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Procedural Skills Decay in Emergency Medicine: A Scoping Review
Kathryn Oskar1, Elise Prehoda2, Richard Sapp3
1Emergency Medicine, University of Vermont, Burlington, USA.
Cureus
|April 8, 2026
Summary
Skill decay in emergency medicine (EM) procedural skills is not well understood. This review highlights gaps in research, calling for more studies on when and how these essential skills are lost over time.
Area of Science:
- Medical Education
- Emergency Medicine
- Skill Acquisition and Retention
Background:
- Skill decay, the loss of acquired abilities after disuse, is a recognized phenomenon.
- Its specific mechanisms and timelines within emergency medicine (EM) procedural skills remain unclear.
- Understanding skill decay is crucial for maintaining physician competency.
Purpose of the Study:
- To conduct a scoping review of the literature on procedural skill decay in EM.
- To identify key themes, findings, and research gaps.
- To inform future research directions and best practices for skill maintenance.
Main Methods:
- Systematic scoping review following PRISMA-ScR guidelines.
- Descriptive content analysis of screened articles.
- Screening of 1349 abstracts and articles, with 37 included.
Main Results:
- Limited focus on skill decay as a primary outcome in existing studies.
- Short and inconsistent timeframes for assessing skill decay.
- Underrepresentation of diverse procedural skills and attending physicians.
- Heavy reliance on simulation and checklist-based assessments.
- Sparse data on skill decay in community-based EM practice.
Conclusions:
- The literature on EM procedural skill decay is heterogeneous and evolving.
- Significant gaps exist in understanding the onset and progression of skill decay.
- Further rigorous, longitudinal research is needed to establish evidence-based maintenance strategies for procedural competency.
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