Skills Training

Earlier this year, I had the privilege of attending a Teaching Course in Cape Town, presented by the Teaching CoOpTeam  #TTCCT18.

I was introduced to Peyton’s Four-Step Approach to Skills Training – of which I am now an avid supporter.

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This method has been recommended by our surgical colleagues for the longest time now ….

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Having been on the unfortunate receiving end of the time-old “see one, do one, teach one” during my medical training, I am delighted to find an educationally sound alternative to that particular brand of academic torture.

I have been told by various teachers that “practice makes perfect” and “perfect practice makes perfect”. But there is much more to learning a skill.

The key to getting better at any technical skill is deliberate practice.

Star musicians and athletes improve by focused and conscious effort. Clinicians can also refine technical skills by mindful and deliberate practice.

Screen Shot 2018-05-02 at 09.04.29The process of transformation for unconscious novice to competent practitioner is not necessarily rapid or easy. It is enhanced by a skilled coach providing insightful and constructive feedback.

The Four-Step approach incorporates deliberate practice into effective skills training.  It is a powerful tool in medical education that I would like to encourage you to add to your armamentarium.

Photo by Element5 Digital on Unsplash

Other resources


  1. Peyton J. Teaching and learning in medical practice. Peyton J (Ed). Manticore Europe, Ltd. 1998 :171–80
  2. Lake FR, Hamdorf JM. Teaching on the run tips 5: teaching a skill. MJA. 2004. 18 (6): 327-328
  3. Green GM, Chen EH. Top 10 ideas to improve your bedside teaching in a busy emergency department. Emerg Med J. 2014; 0: 1-2
  4. Krautter M, Wyrich P, Schultz JH et al.Effects of Peyton’s Four-Step Approach on Objective Performance Measures in Technical Skills Training: A Controlled Trial. Teaching and Learning in Medicine: An International Journal, 23:3, 244-250

Post by @QuirkyMD

Peer Reviewed by @epicEMC



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