teaching clinical skills in a classroom is essential, considering the fact that medical schools are getting larger and larger number of students. Patients, students, and teachers too are getting uncomfortable with having students practice skills for the first time using real patients. Hence the need for students first learning the skill in a classroom before applying the skills to real patients

1. Teaching skills in a classroom
Dr Ibanda Hood
Dr Nsingo Simon Peter
Dr Ssembatya Henry

2. What is a skill?

3. Why should practical skills be taught in a classroom ?
• For many years, medical students and trainees learnt clinical skills by the
principle of ‘see one, do one, teach one’. This model is risky and nobody in
the 21st century, whether patient, trainer, or trainee, should be exposed to its
dangers.
• For the novice, skills should first be attempted in the secure environment of
the skills or simulation Centre and then practiced until such time as they or
their trainers feel they are competent to perform the skills on real patients.
• This is not to ignore the fact that simulation should augment, and not replace,
real clinical practice, and one must be careful to reinforce this message in any
assessment programme.

4. Important facts to remember
• Developing and retaining practical skills is important in a
professional’s life.
• Regular practice of the correct way of performing a task helps in
achieving mastery.
• Learners in our classes will be coming from different backgrounds and
have different capabilities.
• Factual knowledge, psychomotor performance, and learners attitude
will determine how well learners acquire and retain skills.
• We should aim at promoting independent practice of the skill.

5. Important principles when teaching practical
skills
• Teach progressively from simple to complex.
• Teach skills in order in which they will be used.
• Teach one technique at a time.
• Employ continual reinforcement.
• Follow learning with practice.
• Integrate cognitive and psychomotor learning ( train minds and hands).
• Encourage confident use of the skills
N.B The goal of teaching should be to change the behavior of learners and
repeated practice enhance achievement and performance

6. How do we teach skills
A four stage approach is used. The approach consists of
 Set
 dialogue
 closure

7. Set
• Prepare the place/classroom so that it is enough for all students.
• There must be good air circulation since many people are to be in the
room at a time.
• Arrange the class so that each student has good view of what is being
is being demonstrated.
• If students are in groups, ensure there is no interference/noise
coming from different group. E.g. by ordering tasks or use of screens.
• Have all that you need to teach the skills; also, ensure that it
functions.
• Arrange the equipment in a realistic manner removing what is not
essential.

8. set
When candidates arrive for a session, as their teacher, do the following:
 Give them clear, realistic learning outcomes
 Motivate them by telling them how important the skill is.
 Tell them how important the skill is as regards the entire course

9. Dialogue: Four- stage approach

10. Four-stage approach
This model may be expanded or reduced depending on the background
skills of the learner. Video may be used in Stages 1 and 2.
As with all teaching, the learner must be given constructive feedback
and allowed time for practice of the skills

11. closure
Hopefully, most questions will have asked and answered in stage 3 and
stage 4. However, it is also essential that an opportunity be given for
more questions to be asked and answered.
A summary should also be given showing:
 achievement of the objectives of the session
 Linking the objectives to the goals/objectives of the entire course
 Reinforcing the importance and usefulness of the skills

12. Challenges ahead
How do we do skills teaching on “an industrial scale”?

13. References
Bullock, I., Davis, M., Lockey, A., & Mackway-Jones, R. (2008). Pocket
guide for teaching clinical instructors; Blackwell publishing; oxford