#KeyLIMEPodcast 107 – See one, do one…could it hurt one?

KeyLIME Session 107 – Article under review:

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Sawyer T, White M, Zaveri P, Chang T, Ades A, French H5, Anderson J6, Auerbach M7, Johnston L, Kessler D. Learn, See, Practice, Prove, Do, Maintain: An Evidence -Based Pedagogical Framework for Procedural Skill Training in Medicine. Academic Medicine. 2015 Aug;90(8):1025-33

Reviewer: Jonathan Sherbino

 

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Background

Um… “see one, do one, teach one” – That doesn’t seem right.   In this contemporary age of patient safety, the authors of this paper propose a novel framework for teaching procedural skills based on the best evidence from the literature.   With the emphasis on simulation in Med Ed, we are in an era of deliberate practice prior to implementation in the clinical environment.

Purpose

“In this article we describe an evidence based, pedagogical framework for teaching procedural skills in medicine. We developed our proposed framework—learn, see, practice, prove, do, and maintain—based on a review and critical synthesis of the literature.”

Type of Paper

Report of an innovation

Key Points on Methods

A non-systematic critical synthesis of the “mental and motor activities required to execute a manual task” literature was used.  This involved collating evidence to build a unified framework for teaching procedural skills.
The second step involved a critique (or support of the framework) based on empiric evidence from the literature. Incorporated literature included: descriptive reports, quantitative or qualitative studies using (quasi)experimental methods, and existing (non)systematic reviews. Gray literature was included.
There was no critique of the literature included, nor any process to provide an audit trail of the process.

Key Outcomes

Models incorporated into the framework, include the work of Dreyfus & Dreyfus’s developmental stages, Simpson & Harrow’s taxonomy, George Kovac’s editorial on procedural skills in emergency medicine, Ericsson’s work on deliberate practice, Adams’s closed-looped theory of motor learning, and ten Cate’s work on entrustment.

Figure 2-KeyLIME

Key Conclusions

The authors conclude…“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.”

Spare Keys – other take home points for clinician educators

This is a great example of distribution of knowledge.  This paper is the resulting scholarship from a series of national and international workshops given on the material included in the framework.

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