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Synergy of wearable technologies and proficiency-based progression for effecting improvement in procedural skill training
  1. Karthikeyan Kallidaikurichi Srinivasan1,
  2. Eugene Dempsey2,3,
  3. James D O'Leary4,5,
  4. George Shorten6,7
  1. 1Department of Anaesthesia, Adelaide and Meath Hospital, Dublin incorporating the National Children's Hospital, Dublin, Ireland
  2. 2Department of Paediatrics and Child Health, Cork University Maternity Hospital, Cork, Ireland
  3. 3INFANT Centre, University College Cork, Cork, Ireland
  4. 4Department of Anesthesia, University of Toronto, Ontario, Canada
  5. 5Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
  6. 6Department of Anaesthesia, Cork University Hospital, Cork, Ireland
  7. 7ASSERT Centre, University College Cork, Cork, Ireland
  1. Correspondence to Dr Karthikeyan Kallidaikurichi Srinivasan, Department of Anaesthesia, Adelaide and Meath Hospital incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland; karthikeyan.srinivasan{at}

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The move from time-based to competence-based training has been limited by practical (often resource) issues and by the variability of effect offered by different training methodologies. Two independent advances, one technical (wearable recording devices (WRDs)) and the other methodological (proficiency-based progression—PBP),1 may act synergistically to enable consistently effective training in procedural skills. In this article, we describe our ongoing work in which both are integrated in ‘real-world’ training and the potential for these together to transform training in procedural skills.

A potential synergy

Although the proficiency of physicians undertaking procedural skills directly influences patient outcome,2 valid assessment of doctors’ procedural skills is yet a reality. The WRD alone will not be sufficient (as it simply enables acquisition of more data) but these devices can be central to acquiring digital recordings without consuming the learner's attention. Gallagher and colleagues have described PBP for training in procedural skills. This approach consistently achieves greatly superior training effect—including clinical performance—compared with other methods of competency assessment approaches3 but requires the development of unambiguously defined and detailed procedure-specific metrics and errors, so-called ‘procedure characterisation’.1 The success of PBP is dependent on the definition and recognition of specific observable behaviours. In practice, this requires direct (and resource-consuming) expert observation or video acquisition and analysis. The emergence low cost, high-quality WRDs may address this impediment to widespread introduction of PBP. This synergy may enable doctors to acquire a cumulative personal ‘visual data set’ suitable for …

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