BEST Module 6: Teaching Procedures

Bringing Education & Service Together (BEST) is an interdisciplinary service learning project for resident physicians.

Learning Outcomes

By the end of this module, participants will be able to:

  • Develop skills on teaching a learner how to perform a procedure
  • Practice teaching procedures
  • Identify the three phases of teaching procedures

Approach to Teaching Procedures

Learners must go through three phases of psychomotor skills development:

  • Cognitive: Why? & How?
  • Developmental
  • Automated
Cognitive Phase

Learners first need to understand the “why” components of the procedure:

  • Why learn procedure?
  • Indications
  • Contraindications
  • Risks/complications
  • Benefits
  • Alternatives

Since learners prefer active learning, teach through questioning:

  • Has the learner done this procedure before?
  • What does s/he recall about indications, risks, etc.?

Then address the “how” components

  • Demonstrate procedure step by step.

Ask learner to verbalize the steps.

Ask for questions.

Developmental Phase

Next, learners need to practice.

  • Have learner demonstrate procedure for you, explaining each step out loud.
  • Provide guidance for each step, both verbally and physically.
  • Evaluate learner’s proficiency: what did learner do right, wrong?
  • Ask learner to self-evaluate, then give specific feedback, starting with the positive aspects of the performance.
  • Does the learner have any questions, now that s/he has practiced the skills?
  • Rapid cycle deliberate practice is an effective technique of having learners cycle rapidly between deliberate practice and directed feedback.
  • Dividing the procedure up into segments can make it easier to practice and learn.
  • Between segments, pause, debrief, rewind, have the learner try again.
Automated Phase

Finally, learners begin achieving proficiency and are ready for independent performance.

  • Observe performance again, this time with minimal interruption.
  • You can now teach the fine points.
  • Encourage self-directed learning: What are the learner’s future learning goals, and how does s/he want to achieve them? What have you read or done that helped you learn?
  • Arrange for a follow-up session.