Improving Efficiency of Clinical Skills Training: A Randomized Trial

Tolsgaard, Martin G.; Bjørck, Sebastian; Rasmussen, Maria Birkvad; Gustafsson, Amandus; Ringsted, Charlotte

doi:10.1007/s11606-013-2378-4

Cited by 41 publications

(63 citation statements)

References 26 publications

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“…Finally, we examined only the immediate effects of dyad practice on skills transfer and did not attempt to evaluate effects on skills retention. This has, however, been examined in several recent studies, in which no significant differences were found between dyad and single practice in the simulated setting after delays of 2–3 weeks 15, 16, 17, 36…”

Section: Discussionmentioning

confidence: 96%

“…Consequently, although dyad practice is as effective as individual practice during simulation‐based training, it does not guarantee equivalent skills transfer. The positive effects of dyad practice on confidence and metacognition reported in previous studies15, 17 indicate that dyad practice may actually improve the chances of successful skills transfer according to social cognitive theory 19, 22. However, the decreased amount of hands‐on experience may reduce dyad participants’ automaticity of skills during simulation‐based practice, which may impair subsequent skills transfer according to the motor skills learning literature 23, 24…”

Section: Introductionmentioning

confidence: 81%

“…In a study by Tolsgaard et al .,15 medical students were randomised to dyad or single practice during patient encounter management training in a skills laboratory. A retention test using simulated patients showed the dyad group performed better than the single‐practice group and demonstrated improved confidence in managing future patient encounters 15. In a study involving simulation‐based lumbar puncture training, Shanks et al 16.…”

Section: Introductionmentioning

confidence: 99%

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The effect of dyad versus individual simulation‐based ultrasound training on skills transfer

et al. 2015

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ContextDyad practice may be as effective as individual practice during clinical skills training, improve students’ confidence, and reduce costs of training. However, there is little evidence that dyad training is non‐inferior to single‐student practice in terms of skills transfer.ObjectivesThis study was conducted to compare the effectiveness of simulation‐based ultrasound training in pairs (dyad practice) with that of training alone (single‐student practice) on skills transfer.MethodsIn a non‐inferiority trial, 30 ultrasound novices were randomised to dyad (n = 16) or single‐student (n = 14) practice. All participants completed a 2‐hour training programme on a transvaginal ultrasound simulator. Participants in the dyad group practised together and took turns as the active practitioner, whereas participants in the single group practised alone. Performance improvements were evaluated through pre‐, post‐ and transfer tests. The transfer test involved the assessment of a transvaginal ultrasound scan by one of two clinicians using the Objective Structured Assessment of Ultrasound Skills (OSAUS).ResultsThirty participants completed the simulation‐based training and 24 of these completed the transfer test. Dyad training was found to be non‐inferior to single‐student training: transfer test OSAUS scores were significantly higher than the pre‐specified non‐inferiority margin (delta score 7.8%, 95% confidence interval −3.8–19.6%; p = 0.04). More dyad (71.4%) than single (30.0%) trainees achieved OSAUS scores above a pre‐established pass/fail level in the transfer test (p = 0.05). There were significant differences in performance scores before and after training in both groups (pre‐ versus post‐test, p < 0.01) with large effect sizes (Cohen's d = 3.85) and no significant interactions between training type and performance (p = 0.59). The dyad group demonstrated higher training efficiency in terms of simulator score per number of attempts compared with the single‐student group (p = 0.03).ConclusionDyad practice improves the efficiency of simulation‐based training and is non‐inferior to individual practice in terms of skills transfer.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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The effect of dyad versus individual simulation‐based ultrasound training on skills transfer

et al. 2015

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“…Students in a mental health clerkship, learning adolescent psychopathology through cooperative learning, gained more knowledge of the topic than students who learned through lectures (Bahar-Ozvaris, Cetin, Turan, & Peters, 2006). Other researchers (Tolsgaard, Bjørck, Rasmussen, Gustafsson, & Ringsted, 2013) found that training with another learner improves the effectiveness and efficiency of the training session and has positive effects on a clinician's confidence in managing patient cases. Consistent with the introductory message of this article, clinicians must recognize the effectiveness of cooperation and working in teams.…”

Section: Cooperative-based Learningmentioning

confidence: 99%

Cooperative-Based Learning and the Zone of Proximal Development

Clapper

2015

Simulation & Gaming

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Purpose. The purpose of this article is to introduce cooperative-based learning and Vygotsky's zone of proximal development (ZPD) to the simulation literature as two important mutually supportive learning theories that may enhance the effectiveness of simulation-based instruction.Design/Methodology/Approach. A brief literature review of cooperative-based learning and Vygotsky's zone of proximal development (ZPD) is presented, along with a description of how these two important learning theories may be applied to improve simulation-based instruction.Findings. When learning new material or skills, learners sometimes need to be assisted with moving through the disequilibrium process that can occur when the new information contrasts with their existing frames of reference or ways of knowing. Cooperative-based learning and the zone of proximal development (ZPD) can be used to assist the learner with working through the disequilibrium process, including accommodating and assimilating the new skills and information into their own practice.Limitations/Implications. Gaps in the simulation literature, including ways to implement both theories into practice, can lead to incomplete or ineffective simulation-based instruction practices.Originality/Value. Many organizations have implemented simulation into their patient safety program, but have not considered how the zone of proximal development (ZPD) and cooperative-based learning can be used to improve educational outcomes.

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“…This study evaluated the effect of dyad versus solo training on patient encounter skills among pre-clerkship medical students. 4 Forty-nine students participated in a 4-hour course on performing histories and physical examinations, and were then randomized to spend a 4-hour practice session with standardized patients (SP) in dyads or alone. Solo students had 25 minutes for the encounter and 25 minutes to develop a write-up for four cases.…”

Section: Resultsmentioning

confidence: 99%

For the General Internist: A Review of Relevant 2013 Innovations in Medical Education

et al. 2015

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We conducted a review of articles published in 2013 to identify high-quality research in medical education that was relevant to general medicine education practice. Our review team consisted of six general internists with expertise in medical education of varying ranks, as well as a professional medical librarian. We manually searched 15 journals in pairs, and performed an online search using the PubMed search engine for all original research articles in medical education published in 2013. From the total 4,181 citations identified, we selected 65 articles considered most relevant to general medicine educational practice. Each team member then independently reviewed and rated the quality of each selected article using the modified Medical Education Research Study Quality Instrument. We then reviewed the quality and relevance of each selected study and grouped them into categories of propensity for inclusion. Nineteen studies were felt to be of adequate quality and were of moderate to high propensity for inclusion. Team members then independently voted for studies they felt to be of the highest relevance and quality within the 19 selected studies. The ten articles with the greatest number of votes were included in the review. We categorized the studies into five general themes: Improving Clinical Skills in UME, Inpatient Clinical Teaching Methods, Advancements in Continuity Clinic, Handoffs/Transitions in Care, and Trainee Assessment. Most studies in our review of the 2013 literature in general medical education were limited to single institutions and non-randomized study designs; we identified significant limitations of each study. Selected articles may inform future research and practice of medical educators.

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Improving Efficiency of Clinical Skills Training: A Randomized Trial

Cited by 41 publications

References 26 publications

The effect of dyad versus individual simulation‐based ultrasound training on skills transfer

The effect of dyad versus individual simulation‐based ultrasound training on skills transfer

Cooperative-Based Learning and the Zone of Proximal Development

For the General Internist: A Review of Relevant 2013 Innovations in Medical Education

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