Clinical Simulation, Procedural Skills & Assessment

Why a program on how skills are learned

A procedural skill is not acquired by watching, and it is rarely acquired by repetition alone. It develops through practice with a defined goal, feedback specific enough to act on, and assessment that shows whether the skill is actually there. When any of the three is missing, confidence can grow faster than competence, and the gap may only become visible when a patient is involved.

Clinical Simulation, Procedural Skills & Assessment is designed to make that process explicit. It draws on established principles of health-professions education, the same ones behind the Academy’s teaching progression and its assessment framework: Peyton’s four-step approach to demonstration, deliberate practice on simulation models, and Miller’s distinction between knowing, knowing how, showing how and doing. The sources are cited with the Rafiee Educational Approach.

From the model to supervised practice

The program is planned in four modules that follow the path of a skill. The first is simulation-based education: what anatomical models and procedural simulation can and cannot reproduce, and how practice on them is organized so that repetition has a purpose. The second moves from technique to judgment, with case-based learning and clinical scenarios in which the decision to close, to stop or to refer counts as much as the hands, and then to supervised practice, with supervision matched to demonstrated competence and to local regulation.

Feedback has a module of its own, because in procedural teaching it is often left to improvisation. It is designed to address the technique and the decisions that preceded it, and to begin with the learner’s reasoning. The last module is dedicated to the objective assessment of technical skills, clinical judgment, decision-making and safety.

How it will be taught and assessed

The program is designed to be taught the way it describes: through simulation, scenarios, supervised practice where it is allowed, structured feedback and assessment. Assessment follows the domains of the Academy’s assessment framework, which is itself in development: structured direct observation for technique, scenario-based questions in which the reasoning counts, and safety assessed as a behavior during practice as well as knowledge on paper.

Assessment in this program is designed to support learning. It does not replace the credentialing of any institution, and it does not authorize anyone to perform procedures beyond their qualifications, license or local regulation.

How it relates to the other programs

This is an advanced program. It does not introduce new procedures: the skills it uses as material for practice and assessment come from the core programs. Basic sutures and knots are taught in Foundations of Clinical & Minimally Invasive Procedural Medicine, wound management and aesthetic closure in Wound-to-Scar™, and advanced aesthetic surgical technique in Aesthetic Surgical Skills for Physicians. Those programs teach the skills; this one is designed to show how they are learned and how they can be assessed objectively across the curriculum.

It is also intended for educators. Physicians who teach procedural skills, and institutions that want to develop simulation-based teaching or assessment of their own, may find in it a shared method, and the Academy’s collaborations page describes how that work could be undertaken together.

Current status

The program is planned: its content has been outlined, but its development, format and dates have not been announced. Registering interest is the way to be told when that changes, and to tell the Academy what a program on simulation and assessment should address in your setting.

Repetition alone does not make a skill. Practice with a clear goal, specific feedback and honest assessment does.