity of each type of error. Multiple regression results largely confirmed the predictions. Prevention regulatory focus, concerned with obligations, responsibilities, and negative outcomes, predicted L2 speakers’ recognition of grammatical errors and their severity. Conversely, promotion focus, which emphasizes growth, accomplishments, and positive outcomes, positively predicted L2 speakers’ perceptions of pragmatic error severity. These findings contribute to the understanding of how differences in chronic motivational orientations can lead to different L2 use patterns and characteristics.

Awareness of errors is reduced by sleep loss.

The ability to detect and subsequently correct errors is important in preventing the detrimental consequences of sleep loss. The Error Related Negativity (ERN), and the error positivity (Pe) are established neural correlates of error processing. Previous work has shown sleep loss reduces ERN and Pe, indicating sleep loss impairs error-monitoring processes. However, no previous work has examined behavioral error awareness, in conjunction with EEG measures, under sleep loss conditions, and studies of sleep restriction are lacking. Using combined behavioral and EEG measures, we report two studies investigating the impact of total sleep deprivation (TSD) and sleep restriction (SR) on error awareness. Fourteen healthy participants completed the Error Awareness Task under conditions of TSD and 27 completed the same task under conditions of SR. It was found that TSD did not influence behavioral error awareness or ERN or Pe amplitude, however, SR reduced behavioral error awareness, increased the time taken to detect errors, and reduced Pe amplitude. Findings indicate individuals who are chronically sleep restricted are at risk for reduced recognition of errors. Reduced error awareness may be one factor contributing to the increased accidents and injuries seen in contexts where sleep loss is prevalent.

Identifying MT Errors for Higher-Quality Target Language Writing

Second language education has arrived at a phase of proposing effective uses of neural machine translation (NMT). Previous research has explored various aspects of post-editing and suggested that it is crucial to manually edit NMT output to produce better target language (TL) texts. The purpose of this study was to identify NMT errors in output text, so that Japanese TL (English) learners can recognize what to be aware of. The study targeted the NMT output from Japanese-written academic reports, pre-edited by 73 Japanese students with intermediate TL proficiency. The data was analysed and primarily lexical and grammatical issues were detected and systematically classified. Results showed that the use of inappropriate TL vocabulary was the most frequent error, followed by misuse or lack of determiners. Some could be avoided in a pre-editing phase by carefully choosing precise source-language (SL) vocabulary or reducing SL ambiguity, while others required a deeper understanding of TL syntactic rules or the nuance of TL vocabulary. TL Learners need to raise their awareness of these NMT errors for effective post-editing.

Grammatical Errors in Pre-service English Teachers’ Argumentative Essays and their Views Regarding Error Correction

This study seeks to identify grammatical errors in argumentative essays written by prospective teachers of English as a foreign language in the fifth semester of college, determine whether students are aware of their mistakes, and discover their experiences with grammar instruction and error correction. We conducted an Error Analysis and contrasted results with a grammaticality judgment test (GJT) to assess students’ awareness of grammatical errors detected in their essays. Using mixed methods research, we compared results with a survey to discover the students’ views on English grammar learning and error correction. The most common errors were verb phrases, subject usage, clause patterns, prepositions, and verb patterns. Of these errors, prepositions, verbs, and clause patterns were the most problematic in the GJT. When characterizing grammatical errors and contrasting them with their judgments and opinions, we found that students did not overcome their most frequent mistakes, as they failed to identify and correct the same types of errors in the GJT applied one year later. Students are aware of their grammatical weaknesses since the contents considered the most challenging to learn coincide with those in which they perform worst on the test. Finally, students suggest alternative feedback strategies, including peer monitoring, to make their error correction process reflective.

Scaffoldings, Translation Errors, and Language Awareness by Thai University Students


 Translation is considered one of the most complicated tasks for English as a foreign language (EFL) learners to undertake, as achieving faultless translation requires multiple skills. To render perfect meanings between two languages, syntactic and semantic skills are necessary. However, some tasks require even more, namely pragmatic skill, to translate the profound meanings of the words or phrases and the meanings between a paragraph’s lines. This study was conducted to help Thai university students overcome these obstacles. The teacher’s scaffolding procedures were introduced during the translation process in a translation course to increase the students’ awareness of errors so they could consequently produce sound translations. Our findings show the significant effectiveness of scaffoldings for the improvement of translation tasks with appropriate lexical selection and good semantic form. However, the translation of some language aspects, such as figurative language, still needs further support and investigation.

