Abstract
BackgroundThe acquisition of procedural skills is an essential component of learning for medical trainees. The objective of this study was to assess which teaching method of performing urinary catheterisation is associated with most efficient procedural skill acquisition and retention. We evaluated factors affecting acquisition and retention of skills when using simulators as adjuncts to medical training.MethodsForty-two second year medical students were taught urinary catheter insertion using different teaching methods. The interactive group (n = 19) were taught using a lecture format presentation and a high fidelity human urinary catheter simulator. They were provided with the use of simulators prior to examination. The observer group (n = 12) were taught using the same method but without with simulator use prior to examination. The didactic group (n = 11) were taught using the presentation alone. Student characteristics such as hand dexterity and IQ were measured to assess for intrinsic differences. All students were examined at four weeks to measure skill retention.ResultsCatheter scores were significantly higher in the interactive group (p < 0.005). Confidence scores with catheter insertion were similar at index exam however were significantly lower in the didactic group at the retention testing (p < 0.05). Retention scores were higher in the interactive group (p < 0.001). A significant positive correlation was observed between laparoscopy scores and time to completion with overall catheter score (p < 0.05). Teaching method, spatial awareness and time to completion of laparoscopy were significantly associated with higher catheter scores at index exam (p = 0.001). Retention scores at 4 weeks were significantly associated with teaching method and original catheter score (p = 0.001).ConclusionThe importance of simulators in teaching a complex procedural skill has been highlighted. Didactic teaching method was associated with a significantly higher rate of learning decay at retention testing.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-014-0264-3) contains supplementary material, which is available to authorized users.
Highlights
The acquisition of procedural skills is an essential component of learning for medical trainees
The aims of this study was to assess which teaching method in performing urinary catheter insertion is associated with most efficient skill acquisition and longer learner retention in undergraduate medical students
Student confidence levels with urinary catheter insertion All students were asked to document their level of confidence with catheterisation at different stages of the teaching and examination process
Summary
The acquisition of procedural skills is an essential component of learning for medical trainees. With the introduction of the European working time directive and the regulation of the profession and training bodies, there is an increased emphasis surrounding the acquisition, assessment and retention of procedural skills within medical training facilities [1,2,3]. During the introduction of laparoscopic cholecystectomy, complication rates such as common bile duct damage, bleeding and iatrogenic injuries increased by 25% [8] It was clearly evident from various studies that complications rates could be reduced to an acceptable rate with training using inanimate simulators [9,10,11]. Medical students and junior doctors undergo simulation training modules in order to learn procedural skills such as suturing and urinary catheterisation in a controlled environment free of any adverse consequences to actual patients
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