Fig 1. learning in clinical practice This study will aim to find: Aims Rumman Ahmed (BSc), Cherry Buckwell (Lecturer in Medical Education) Methods Results Conclusion Barts and The London school of Medicine and Dentistry, Queen Mary University of London, Centre for Medical Education, Institute of Health Sciences, Turner Street, London, E1 2AD Rumman Ahmed - Cherry Buckwell - References Bandura, A. (1977). Social Learning Theory. New Jersey: Prentice Hall Crosby, J.R. (2001). Curriculum Goals. In: Dent JA, Harden RM, eds. A Practical Guide for Medical Teachers. Edinburgh: Churchill Livingstone. pp. 25–38. Kolb, D.A. (1984). 'Experiential Learning experience as a source of learning and development', New Jersey: Prentice Hall Lave, J. Wenger, E. (1991). Situated Learning: Legitimate Peripheral Participation. Cambridge: Cambridge University Press. Walker, M., & Peyton, R. (1998). Teaching in the theatre. In: Peyton JWR ed. Teaching and Learning in Medical Practice. Rickmansworth, England: Manticore Publishers Europe Ltd. Fig.1. Bay Area Medical Academy URL: Last accessed: [01/09/10].  Prior observation in clinical practice can significantly raise confidence.  The intervention group performed marginally better than the control group in OSCE.  Communication skills, familiarisation with the professional context and realities of practice are unique benefits of observational learning. Background Utility of Prior Observation Familiarisation with professional context Equipment and objects Professional setting Expert acting as role model Important to see what to do first Mimicking procedure Acknowledge the relevance of different steps Learning communication with patients How to treat the patient Types of questions to ask the patient Centre for Medical Education, Institute of Health Sciences Education, Barts & the London Does Prior Observational Exposure to Clinical Practice Enhance Procedural Learning in Simulation Training? o For medical students, simulation is often their first encounter of clinical procedures ranging in type from fundoscopy to vaginal examination. o Traditionally however, students have been introduced to procedures – such as in surgery – by undertaking direct experience in clinical practice albeit in an observational and quite nominal role. o The growing role of simulation in medical training prompts us to query how simulation can be best used alongside other currently available teaching methods to provide the optimal instructional sequence. whether observation of a procedure - in this case venepuncture - in clinical practice, prior to undertaking simulation training, enhances learning. Theoretical bases of observational learning Kolb’s learning cycle (1984) Bandura’s model of observational learning (1977) Lave and Wenger’s ‘situated learning’ model (1991) Others – Walker & Peyton (1998) and Crosby (2001)  Recruited 18 first year students with no prior experience of venepuncture and randomised into intervention and control  All received an introductory lecture on venepuncture and video demonstration of venepuncture in simulation.  Control – simulation and modified OSCE  Intervention – observation in phlebotomy dept., simulation, and modified OSCE  Participants were required to fill out questionnaires at different points along this training programme  Open ended questions – anticipated difficulties, perceptions etc.  Student’s level of competence and confidence was self-rated throughout on a quantitative scale with ‘qualitative’ labels Quantitative results: 1.Intervention group showed a rise in confidence post observation compared to post intro lecture and was higher post simulation. 2.Marginally higher average marks for the intervention group. 3.Fluency of procedure was also marginally greater for the intervention group. Qualitative results: 1.Majority anticipated handling of the needle and locating of the vein to be the most difficult aspects post lecture. 2.Learning points identified by participants as unique to observation (diagram below):