P-189 Systematic management and confirmation of safety (Safety management manual; 7 CHA IVF laboratory instructions; Field training; Lecture; Inspection) can prevent embryo mix-up in IVF laboratory

Abstract Study question Is systematic patient safety management training effective in improving awareness in safety confirmation and preventing errors in Embryo mix-up for embryologists? Summary answer From survey for 116 embryologists, they responded that they followed safety management instructions and regulations, and that they improved their safety work capability and awareness What is known already The cases of embryo mix-up known through the media include errors of sperm change during IUI, fertilization, Freeze-thawing, PGT, and Embryo transfer process, but there will be more due to statistical difficulties. Errors mostly occur because clinics do not have the right protocol. Currently, there aren’t any regulations or policies to track eggs, sperm, embryos or frozen embryos during ART. For this reason, infertile couples have to choose clinics with high pregnancy rates and safe clinics on their own to perform assisted reproductive techniques. Study design, size, duration This study was conducted through a survey of 116 embryologists who worked at five clinics of CHA fertility centers. The patient safety management system was created from the CHA fertility Center itself. From August 2021 to December 2022, safety confirmation training was conducted for 16 months. All embryologists were anonymously surveyed twice with 32 questions. The first survey was conducted in April 2022, and the second survey was in December 2022. Participants/materials, setting, methods The survey was conducted in 32 items with 10 categories. Interviewees’ made response for each item in five steps. Each item asked 1) Learning in the standard safety manual 2) Changes in safety awareness before and after training, 3) Compliance to the seven safety instruction (double checks) for each work part, 4) Level of difficulty in education, 5) Effects of education and 6) Suggestions for safety confirmation. Main results and the role of chance In the first survey, 61 out of 112 responded (54.5%) 60 out of 116 (51.7%) in the second. The answers were scored using a 5-point Likert scale (1 = strong disagree, 5 = Strong agree). 1. The mean score for work satisfaction was 3.1 ± 0.8 out of 5 in the first survey and 3.1 ± 0.7 out of 5 in the second. Work satisfaction remained unchanged. 2. The perception of patient safety confirmation was 3.7/5 before training and 4.0/5 after training (p < 0.03) in the second which improved the perception of safety confirmation. 3. The safety confirmation ability through training was improved to 4.1/5(p < 0.01) after training compared to 3.8/5 in both the first and second surveys. 4. The necessity and importance of safety training were considered important in the first survey as it scored 3.6/5 and 4.5/5 (p < 0.001) in the second survey. 5. In the course of work, they responded that their safety management skills were improved (1st: 3.4/5, 2nd: 4.5/5(p < 0.05)) by the effects of training. As for CHA IVF lab, the embryologists were well aware of the guidelines (scoring 4.5/5 in the first and second survey) to know seven safety instructions (which are double check, outloud, RI witness, monitoring, document, information) should be followed well. Limitations, reasons for caution Embryo mix-up during ART procedures can be a major mistake to be avoided. The confirmed documentations can make errors any time. Establishing the safety protocol of the same process as ART procedure, the system, and education are important, but the most important is the safety management capability of the manager. Wider implications of the findings The safety management manual, the 7 CHA IVF laboratory patient safety instructions, online lecture training, field training, and inspection have raised awareness of the safety errors and the importance of double checking. Errors in safety can be prevented through systematic system development and repeated safety training. Trial registration number non-clinical trials

Healthcare professional’s knowledge and awareness of the medication error reporting systems in the Kuwaiti hospitals

Abstract Objective. A survey was conducted to explore healthcare professional’s (HCPs) knowledge and attitude towards medication errors reporting processes and systems used in their local hospitals. Methods. There were 696 respondents and the observational survey showed the diverse perspectives of HCPs from diverse professions (doctors, pharmacists and nurses) who are at different stages in their career. The survey results highlighted the deficiencies in the medication safety management process, including the follow-up on witnessed or discovered medication errors, the effectiveness of the used reporting systems for medication errors, the standardisation of electronic prescribing software, and the training of HCPs at the six hospitals on medication safety. Key finding. Only 46% of the surveyed stated that their hospital had a mechanism in place for reporting medication errors and 60.7% of the participants agreed that they would submit reports provided the system is not used for performance management and only those need to know will be able to identify their name. Regarding prescription writing, 51% of surveyed HCPs said they utilise electronic prescribing software; however, the overall usage rate of electronic prescribing systems was 49%, with handwritten prescriptions remaining the option used in the majority of the time. In terms of HCP training, 20% of the survey respondents said they did not receive any instruction or direction in the hospitals on pharmacovigilance and patient safety. Conclusions. The Kuwaiti MoH should build a national electronic incident reporting system and establish standardised rules and protocols for incident reporting that is to be anonymous and of compulsory use by all government and private hospitals.

