Abstract
Transferring procedural skills from simulation to clinical practice: a mixed methods evaluation
Author(s): Debra Nestel, David CampbellBackground: When procedures are performed on patients many skills are required for safe and effective practice. ‘Technical’ competence on its own is insufficient. This study evaluates the impact of Simulation-based Training for Enhanced Procedural Skills (STEPS), a two-part program designed to prepare students for safe practice of procedural skills. In this study, the procedure was peripheral intravenous (IV) cannulation.
Methods: Convenience sampling was used to recruit medical students to experimental and control groups. All participants completed questionnaires on demographics, knowledge and experience of IV cannulation. The STEPS program was evaluated in simulation with pre- and post-testing using the Direct Observation of Procedural Skills (DOPS) rating form. Self-assessments and judgments by simulated patients (SPs) and clinicians were made using the same form. Transfer of learning was evaluated through workplace assessments. Quantitative data were analyzed using descriptive statistics and tests for non-parametric data while qualitative data were analyzed thematically.
Results: Fifteen medical students completed STEPS. Twenty students formed the control group. All had prior experience of simulation although the extent and nature was highly variable.
Response to STEPS: Students responded positively to STEPS, valuing quick access to specific information, the STEPS framework and alignment of patient perspectives with ‘technical’ skills. At post-test 1, students showed increased scores in self- and SP assessments in simulations, and students worked more efficiently. However, there was no difference in knowledge tests and clinicians’ ratings of student performance.
Workplace assessments: Students who participated in STEPS scored higher than those in the control group in IV cannulation on real patients (p < 0.05).
Conclusion: STEPS supported the transfer of learning from simulation to clinical practice. Teaching technical and professional skills relevant for procedural skills in one program was highly valued. The DOPS rating form provided a link between learning in simulation and performing in clinical settings. Limitations are discussed in the text.
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