Challenges in Learning Procedural Skills: Student Perspectives and Lessons Learned for Curricular Design

Kodikara, Kaumudee; Seneviratne, Thilanka; Godamunne, P.K.S.; Premaratna, R.

doi:10.1080/10401334.2023.2226633

Cited by 3 publications

(3 citation statements)

References 113 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The pre-clinical period fraught with teaching basic sciences, is used less to equip students with skills needed at the bedside to participate in patient care during clerkships [ 3 ]. Thus, clerkships are still the primary source for learning and acquiring clinical skills in traditional medical curricula [ 4 – 6 ]. However, traditional curricula are no longer recommended, and many medical schools have undertaken curricula reforms to move towards integrated curricula [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, basic clinical skills acquisition during clerkships occurs in a rather "haphazard" fashion [ 6 , 8 – 12 ]. Practicing invasive procedures on patients without proper training imposes an ethical issue [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…A growing number of learners, finite resources, and increasing emphasis on patients' right to trained care hinder medical students' learning procedural skills in the clinical setting [ 14 ]. Further, students report inadequate supervision by the clinical teachers, lack of assessments and feedback on learner performance, and reduced opportunities for learning [ 6 , 8 , 12 ] as barriers to learning procedural skills at the bedside. Although patients are willing to accept trainee involvement in nonprocedural care, they usually are reluctant to allow medical students to perform procedures on them [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

Kodikara,

Seneviratne,

Premaratna

2023

BMC Med Educ

Self Cite

View full text Add to dashboard Cite

Background The effectiveness of simulation-based training for skill acquisition is widely recognized. However, the impact of simulation-based procedural training (SBPT) on pre-clerkship medical students and the retention of procedural skills learned through this modality are rarely investigated. Methods A prospective cohort study was conducted among pre-clerkship medical students. Learners underwent SBPT in venipuncture in the skills laboratory. Assessments were conducted at two main points: 1) immediate assessment following the training and 2) delayed assessment one year after training. Learner self-assessments, independent assessor assessments for procedural competency, and communication skills assessments were conducted in both instances. The students were assessed for their competency in performing venipuncture by an independent assessor immediately following the training in the simulated setting and one-year post-training in the clinical setting, using the Integrated Procedural Protocol Instrument (IPPI). The student’s communication skills were assessed by standardized patients (SP) and actual patients in the simulated and clinical settings, respectively, using the Communication Assessment Tool (CAT). Results Fifty-five pre-clerkship medical students were recruited for the study. A significant increase was observed in self-confidence [mean: 2.89 SD (Standard Deviation) (0.69)] and self-perceived competency [mean: 2.42 SD (0.57)] in performing venipuncture, which further improved at the delayed assessment conducted in the clinical setting (p < 0.001). Similarly, the IPPI ratings showed an improvement [immediate assessment: mean: 2.25 SD (1.62); delayed assessment: mean: 2.78 SD (0.53); p < 0.01] in venipuncture skills when assessed by an independent assessor blinded to the study design. A significant difference (p < 0.01) was also observed in doctor-patient communication when evaluated by SPs [mean: 2.49 SD (0.57)] and patients [mean: 3.76 SD (0.74)]. Conclusion Simulation-based venipuncture training enabled students to perform the procedure with confidence and technical accuracy. Improved rating scores received at a one-year interval denote the impact of clinical training on skills acquisition. The durability of skills learned via SBPT needs to be further investigated.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

Kodikara,

Seneviratne,

Premaratna

2023

BMC Med Educ

Self Cite

View full text Add to dashboard Cite

show abstract

Procedural simulation in venipuncture for medical undergraduates and its transfer to the bedside: a cluster randomized study

Kodikara,

Seneviratne,

Premaratna

2023

Adv in Health Sci Educ

View full text Add to dashboard Cite

Identifying essential procedural competencies for medical students: a modified Delphi survey

Kodikara,

Seneviratne,

Premaratna

2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background Although medical students need to acquire specific procedural skills during their undergraduate training, agreement on what skills they should be trained upon and the competency levels that need to be achieved in these skills is inconclusive. This study aimed to identify core procedural skills competencies for Sri Lankan medical students and establish the importance of pre-clerkship procedural training to improve these skills. Methods A three-round, online modified Delphi survey was used to identify consensus on essential procedural skills and competencies for graduating medical students in Sri Lanka. An initial questionnaire was developed using content identified from the literature and student logbooks. The expert panel included seventeen clinicians involved in undergraduate medical education and supervision of resident physicians. In Round 1, they rated their agreement on including 64 procedural skills, and 4 suggested additional procedures in undergraduate training. In Round 2, experts re-appraised 38 skills and rated the level of competency (i.e., Observer to Proficient). In Round 3, experts re-appraised the ratings of 35 essential procedures and rated the support for a pre-clerkship procedural curriculum for medical students. Results Consensus, defined as > 75% agreement, was established with 25 procedural skills across eight categories: cardiovascular, respiratory, gastrointestinal, surgical, gynecology and obstetrics, urogenital, diagnostic, and injections. Nasogastric tube insertion, venipuncture, handwashing, nose/throat/wound swab, measuring capillary packed cell volume, surgical scrub, gown, and gloving were rated with the highest level of agreement as requiring a 'proficient' level of competency. A majority of the experts were in support of a pre-clerkship procedural curriculum for medical students. Conclusions The findings from this Delphi survey provide critical information about core procedural skills and competencies for Sri Lankan undergraduate medical curricula. The results support the importance of teaching these procedures within the pre-clerkship years of medical curricula. Including highly experienced clinician educators in the expert panel validates the study findings, which demonstrate the importance of aligning existing medical curricula with competency-based medical education.

show abstract

Challenges in Learning Procedural Skills: Student Perspectives and Lessons Learned for Curricular Design

Cited by 3 publications

References 113 publications

Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

Procedural simulation in venipuncture for medical undergraduates and its transfer to the bedside: a cluster randomized study

Identifying essential procedural competencies for medical students: a modified Delphi survey

Contact Info

Product

Resources

About