Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicine

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 approac...

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Vydáno v:	Academic medicine Ročník 90; číslo 8; s. 1025
Hlavní autoři:	Sawyer, Taylor, White, Marjorie, Zaveri, Pavan, Chang, Todd, Ades, Anne, French, Heather, Anderson, JoDee, Auerbach, Marc, Johnston, Lindsay, Kessler, David
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States 01.08.2015
Témata:	Clinical Competence Competency-Based Education - methods Educational Measurement Evidence-Based Medicine Female Humans Learning Male Models, Educational
ISSN:	1938-808X, 1938-808X
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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.
AbstractList	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. 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.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.
Author	White, Marjorie Anderson, JoDee Johnston, Lindsay Kessler, David Ades, Anne Chang, Todd French, Heather Zaveri, Pavan Auerbach, Marc Sawyer, Taylor
Author_xml	– sequence: 1 givenname: Taylor surname: Sawyer fullname: Sawyer, Taylor organization: T. Sawyer is assistant professor, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington. M. White is assistant professor, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama. P. Zaveri is assistant professor, Division of Emergency Medicine, Children's National Health System, Washington, DC. T. Chang is assistant professor, Division of Emergency Medicine and Transport, Children's Hospital Los Angeles, Los Angeles, California. A. Ades is associate professor, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. H. French is assistant professor, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. J. Anderson is associate professor, Department of Pediatrics, Oregon Health Sciences University, Portland, Oregon. M. Auerbach is assistant professor, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut. L. Johnston is assistant professor, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut. D. Kessler is assistant professor, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York – sequence: 2 givenname: Marjorie surname: White fullname: White, Marjorie – sequence: 3 givenname: Pavan surname: Zaveri fullname: Zaveri, Pavan – sequence: 4 givenname: Todd surname: Chang fullname: Chang, Todd – sequence: 5 givenname: Anne surname: Ades fullname: Ades, Anne – sequence: 6 givenname: Heather surname: French fullname: French, Heather – sequence: 7 givenname: JoDee surname: Anderson fullname: Anderson, JoDee – sequence: 8 givenname: Marc surname: Auerbach fullname: Auerbach, Marc – sequence: 9 givenname: Lindsay surname: Johnston fullname: Johnston, Lindsay – sequence: 10 givenname: David surname: Kessler fullname: Kessler, David
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Snippet	Acquisition of competency in procedural skills is a fundamental goal of medical training. In this Perspective, the authors propose an evidence-based...
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SubjectTerms	Clinical Competence Competency-Based Education - methods Educational Measurement Evidence-Based Medicine Female Humans Learning Male Models, Educational
Title	Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicine
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