Improving Patient Safety: Engaging Students in Interprofessional Team-Based Learning (TBL)

Complex healthcare systems and ambiguous clinical decisions can result in medical errors which threaten patient safety. There is a need for improved awareness of medical errors across healthcare disciplines. We utilised team-based learning (TBL) to pilot an interprofessional patient safety module for senior health professional students. We evaluated the use of TBL within the interprofessional context to achieve student learning outcomes. Twenty-seven students from pharmacy (n=11), nursing (n=8) and medicine (n=8) faculties participated. Data were collected via questionnaires, focus groups, class observation and student test scores. Quantitative data were analysed using descriptive statistics. Framework analysis was used to code qualitative data using social capital as a conceptual framework. In total, 26/27 (96%) of participants completed the questionnaire and 20/27 (70%) attended focus groups. There was no significant difference in prior knowledge between the disciplines. The TBL module enriched the learning environment and enabled students to prepare, problem-solve and interact with facilitators. The TBL pedagogy and interprofessional framework enabled the development of social capital among students. The module demonstrated the potential of interprofessional education to shift knowledge and attitudes towards a greater appreciation of patient safety issues and better prepare health professional students for the workforce. The TBL pedagogy strengthened knowledge sharing and fostered collaboration across disciplines.

Exploring medical students’ metacognitive and regulatory dimensions of diagnostic problem solving

ABSTRACT Solving clinical problems requires an individual to apply not only domain-specific medical knowledge and cognitive skills for reasoning, but also to be consciously aware of, monitor, and evaluate their thinking processes (i.e., metacognition). The purpose of this study was to map critical metacognitive dimensions of clinical problem solving and to explore the structural relationships among them, which may help frame a conceptual framework and better pedagogy for effective intervention. A context-specific inventory was adapted and modified from a domain-general instrument to capture essential metacognitive skills for learning and solving clinical problems. This inventory was administered to 72 undergraduate medical students to survey their capabilities in five dimensions: knowledge of cognition, objectives, problem representation, monitoring, and evaluation. The interplay among these dimensions was further examined using partial least squares structural equation modeling. Our findings revealed that the medical students fell short of some expert-like, metacognitive, and regulatory competence, even after receiving years of medical education and on-site training. In particular, they did not know when a holistic understanding of a problem had been reached. Many of them often do not have a set of clear diagnostic procedures in mind, nor do they concurrently monitor their thinking during diagnostic reasoning. Moreover, their lack of self-improving approaches seemed to worsen their learning. Finally, the structural equation model indicated that knowledge of cognition and objectives significantly predicted problem representation, suggesting that medical learners’ knowledge of and goals for learning are influential in framing the clinical problems at hand. A significant linear prediction path was observed from problem representation, monitoring, to evaluation, signifying a possible sequenced process of clinical problem solving. Metacognitive-based instruction can help improve clinical problem-solving skills and awareness of potential biases or errors.

The effect of a brief mindfulness-based stress reduction program on strengthening awareness of medical errors and risks among nursing students

InformationHealthcare professionals' awareness of medical errors and risks results in effective medical error reporting and patient safety. Mindfulness has positive effects on strengthening attention and awareness. However, little is known about the use of mindfulness in patient safety education among nursing students. This study aimed to examine if a brief mindfulness-based stress reduction program would have a beneficial impact on (a) medical error attitudes, (b) the number of medical errors and risks in a simulation environment, and (c) self-confidence and satisfaction among nursing students. MethodsA quasi-experimental design with a control group was conducted with 78 third-year nursing students at a private, accredited, nursing program in Istanbul, Türkiye. ResultsThere was a statistically significant improvement in the intervention group between the pre-test and post-test for medical error attitudes (p < 0.001), and the number of medical errors and risks in a simulation environment (p < 0.001). There was no statistical difference in the intervention and control groups for self-confidence and satisfaction (p > 0.05). ConclusionThese results suggest that a brief mindfulness-based stress reduction program positively strengthens nursing students' awareness of medical errors and risks.

Errors in nursing practices: What are the attitudes of nurses toward medical errors?

