Acquisition and retention of complex procedural skills amongst medical trainees

Introduction: The acquisition of clinical 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 skill acquisition and retention. We evaluated factors affecting acquisition and retention of skills when using simulators as adjuncts to medical training. Methods: Forty-two second year medical students were taught urinary catheter insertion using different teaching methods. The interactive group (n = 19) were taught using a PowerPoint 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 PowerPoint alone. Student characteristics such as hand dexterity and IQ was measured to assess intrinsic differences. All students were examined at 4 weeks to measure retention. Results: Catheter scores were significantly higher in the interactive group (p<0.005).Confidence scores with catheter insertion were significantly lower in the didactic group at the retention test (p<0.05).Retention scores were higher in the interactive group (p<0.001). A significant positive correlation was observed between laparoscopy scores, 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 (p = 0.001).Retention scores at 4 weeks were significantly associated with teaching method and original catheter score (p = 0.001). Conclusion: The 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.