Review of comparative studies of clinical skills training

Our aim was to undertake a systematic review of the comparison of the methods used to train staff in clinical skills.

The only studies considered were those that compared two different training methods and contained defined outcome measures. The skills of intubation, venous cannulation and central venous line insertion were chosen as representative of the type of physical skills taught to clinicians.

Only nine papers met the eligibility criteria with most papers evaluating a single teaching method. A wide range of teaching methods were used, including lectures, computer-based teaching, manikins and video assisted feedback. The studies included nurses, doctors, paramedics and medical students.

Although no clear conclusions can be drawn from the studies, it appears that the teaching methods used have little effect on outcomes. In contrast, better outcomes are associated with workplace-based training and a course which provides repeated episodes of training spaced out over a period of weeks/months with the facility for practice of the skill. These findings are important as many current clinical skills training courses do not use the techniques associated with better outcomes.