Complex procedural skills are retained for a minimum of 1 yr after a single high-fidelity simulation training session

Boet, Sylvain; Borges, Bruno C. R.; Naik, Viren N.; Siu, Lyndon; Riem, Nicole; Chandra, Deven B.; Bould, M. Dylan; Joo, Hwan S.

doi:10.1093/bja/aer160

Cited by 148 publications

(52 citation statements)

References 25 publications

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“…The effectiveness and retention of other skills taught in the SBME setting have been studied less, and much heterogeneity is seen with regards to performed skills, study subjects and teaching methods, rendering data interpretation difficult. Examples include competencies in laparoscopic surgery or colonoscopy by surgical residents after 3 months [13,19], a significant decay in temporary haemodialysis catheter insertion skills by nephrology fellows after 6 months [20] and a satisfactory retention of a rare but crucial procedural skill like coniotomy performed by trained anaesthetist up to one year [21]. This heterogeneity in findings makes it hard if not impossible to draw any conclusions for skills lab training in medical undergraduates.…”

Section: Introductionmentioning

confidence: 99%

“Best Practice” Skills Lab Training vs. a “see one, do one” Approach in Undergraduate Medical Education: An RCT on Students’ Long-Term Ability to Perform Procedural Clinical Skills

Herrmann–Werner¹,

Nikendei

Keifenheim³

et al. 2013

PLoS ONE

121

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BackgroundBenefits of skills lab training are widely accepted, but there is sparse research on its long-term effectiveness. We therefore conducted a prospective, randomised controlled-trial to investigate whether in a simulated setting students trained according to a "best practice" model (BPSL) perform two skills of different complexity (nasogastral tube insertion, NGT; intravenous cannulation, IVC) better than students trained with a traditional "see one, do one" teaching approach (TRAD), at follow-up of 3 or 6 months.Methodology and Principal Findings94 first-year medical students were randomly assigned to one of four groups: BPSL training or TRAD teaching with follow-up at 3 (3M) or 6 (6M) months. BPSL included structured feedback, practice on manikins, and Peyton’s "Four-Step-Approach", while TRAD was only based on the "see one - do one" principle. At follow-up, manikins were used to assess students’ performance by two independent blinded video-assessors using binary checklists and a single-item global assessment scale. BPSL students scored significantly higher immediately after training (NGT: BPSL3M 94.8%±0.2 and BPSL6M 95.4%±0.3 percentage of maximal score ± SEM; TRAD3M 86.1%±0.5 and TRAD6M 84.7%±0.4. IVC: BPSL3M 86.4%±0.5 and BPSL6M 88.0%±0.5; TRAD3M 73.2%±0.7 and TRAD6M 72.5%±0.7) and lost significantly less of their performance ability at each follow-up (NGT: BPSL3M 86.3%±0.3 and TRAD3M 70.3%±0.6; BPSL6M 89.0%±0.3 and TRAD6M 65.4%±0.6; IVC: BPSL3M 79.5%±0.5 and TRAD3M 56.5%±0.5; BPSL6M 73.2%±0.4 and TRAD6M 51.5%±0.8). In addition, BPSL students were more often rated clinically competent at all assessment times. The superiority at assessment after training was higher for the more complex skill (IVC), whereas NGT with its lower complexity profited more with regard to long-term retention.ConclusionsThis study shows that within a simulated setting BPSL is significantly more effective than TRAD for skills of different complexity assessed immediately after training and at follow-up. The advantages of BPSL training are seen especially in long-term retention.

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Section: Introductionmentioning

confidence: 99%

“Best Practice” Skills Lab Training vs. a “see one, do one” Approach in Undergraduate Medical Education: An RCT on Students’ Long-Term Ability to Perform Procedural Clinical Skills

Herrmann–Werner¹,

Nikendei

Keifenheim³

et al. 2013

PLoS ONE

121

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“…Similarly, Crofts et al demonstrated that acquired skill at managing shoulder dystocia in obstetrics is largely maintained up to 12 months post-SBME training among midwives and doctors in the UK[38]. Boet and coauthors have shown effects to last for 1 year[39].…”

Section: Does It Work?mentioning

confidence: 96%

Simulation-a new educational paradigm?

Konia

Yao

2013

J Biomed Res

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Simulation is a modern educational tool that has recently gained in the field of medical education. The use of simulation continues to expand, and studies evaluating the effectiveness of simulation-based medical education are ongoing. The history of medical education and adult educational theory are reviewed, and the details of effective simulation techniques are described. Finally, outcomes of simulation-based medical education are summarized.

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“…Most procedural skills are taught during patient-based encounters as the clinical need arises 2. Some procedures are commonly encountered in the clinical environment, such as central venous lines, endotracheal intubation, and laceration repair; while others appear to be more rarely encountered, including needle thoracentesis, cricothyroidotomy, and urgent thoracotomy for trauma 3. This may be because the indications for such procedures require a very specific clinical scenario, which may be rare, or the procedure itself may be a last ditch effort to save a patient’s life.…”

Section: Introductionmentioning

confidence: 99%

“…The effectiveness of high fidelity simulations, simulated patients, and anatomic simulators are well-documented 3–7. The most common high fidelity simulations use manikins with realistic features responding physiologically to interventions and performance of procedures.…”

Section: Introductionmentioning

confidence: 99%

“…The most common high fidelity simulations use manikins with realistic features responding physiologically to interventions and performance of procedures. In addition, “simulation has been shown to be effective in teaching complex emergency procedural skills”,3 and these skills can be retained for at least 1 year after a single session 3…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An innovative longitudinal curriculum to increase emergency medicine residents’ exposure to rarely encountered and technically challenging procedures

Grall¹,

Stoneking²,

DeLuca³

et al. 2014

AMEP

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BackgroundProcedural skills have historically been taught at the bedside. In this study, we aimed to increase resident knowledge of uncommon emergency medical procedures to increase residents’ procedural skills in common and uncommon emergency medical procedures and to integrate cognitive training with hands-on procedural instruction using high- and low-fidelity simulation.MethodsWe developed 13 anatomically/physiologically-based procedure modules focusing on uncommon clinical procedures and/or those requiring higher levels of technical skills. A departmental expert directed each session with collaboration from colleagues in related subspecialties. Sessions were developed based on Manthey and Fitch’s stages of procedural competency including 1) knowledge acquisition, 2) experience/technical skill development, and 3) competency evaluation. We then distributed a brief, 10-question, online survey to our residents in order to solicit feedback regarding their perceptions of increased knowledge and ability in uncommon and common emergency medical procedures, and their perception of the effectiveness of integrated cognitive training with hands-on instruction through high- and low-fidelity simulation.ResultsFifty percent of our residents (11/22) responded to our survey. Responses indicated the procedure series helped with understanding of both uncommon (65% strongly agreed [SA], 35% agreed [A]) and common (55% SA, 45% A) emergency medicine procedures and increased residents’ ability to perform uncommon (55% SA, 45% A) and common (45% SA, 55% A) emergency medical procedures. In addition, survey results indicated that the residents were able to reach their goal numbers.ConclusionBased on survey results, the procedure series improved our residents’ perceived understanding of and perceived ability to perform uncommon and more technically challenging procedures. Further, results suggest that the use of a cognitive curriculum model as developed by Manthey and Fitch is adaptable and could be modified to fit the needs of other medical specialties.

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Complex procedural skills are retained for a minimum of 1 yr after a single high-fidelity simulation training session

Abstract: After a single simulation training session, improvements in cricothyroidotomy skills are retained for at least 1 yr. These findings suggest that high-fidelity simulation training, along with practice and feedback, can be used to maintain complex procedural skills for at least 1 yr.

Cited by 148 publications

References 25 publications

“Best Practice” Skills Lab Training vs. a “see one, do one” Approach in Undergraduate Medical Education: An RCT on Students’ Long-Term Ability to Perform Procedural Clinical Skills

“Best Practice” Skills Lab Training vs. a “see one, do one” Approach in Undergraduate Medical Education: An RCT on Students’ Long-Term Ability to Perform Procedural Clinical Skills

Simulation-a new educational paradigm?

An innovative longitudinal curriculum to increase emergency medicine residents’ exposure to rarely encountered and technically challenging procedures

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Complex procedural skills are retained for a minimum of 1 yr after a single high-fidelity simulation training session

Abstract: After a single simulation training session, improvements in cricothyroidotomy skills are retained for at least 1 yr. These findings suggest that high-fidelity simulation training, along with practice and feedback, can be used to maintain complex procedural skills for at least 1 yr.

Cited by 148 publications

References 25 publications

“Best Practice” Skills Lab Training vs. a “see one, do one” Approach in Undergraduate Medical Education: An RCT on Students’ Long-Term Ability to Perform Procedural Clinical Skills

“Best Practice” Skills Lab Training vs. a “see one, do one” Approach in Undergraduate Medical Education: An RCT on Students’ Long-Term Ability to Perform Procedural Clinical Skills

Simulation-a new educational paradigm?

An innovative longitudinal curriculum to increase emergency medicine residents&rsquo; exposure to rarely encountered and technically challenging procedures

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Product

Resources

About

An innovative longitudinal curriculum to increase emergency medicine residents’ exposure to rarely encountered and technically challenging procedures