TY - JOUR
T1 - Learn, See, Practice, Prove, Do, Maintain
T2 - An Evidence-Based Pedagogical Framework for Procedural Skill Training in Medicine
AU - Sawyer, Taylor
AU - White, Marjorie
AU - Zaveri, Pavan
AU - Chang, Todd
AU - Ades, Anne
AU - French, Heather
AU - Anderson, Jodee
AU - Auerbach, Marc
AU - Johnston, Lindsay
AU - Kessler, David
N1 - Publisher Copyright:
Copyright © by the Association of American Medical Colleges. Unauthorized reproduction of this article is prohibited.
PY - 2015/8/31
Y1 - 2015/8/31
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84938254136&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84938254136&partnerID=8YFLogxK
U2 - 10.1097/ACM.0000000000000734
DO - 10.1097/ACM.0000000000000734
M3 - Review article
C2 - 25881645
AN - SCOPUS:84938254136
SN - 1040-2446
VL - 90
SP - 1025
EP - 1033
JO - Academic Medicine
JF - Academic Medicine
IS - 8
ER -