BMJ  2008;336:1129-1131 (17 May), doi:10.1136/bmj.39517.686956.47

Practice

Teaching Rounds

Teaching procedural skills

¹ University of Toronto, ² Division of General Surgery, St Michael’s Hospital, Toronto, ON M5B 1W8, Canada

"See one, do one" is not the best way to teach the complex technical procedures needed in many hospital based specialties

The first 150 words of the full text of this article appear below.

For many patients, a successful clinical outcome depends on having a well performed technical procedure. Crucial for surgeons, technical competence is becoming an important element of training for many hospital based specialists: interventional radiologists, cardiologists, gastroenterologists, endovascular therapists, and others. "See one, do one" is no longer appropriate for educating health professionals to perform complex procedures. Graduated independence, the hallmark of the approach to teaching procedural skills, is being challenged by concerns for patients’ safety, the skyrocketing complexity of procedures, and a diminishing work week for trainees. Finding the balance between patients’ safety and doctors’ training will require a more structured approach to our skills curriculum, including continuous assessment of skills, constructive feedback, and provision of opportunities for deliberate practice in the teaching environment.

This paper aims to provide an evidence based algorithm for procedural skills training. It focuses on teaching technical skills, which are just one component of a . . . [Full text of this article]

What do we know about current teaching of procedural skills?

Pre-patient training
Training in a clinical situation
Practise basic psychomotor skills until proficiency criteria are achieved
Acquire knowledge that is specific to the procedure
Demonstration of the procedure
Break the procedure into key steps
Comprehension
Perform single components of a procedure
Performing an entire procedure
Assessment and feedback throughout the learning process

What are the challenges?

Difficulties associated with the system
Difficulties associated with the learner
Difficulties associated with the trainer

What next?

Key points

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Rapid Responses:

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An Appeal for Accurate References to the Original Sources of Scientific Findings.

Anthony G Gallagher, et al.
bmj.com, 27 May 2008 [Full text]