This study aims to determine the attitudes of nurses towards medical errors and related factors. The study was designed as a descriptive and cross-sectional study. A total of 119 nurses completed a questionnaire on personal information and Medical Errors Attitude Scale. It was determined that nurses’ attitudes towards medical errors were positive. It was found that nurses’ awareness of medical errors and reporting errors was high. The medical error perception of nurses with less years of work experience in the unit was found to be more negative. Many medical errors are actually caused by preventable conditions. At this point, the best way to prevent medical errors is to create an institutional culture based on patient safety. Within the scope of quality control studies in health institutions, the development of patient safety culture and development of nurses’ attitudes towards medical errors should be supported.

A room of errors simulation to improve pharmacy operators' knowledge of cytotoxic drug production.

We used an educational healthcare simulation tool called room of errors (ROE) to raise pharmacy operators' awareness of potential errors in a chemotherapy production process and assessed its impact on their knowledge and satisfaction. Twenty-five errors (compiled from internal procedures, literature and our hospital's reported incidents) were categorised as static (n = 7, visible by the participant anytime) and dynamic (n = 18, made by a pseudooperator in front of the participant). Our simulated cytotoxic production unit (CPU) hosted the 1 h-simulation. Two pharmacists (supervisor/pseudo-operator) welcomed the trainee for a 10-min briefing. During the 20-min simulation, participants watched the pseudo-operator's gestures in a simulated chemotherapy production process. Participants called out each error observed (recorded by the supervisor). A 20-min debriefing followed. ROE's impact on knowledge was measured through participants' answers to a before-and after 18-item questionnaire about CPU's procedures and certainty about answers on a scale (0%-100%). Participants evaluated the training using a satisfaction questionnaire (Likert scale, 1-6). The 14 participants detected 70.4% ± 11.4% of errors. Least-detected errors were "using non-disinfected vials" (42.9%) and "touching syringe plunger" (0%). Critical errors (expired leftovers or glucose instead of sodium chloride) were detected at 57.1%. Knowledge improved from 60.3% to 94.1% (p < 0.001) and certainty from 75.3% to 98.8% (p < 0.001). Participants appreciated this non-judgmental, informative, and original training (satisfaction 95.7%). Some pointed out difficulties settling into the game quickly and visualising static and dynamic errors simultaneously. This ROE simulation improved operators' knowledge and certainty. Longer-term testing should be done to measure knowledge retention over time.

Awareness of refractive error and diabetic retinopathy in the rural population of western India

Purpose: To assess the awareness, knowledge and treatment seeking tendencies about refractive error and diabetic retinopathy in rural western India. Methods: The study was done from July 2019 to September 2019 in 1000 subjects in the rural population in the vicinity of Dhiraj general hospital, Pipariya. Demographic details about age, gender and literacy were collected. A questionnaire based door to door survey was done and their responses were graded and data was analysed. Results: There were 475(47.5%) males and 525(52.5%) females. 590(59%) were between the ages of 20-50 years and 410(41%) were above 50 years of age. 210(21%) were illiterate, 565(56.5%) had received primary education and 225(22.5%) had received secondary education and above. It was observed that there was more awareness, knowledge and treatment seeking tendencies in educated subjects (p&lt;0.01). Younger subjects had more knowledge about refractive error and older age group had more knowledge about diabetic retinopathy. Conclusion: Our study strongly suggests that there is lack of awareness, knowledge and treatment seeking tendencies in the rural population in western India. More effective health education in the form of public health care programmes and mass media awareness might be beneficial.

O058 Awareness of errors is impaired by sleep restriction but not total sleep deprivation

Abstract Introduction Detecting and correcting errors is important in preventing detrimental consequences of sleep loss. We report the first study to utilise both behavioural and EEG measures of error awareness, and we compare the effects of total sleep deprivation (TSD) and sleep restriction (SR). Methods Twenty-seven healthy adults (14F, age=27.2±5.1y) were studied both well-rested ( WR 9h sleep/night) and following SR (3 nights of 3h sleep/night), completing the Error Awareness Task (EAT) once/day (8-9h post-habitual wake). Thirteen healthy adults (3F, age=26.2±4.1y) underwent 34h TSD, completing the Error Awareness Task (at 3h and 27h post-wake). The EAT required participants to withhold responding to “nogo” stimuli and signal errors when they occurred. ERP measures included the Error Related Negativity (ERN) and Error Positivity (Pe). Results SR increased error rate (p&amp;lt;.001), decreased error awareness (p&amp;lt;.001) and slowed error recognition (p&amp;lt;.01). ERN amplitude was unaffected, and Pe amplitude was reduced. TSD did not significantly affect error rate, error awareness rate, the time taken to detect errors, or either ERP measure. Discussion SR impaired the ability to recognise errors in real time, despite a greater number of errors being made. EEG findings further indicate conscious error awareness is reduced following SR. However, unconscious error detection appears resilient to sleep loss. Findings suggest error awareness may be more sensitive to chronic versus acute sleep loss. In occupations where SR is common, recognition of errors may be reduced. Reduced error recognition may explain the increased accident and injury rates seen in contexts where sleep loss is common.

