Teaching Procedural Skills
Educational Steps Required to Teach a Complex Psychomotor Skills
| Skill Step | Educator Behavior |
|---|---|
| Task Analysis and cognitive load awareness | Prior to the skill teaching session, the task or knowledge required to perform the task is broken down into chunks. The steps to teach each skill chunk are itemized and should contain no more than nine sequenced steps (preferably seven) in any teaching session. |
| Identifying learner skill level and learning needs | Ascertain learners' needs and prior knowledge and skill level to focus the skill teaching session |
| Pre-skill conceptualization (sensory norms) | Describe when and when not to perform the skill. review all key information linked to competent skill execution (including equipment handling) and what the task should look, sound and feel like. |
| Demonstration - visualization (visual standard of performance) | Educator silently demonstrated the skill with the correct sequence and timing. A silent video clip of the skill may also serve as a synchronous or asynchronous learning tool. |
| Demonstration - verbalization | Educator repeats the skill demonstration whilst describing the demonstrated skill steps to the learner |
| Immediate error correction, limit guidance and coaching | Correct all narrated or executed skill errors immediately as they occur. Minimize verbal guidance and coaching. Withhold feedback until the conclusion of the task. |
| Verbalization - execution | The learner describes the skill steps with the correct skill sequence and timing in advance to the educator executing the skill. Corrects incorrectly rehearsed skill step(s) as they occur. |
| Verbalization - performance | The learner describes the skill steps prior to executing the task steps. Educator withholds feedback |
| Skill practice | Skills are developed using multiple, short practice sessions of less than 60 minutes in duration. |
| Post skill-execution feedback | Educator provides feedback at the conclusion (terminal) of the skill performance. |
Principles
Principles that Guide Effective Teaching of Manual Skills (Bartholomew, D. (2001). Teaching manual skills in Hudson, A. & Watson, D. (Eds.). The clinical teaching handbook. Columbus, Ohio: The Ohio State University College of Medicine and Public Health)
- Establish objectives and provide clear expectations
- Performance assessment criteria should be provided at the beginning
- Demonstrate the entire task from beginning to end
- Instructor example is only effective in small groups
- Videotaping a 鈥渕aster鈥 at work is very useful
- Dissect the skills down to the basic sequence of steps
- Equipment and assistance needs must be anticipated
- Patient preparation
- Demonstrate each step in sequence
- Trainee verbalization of each step of the procedure to the instructor will allow an opportunity to clarify misconceptions prior to practice
- Teaching tools
Patients are the most expensive and time consuming option, requiring one to one supervision - Models can be very expensive
- Practice, Practice, and more Practice
- Small group practice is an effective and manageable technique to allow trainees to benefit from and teach each other
- Supervised practice
- Feedback is the most important factor in teaching manual skills
- Self-assessment
- Performance checklists
- Instructor feedback must be immediate with corrective insight provided
- Stimulate provocative thought
- Instructor critique
References
Bartholomew, D. (2001). Teaching manual skills in Hudson, A. & Watson, D. (Eds.) The clinical teaching handbook. Columbus, Ohio: The Ohio State University College of Medicine and Public Health.
Nicholls et al (2016). Teaching psychomotor skills in the twenty-first century: Revisiting and reviewing instructional approaches through the lens of contemporary literature. Medical Teacher, Vol. 38, No. 10, 1056-1063.