Proficiency-Based Progression Training: Key To Effective Clinical Procedural Teaching?

Abstract

IMPORTANCE Proficiency-Based Progression (PBP) training is a form of training in which the trainee has to achieve a benchmark that has been quantitatively defined.  This is contrary to conventional training where progression benchmarks are arbitrary, This form of training may find its place in surgery and procedural medicine with some studies finding it to be effective while others claim to have seen no impact on trainees.

METHODS A systematic literature search was conducted on PubMed and Cochrane library and 15 eligible RCTs were extracted in which proficiency-based progression (PBP) training was compared with traditional surgical training methods.  

RESULT 15 RCTs were included (412 participants from all RCTs). The PBP group demonstrated a reduced number of procedural errors as compared to the non-PBP group (Weighted Mean Difference: —6.14 errors, 95% Confidence Interval (CI) —8.63 to —3.65, p  < 0.00001), as well as a reduction in procedural time in the PBP group as compared to the non-PBP group (Weighted Mean Difference: —5.46, 95% Confidence Interval (CI) —8.56 to —2.37, p = 0.0005) but the non-PBP group performed more procedural steps than the PBP group (Weighted Mean Difference: 2.18, 95% Confidence Interval (CI) —1.31 to 5.66, p < 0.00001).

CONCLUSION Our meta-analysis shows that PBP-trained groups outperform their traditional counterparts by completing procedures quicker and making fewer errors. This model of training may be an effective training tool for the future.