Situation awareness in outage work – A study of events occurring in U.S. nuclear power plants between 2016 and 2020

In this study, we sought to identify if human errors responsible for incidents occurring during scheduled outage periods in nuclear power plants correspond to situation awareness errors in perception, comprehension, or projection. We also sought to identify factors contributing to situation awareness errors at all levels. To do this, we analysed 58 events occurring during planned nuclear power plant outages between 2016 and 2020, as documented in U.S. Licensee Event Reports (LERs). Of the human errors analysed in these events, 14 were classified as situation awareness errors related to perception (Level 1 errors), 30 were classified as situation awareness errors related to comprehension (Level 2 errors), and an additional 14 were classified as situation awareness errors related to projection (Level 3 errors). Furthermore, we found that insufficient procedure use was identified in the LERs as a factor contributing to most errors occurring at Level 1, whereas insufficient procedures was identified to contribute to most errors occurring at Level 2 and 3.

Evacuation action during torrential rain considering situation awareness error using protection motivation theory

The torrential rains in July 2018 caused considerable river overflow, flood damage, and landslides, particularly in western Japan. At that time, 232 fatalities and missing persons were recorded, with most human damage caused by delays in evacuation. These delays occur during most torrential rain events, and can presumably be attributed to a situation awareness error in the disaster response of residents. This study analyzed the evacuation decision-making structure by adding a situation awareness error to the protection motivation theory framework. Accordingly, the evacuation actions of residents during torrential rains in Japan in 2018 were surveyed and analyzed using structural equation modeling and logistic regression. Most respondents chose not to evacuate despite showing a high intention to do so. Such respondents evacuated only in response to a trigger such as a dramatic change in their surrounding environment or the receipt of an evacuation appeal. By considering situation awareness errors in protection motivation theory, this study identified active and passive evacuation decisions to clarify the stage at which evacuation delays occurred. The findings provide guidance on the stage of situation awareness that should be promoted and the specific measures required to achieve efficient evacuation.

Inconsistent attentional contexts impair relearning following gradual visuomotor adaptation.

One of the brain's primary functions is to promote actions in dynamic, distracting environments. Because distractions divert attention from our primary goals, we must learn to maintain accurate actions under sensory and cognitive distractions. Visuomotor adaptation is a learning process that restores performance when sensorimotor capacities or environmental conditions are abruptly or gradually altered. Prior work showed that learning to counteract an abrupt perturbation under a particular single- or dual-task setting (i.e., attentional context) was associated with better recall under the same conditions. This suggested that the attentional context was encoded during adaptation and used as a recall cue. The current study investigated whether the attentional context (i.e., single vs. dual task) also affected adaptation and recall to a gradual perturbation, which limited awareness of movement errors. During adaptation, participants moved a cursor to a target while learning to counteract a visuomotor rotation that increased from 0° to 45° by 0.3° each trial, with or without performing a secondary task. Relearning was impaired when the attentional context was different between adaptation and recall (experiment 1), even when the exposure to the attentional context was limited to the early or late half of adaptation (experiment 2). Changing the secondary task did not affect relearning, indicating that the attentional context, rather than specific stimuli or tasks, was associated with better recall performance (experiment 3). These findings highlight the importance of cognitive factors, such as attention, in visuomotor adaptation and have implications for learning and rehabilitation paradigms.NEW & NOTEWORTHY Adaptation acquired under single- or dual-task setting, which created an undivided or divided attentional context, respectively, was impaired when relearning occurred under different conditions (i.e., shifting from a dual to single task). Changes to the attentional context impaired relearning when the initial adaptation was to a gradual perturbation. Explicit awareness of the perturbation was not necessary for this effect to be robust, nor was the effect attributable to changes in the secondary task requirements.