This article I recently came across brought up an interesting thought, why do I teach medical skills in the manner I do? Typically, I teach these skills in the manner that I was taught, and continue to be educated through continuing medical education (CME) to maintain my working paramedic certification. As this article points out, most of these skills are taught in a manner that is not based on any evidence or research, we simply do what's always been done. We usually present the theory behind the intervention (as pre-reading for more advanced skills), then demonstrate in class, discuss evaluation, and break into smaller groups for simulated practice. Based on this recent research, I'm not doing a bad job, but improvements could be made. Ideally, pre-reading should be given, along with an emphasis on a pre-class instructional video, including access to the evaluative criteria that will be used. Then in class, review the material, demonstrate, followed by simulated practice. Students should then perform ten repetitions of the skill within the next ten days. Skill competence levels were retained much longer and with better evaluation scores when all these components were in place. This is an important process to consider, for as the article also states, often students learn medical interventions and skills months before actual live practice, and our instruction must be evidence based to ensure we are utilizing the most effective methods. It is also mentioned that when possible, spaced reinforcement promotes further success than a single long duration lesson and practice session. For my context, to use IV's as an example, it would be better to teach the basic initiation on a perfect patient presentation, and in subsequent shorter sessions introduce variations in technique for difficult patient populations, over attempting to teach this all at once. Overall this will be a simple and relatively small change in my teaching practice, but one that will now be evidence based and promote better long term competence, which is important to my personal philosophy. Routt, E., Mansouri, Y., de Moll, E. H., Bernstein, D. M., Bernardo, S. G., & Levitt, J. (2015). Teaching the simple suture to medical students for long-term retention of skill. JAMA Dermatology, 151(7), 761-765. doi:10.1001/jamadermatol.2015.118
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AuthorI teach Paramedicine at Cambrian College, in Sudbury, Ontario. I also continue to work as a paramedic, and ride bikes. This is my third semester in the PME program, and I look forward to learning with everyone! Archives
March 2017
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