Psychomotor Skill Development

Training for Clinical Preceptorship

Gugsa Nemera (PhD)

1 GN 12/25/2023
 Psychomotor skill

12/25/2023 GN 2
 •Session Objectives
•Introduction
Outline •Psychomotor Skill development
•Coaching
•Feedback
Session objectives
At the end of the session, participants will be able to:
• Describe psychomotor skill development
• Analyze the basics for psychomotor skill
demonstration, coaching, and providing feedback
• Demonstrate psychomotor skill demonstration,
coaching, and providing feedback
• How to use SDA for teaching psychomotor skills for
preceptee
 Energizer

1 2 3 4
Punch your palm Sit down and Jump on your Turn 360 degree
on the hand of stand up feet
your friend who quickly.
is standing in
front of you.

12/25/2023 GN 5
 Psychomotor Skill
• Motor skill consists of movement,
coordination, manipulation, dexterity, grace,
strength, and speed to use precision
instruments or tools
• Represent activities that are primarily
movement-oriented
• Requires an integration of related knowledge and
values
• Performance Competency required to ensure
the delivery of safe patient care
 Psychomotor skill learning consideration

• Repeated practice assists

learner’s acquisition and
retention of skills
• Skill Learning involves more
than just performing the skill
manually
 Stages of psychomotor skill development

Skill acquisition Skill competency Skill proficiency

Students know the task and how it Students perform procedures Occurs with repeated practice over
should be performed. confidently, correctly, and time, usually after graduation
The learner sees others perform expected for graduation
the skill
Acquires a mental picture of the
required steps.
Do not always perform it correctly
But can perform the procedure,
usually with supervision
Facilitation of Psychomotor skill development
What are ways to improve skills performance?
Motor learning models such as practice, feedback, and knowledge of results
o Introduce and demonstrate the task.
o Observe students as they practice the task.
o Give feedback to students on how well they performed the task.
o Assess students for competency in the task.

How are skills learned?

• Requires repetition
• Step-by-step order
• Use of models
Think-Pair-Share (5 min)

• How do you teach or demonstrate skills for students in a skill

development lab or clinical teaching environment?

• Use of
o George and Doto’s five-step model

o Peyton's four-step model

o Whole-part-whole model
 George and Doto’s (2001) five-step model

1. Overview
2. Demonstrate the skill exactly as it should be done without talking
through the procedure
3. Repeat the procedure, but take time to describe in detail each step in
the process
4. Students talk through the skill
• By asking students to describe step by step how to do the skill, the preceptor will ensure
that the students understand and remember each step in the sequence of performing the
skill

5. The students perform the skill

• Now, students are ready to make their first attempt at the skill with the preceptor
carefully observing and providing feedback or coaching as needed

12/25/2023 GN 11
 Peyton's four-step model
Demonstration
• Preceptor demonstrates the skill at normal
speed and without additional comments
Deconstruction
• Preceptor demonstrates the skill by breaking it
down into simple steps while describing each
step.
Formulation
• Preceptor demonstrates the skills while being
‘talked through’ the steps by the learner
Performance
• Preceptee demonstrates the skill while
describing each step.

12/25/2023 GN 12
 Whole-part-whole model
The preceptor demonstrates the entire skill, beginning to end,
naming each step (Whole)

The preceptor demonstrates the skill again, step-by-step,

explaining each part in detail (Part)

The preceptor demonstrates the entire skill, beginning to end,

without interruption and usually without commentary (Whole)

12/25/2023 GN 13
Requirements for Psychomotor Skills Demonstration
• Assemble the necessary materials with no Assumption
• Make sure everyone has an adequate view
• Use a skills checklist/learning guide as a basis for the skill
• Use videos to show steps (if necessary) by using
standardized video, SDA
• Integrate cognitive and affective components with skill
performance
o Understands why the skill is done a certain way
o Knows when the skill is indicated
• Model appropriate behavior
• Show the skill in a step-by-step manner based on the
familiar model
 • A lifesaving m-health tool for midwives and other
skilled birth attendants​
• The safe delivery apps use animated instructions to
guide health workers in basic emergency obstetric
and newborn care.​
Introduction to • It includes videos, descriptions of practical procedures,
Safe Delivery action cards, drug lists, and my learning that midwives
and health workers can always refer to.
App(SDA) • The safe delivery app is free to download and works
offline.
• You can choose between different versions within the
apps /global or national and
with different languages of the national
country versions aligned with the national guidelines.

12/25/2023 GN 15
Download the Safe Delivery app

Step 1
Play Store
• