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Teaching Procedural Skills

Teaching Procedural Skills. Beyond “See one, Do one, Teach one”. Dr. Jason Frank and Janet Nuth, Dept of Emergency Medicine, University of Ottawa. Objectives. Describe and demonstrate the basic principles for teaching procedural and technical skills

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Teaching Procedural Skills

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  1. Teaching Procedural Skills Beyond “See one, Do one, Teach one” Dr. Jason Frank and Janet Nuth, Dept of Emergency Medicine, University of Ottawa

  2. Objectives • Describe and demonstrate the basic principles for teaching procedural and technical skills • Define competence in performing procedural skills • Discuss common errors made by supervisors when teaching procedural skills

  3. Video Scenarios • So what went wrong?

  4. Model for Teaching Procedures: • A :Assess the learner • B : Basic Concepts • C: Contraindications/ Complications • D: Demonstrate the Procedure • E : Explain and Breakdown the Steps • F: Feedback/ Answer Questions • E:( Learner) Explains and Verbalizes Steps • D: (Learner) Demonstrates the Procedure • F : Feedback on performance

  5. A: Assess the learner • What does the learner already know? • Ask them to teach you the skill first • Plan ahead: Have the learner prepare and do reading ahead of time

  6. B: Basic Concepts • Learner understands the cognitive elements of the skill: why and when it is done • Learner knows the instruments and tools involved in the skill

  7. C:Complications and Contraindications • Learner should know when the procedure is not done and the precautions and complications that are involved

  8. D: Demonstration • The learner sees the skill demonstrated in its entirety • Gives them a mental picture of what the skill should look like when done correctly

  9. E: Explanation • Preceptor repeats the procedure breaking it down into steps and verbalizing each step • Allows learners to see how each step fits into the optimal sequence • Learners perform better with series of small steps

  10. F: Feedback • Ask for feedback • Allow learner to clarify steps or ask questions

  11. E: Explanation • Learner now talks through the skill describing step by step how it is performed • Helps commit the process to memory

  12. D: Demonstration • Learner now performs the skill with the preceptor observing

  13. Start by practicing small portions of the skill • Link small portions together • Practice entire skill continuously

  14. F: Feedback • Provide feedback • encourage self-assessment • be specific and timely (right after the performance) • ensure the feedback is non-judgmental and performance- based • start with what you liked, make a suggestion for improvement, end with a positive aspect of the performance

  15. Allow for practice • Ensure varying degrees of complexity • Allow for practice under less than ideal conditions

  16. Model for Teaching Procedures: • A :Assess the learner • B : Basic Concepts • C: Contraindications/ Complications • D: Demonstrate the Procedure • E : Explain and Breakdown the Steps • F: Feedback/ Answer Questions • E:( Learner) Explains and Verbalizes Steps • D: (Learner) Demonstrates the Procedure • F: Feedback on Performance

  17. Practicing a Procedure • Juggling • Tying tie, shoe • Card trick, shuffling cards • Paper airplane, origami • Putting, tennis serve, dribbling basketball, heading soccer ball • Applying lipstick, blowing bubble gum • Calligraphy • Knot tying

  18. Educational Models • Volunteers • Mannequins/ Models • Mannequins with simulated patient • Cadaver/Animal laboratories • Simulators • Newly Dead

  19. When there is difficulty • Learner problem: fine motor coordination • Inadequate description: not paid attention, too much time lapse • Imprinting incorrect performance • Improper feedback • Affective factors: fear, anxiety, sense of skill irrelevance • Inaccurate learner perception of performance

  20. But are they competent?

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