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Preliminary evaluation of the efficacy of an intervention incorporating precision teaching to train procedural skills among final cycle medical students
  1. Sinéad Lydon1,
  2. Nadine Burns2,
  3. Olive Healy2,
  4. Paul O'Connor1,
  5. Bronwyn Reid McDermott1,
  6. Dara Byrne1
  1. 1 School of Medicine, National University of Ireland Galway, Galway, Ireland
  2. 2 School of Psychology, Trinity College Dublin, Dublin, Ireland
  1. Correspondence to Dr Sinéad Lydon, Post: School of Medicine, National University of Ireland, Galway, Co. Galway, Ireland; sinead.lydon{at}


Introduction A lack of preparedness for practice has been observed among new medical graduates. Simulation technology may offer one means of producing competency. This paper describes the application of a simulation-based intervention incorporating precision teaching (PT), a method of defining target skills, assessing individual progress and guiding instructional decisions, which is used to monitor learning and the development of behavioural fluency in other domains, to procedural skills training. Behavioural fluency refers to accurate and rapid responding that does not deteriorate with time, is resistant to distraction and can be adapted into new, more complex responses.

Method This study used a between-groups design to evaluate the efficacy of a simulation-based intervention incorporating PT for teaching venepuncture among 11 medical students. The intervention consisted of timed learning trials during which participants carried out the skill in pairs and received corrective feedback. Two control groups of 11 untrained medical students and 11 junior doctors were also included in the study.

Results Intervention group participants required an average of five trials and 21.9 min to reach the criterion for fluency. The intervention group demonstrated significantly higher accuracy in venepuncture performance than either control group. Improvements persisted over time, did not deteriorate during distraction, generalised to performance with patients and performance of an untargeted skill also improved.

Conclusions The outcomes of this preliminary study support the application of PT within medical education. The implications of these data for clinical and procedural skills training are explored and suggestions are made for further research.

  • simulation education
  • procedural skills
  • behavioural fluency
  • precision teaching
  • mastery

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  • Contributors SL, NB, OH, POC and DB were involved in the design and planning of the study. SL, NB and BRM collected all data for the study. NB and SL analysed the data and drafted the initial manuscript while OH, POC, BRMD and DB assisted with redrafting it. All authors reviewed and approved the manuscript prior to submission. SL accepts responsibility for the overall content as a guarantor.

  • Competing interests None declared.

  • Ethics approval NUI Galway's Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data collected as part of this study are described in the submitted manuscripts. We are happy to consider sharing data with anyone who should request this.

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