Deliberate practice using validated metrics improves skill acquisition in performance of ultrasound-guided peripheral nerve block in a simulated setting

Ahmed, Osman; Azher, Imran; Gallagher, Anthony G.; Breslin, Dara S.; O’Donnell, Brian D.; Shorten, George

doi:10.1016/j.jclinane.2018.04.015

Cited by 12 publications

(12 citation statements)

References 27 publications

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“…The authors reported that while performance improved among both groups, there were no differences in participant skill performance or retention between groups [8]. In contrast, a study of medical students learning ultrasound guided regional anesthesia techniques concluded that the deliberate practice resulted in fewer errors compared to self-guided practice [19]. Both of these studies are subject to important limitations including a small sample size at a single institution.…”

Section: Discussionmentioning

confidence: 99%

“…An alternative to DP + ML is self-guided practice (also referred to as self-directed or self-regulated) whereby “ individuals take the initiative, with or without the help of others in diagnosing their learning needs, formulating learning goals, identifying human and material resources for learning, choosing and implementing appropriate learning strategies, and evaluating learning outcomes ” [18]. The few studies that compare DP with self-guided practice yielded mixed results while also limited by both small sample sizes and generalizability of a single institution setting [8, 19].…”

Section: Introductionmentioning

confidence: 99%

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Perfecting practice: a protocol for assessing simulation-based mastery learning and deliberate practice versus self-guided practice for bougie-assisted cricothyroidotomy performance

Petrosoniak

Gray

et al. 2019

BMC Med Educ

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Background Simulation-based medical education (SBME) is a cornerstone for procedural skill training in residency education. Multiple studies have concluded that SBME is highly effective, superior to traditional clinical education, and translates to improved patient outcomes. Additionally it is widely accepted that mastery learning, which comprises deliberate practice, is essential for expert level performance for routine skills; however, given that highly structured practice is more time and resource-intensive, it is important to assess its value for the acquisition of rarely performed technical skills. The bougie-assisted cricothyroidotomy (BAC), a rarely performed, lifesaving procedure, is an ideal skill for evaluating the utility of highly structured practice as it is relevant across many acute care specialties and rare – making it unlikely for learners to have had significant previous training or clinical experience. The purpose of this study is to compare a modified mastery learning approach with deliberate practice versus self-guided practice on technical skill performance using a bougie-assisted cricothyroidotomy model. Methods A multi-centre, randomized study will be conducted at four Canadian and one American residency programs with 160 residents assigned to either mastery learning and deliberate practice (ML + DP), or self-guided practice for BAC. Skill performance, using a global rating scale, will be assessed before, immediately after practice, and 6 months later. The two groups will be compared to assess whether the type of practice impacts performance and skill retention. Discussion Mastery learning coupled with deliberate practice provides systematic and focused feedback during skill acquisition. However, it is resource-intensive and its efficacy is not fully defined. This multi-centre study will provide generalizable data about the utility of highly structured practice for technical skill acquisition of a rare, lifesaving procedure within postgraduate medical education. Study findings will guide educators in the selection of an optimal training strategy, addressing both short and long term performance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perfecting practice: a protocol for assessing simulation-based mastery learning and deliberate practice versus self-guided practice for bougie-assisted cricothyroidotomy performance

Petrosoniak

Gray

et al. 2019

BMC Med Educ

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“…Early, repetitive, and condensed training has also been shown to decrease the length of the total time necessary to achieve competency in fields both within and outside of medicine. [10][11][12] The main limitation of this program is the lack of a randomized, control group with which to compare the performance of interns. We cannot entirely exclude that this particular intern class may be exceptionally capable and would have performed well even without a formal boot camp program.…”

Section: Discussionmentioning

confidence: 99%

Surgical Pathology “Boot Camp”: A Military Experience

Smith

Collins

Hall

2019

Archives of Pathology &Amp; Laboratory Medicine

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Context.— A common concern in pathology residency training is the variability with which incoming trainees have attained basic pathology competencies during undergraduate medical education. While multifactorial deficiencies are likely due to recent de-emphasis of dedicated pathology courses during preclinical training, accelerating the transition from medical student to pathology resident is critical—particularly in military practice where a greater degree of autonomy is required of recent graduates. Objective.— To describe the implementation and results of a 4-week surgical pathology “boot camp” in the largest military pathology residency program in the United States. Design.— Interns were administered an assessment on basic pathology knowledge, slide practicals, and a skills self-assessment. All specimens were grossed by interns with constant direct supervision. A daily microscopic didactic session was given by an upper level resident and a daily gross conference was led by the interns. Subsequent academic performance was evaluated via monthly slide practicals and diagnostic agreement with faculty. Results.— Following boot camp, average scores on the knowledge assessment increased from 36.0% ± 16.2% (standard deviation [SD]) to 80.0% ± 12.6% (SD) (P < .001). Slide practical scores showed an increase from 32% ± 12.0% (SD) to 74.0% ± 16.2% (SD) (P < .001). Skills self-assessment showed a global increase across all measures. Throughout the following academic year, postgraduate year 1 (PGY1) residents performed at the same level of current PGY2 residents, based on surgical pathology faculty diagnostic agreement and slide practical performance. Conclusions.— An intense 4-week surgical pathology rotation specifically tailored to incoming interns was successful in transitioning medical students to pathology residents within a relatively short time.

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“…One method to assist faculty may be using assessment tools to frame the feedback, as done by Ahmed et al. [8] and de Olivera Filho et al. [9].…”

Section: Fundamentals Of Regional Anaesthesia Trainingmentioning

confidence: 99%

Contemporary training methods in regional anaesthesia: fundamentals and innovations

2021

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Summary Over the past two decades, regional anaesthesia and medical education as a whole have undergone a renaissance. Significant changes in our teaching methods and clinical practice have been influenced by improvements in our theoretical understanding as well as by technological innovations. More recently, there has been a focus on using foundational education principles to teach regional anaesthesia, and the evidence on how to best teach and assess trainees is growing. This narrative review will discuss fundamentals and innovations in regional anaesthesia training. We present the fundamentals in regional anaesthesia training, specifically the current state of simulation‐based education, deliberate practice and curriculum design based on competency‐based progression. Moving into the future, we present the latest innovations in web‐based learning, emerging technologies for teaching and assessment and new developments in alternate reality learning systems.

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Deliberate practice using validated metrics improves skill acquisition in performance of ultrasound-guided peripheral nerve block in a simulated setting

Cited by 12 publications

References 27 publications

Perfecting practice: a protocol for assessing simulation-based mastery learning and deliberate practice versus self-guided practice for bougie-assisted cricothyroidotomy performance

Perfecting practice: a protocol for assessing simulation-based mastery learning and deliberate practice versus self-guided practice for bougie-assisted cricothyroidotomy performance

Surgical Pathology “Boot Camp”: A Military Experience

Contemporary training methods in regional anaesthesia: fundamentals and innovations

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