Experience informed procedural skills training

IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher Pub Date : 2024-01-04 DOI:10.1111/tct.13719

Daniel Loeb MD, MEd, Andrew Lautz MD, Jacob Fleck, Matthew Zackoff MD, MEd

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引用次数: 0

Abstract

Background

Paediatric critical care (PCC) physicians must perform several emergent procedures independently and competently—requiring transition from novice to competent over a 3-year fellowship. However, skill acquisition is not uniform. Individualised training, adapted to the unique experiences and requirements of each trainee, may enhance competency.

Approach

An individualised, longitudinal critical procedure course was initiated at a large academic paediatric medical centre in July 2022 for PCC fellows (n = 5). The course, informed by procedural performance profiles (P3) generated through real-time clinical assessments in the paediatric intensive care unit (PICU), was split into three phases: (1) an Initial Simulation Bootcamp—a 2-day introductory session; (2) Quarterly Structured Booster Sessions (QSBS)—spaced repetition of deliberate practice training individualised to each fellow; and (3) an Annual Refresher Training—a core skills and advanced technique training day.

Evaluation

Fellows began with minimal experience, which formed their initial P3s. Ninety-two percent (166/180) of bedside procedures received real-time feedback, enabling longitudinal P3 modification, which identified focus areas for the QSBS. The sessions were well attended and received. Eighty-nine percent (QSBS #1 5/5, QSBS #2 3/4) of respondents reflected positively on the course's impact on procedural understanding. The course was perceived as more effective than traditional modalities, except bedside training.

Implication

Implementation of a spaced repetition, deliberate practice course informed by longitudinally tracked real-life performance data is feasible for educators and preferred by trainees. This educational construct can be applied to other clinical skills, bringing precision medicine approach to training.

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经验丰富的程序技能培训。

背景：儿科重症监护（PCC）医生必须独立、胜任地完成几项紧急手术，这就要求他们在 3 年的实习期内从新手过渡到胜任者。然而，技能的掌握并不统一。根据每位受训者的独特经历和要求进行个性化培训，可以提高他们的能力：方法：2022 年 7 月，一家大型学术儿科医疗中心为 PCC 学员（n = 5）开设了个性化的纵向关键程序课程。该课程以儿科重症监护室（PICU）实时临床评估生成的手术表现档案（P3）为依据，分为三个阶段：（1）初始模拟训练营--为期两天的入门课程；（2）季度结构化强化课程（QSBS）--针对每位研究员的有间隔重复的刻意练习训练；以及（3）年度进修培训--核心技能和高级技术培训日：学员们从最基本的经验开始，这形成了他们最初的 P3。92%（166/180）的床旁手术得到了实时反馈，从而对 P3 进行了纵向修改，确定了 QSBS 的重点领域。这些会议得到了广泛的参与和好评。89% 的受访者（QSBS #1 5/5，QSBS #2 3/4）对课程对程序理解的影响给予了积极评价。除床边培训外，该课程被认为比传统模式更有效：启示：以纵向追踪的真实表现数据为依据，实施间隔重复、刻意练习课程，对教育者来说是可行的，也是受训者的首选。这种教育结构可应用于其他临床技能，为培训带来精准医学方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Teacher MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

2.90

自引率

5.60%

发文量

113

期刊介绍： The Clinical Teacher has been designed with the active, practising clinician in mind. It aims to provide a digest of current research, practice and thinking in medical education presented in a readable, stimulating and practical style. The journal includes sections for reviews of the literature relating to clinical teaching bringing authoritative views on the latest thinking about modern teaching. There are also sections on specific teaching approaches, a digest of the latest research published in Medical Education and other teaching journals, reports of initiatives and advances in thinking and practical teaching from around the world, and expert community and discussion on challenging and controversial issues in today"s clinical education.