Learn, See, Practice, Prove, Do, Maintain: An Evidence-Based Pedagogical Framework for Procedural Skill Training in Medicine. (August 2015)

• Record Type: Journal Article
• Authors: Sawyer, Taylor; White, Marjorie; Zaveri, Pavan; Chang, Todd; Ades, Anne; French, Heather; Anderson, JoDee; Auerbach, Marc; Johnston, Lindsay; Kessler, David
• Is Part Of: Academic medicine. Volume 90:Number 8(2015)
• Publication Date: 2015-08
• Subjects: Medical education -- Periodicals; Medical policy -- Periodicals; Medical personnel -- Periodicals; Periodicals; 610.711
• DOI: 10.1097/ACM.0000000000000734
• Languages: English
• ISSNs: 1040-2446

Abstract

Abstract : Acquisition of competency in procedural skills is a fundamental goal of medical training. In this Perspective, the authors propose an evidence-based pedagogical framework for procedural skill training. The framework was developed based on a review of the literature using a critical synthesis approach and builds on earlier models of procedural skill training in medicine. The authors begin by describing the fundamentals of procedural skill development. Then, a six-step pedagogical framework for procedural skills training is presented: Learn, See, Practice, Prove, Do, and Maintain . In this framework, procedural skill training begins with the learner acquiring requisite cognitive knowledge through didactic education ( Learn ) and observation of the procedure ( See ). The learner then progresses to the stage of psychomotor skill acquisition and is allowed to deliberately practice the procedure on a simulator ( Practice ). Simulation-based mastery learning is employed to allow the trainee to prove competency prior to performing the procedure on a patient ( Prove ). Once competency is demonstrated on a simulator, the trainee is allowed to perform the procedure on patients with direct supervision, until he or she can be entrusted to perform the procedure independently ( Do ). Maintenance of the skill is ensured through continued clinical practice, supplemented by simulation-based training as needed ( Maintain ). Evidence in support of each component of the framework is presented. Implementation of the proposed framework presents a paradigm shift in procedural skill training. However, the authors believe that adoption of the framework will improve procedural skill training and patient safety.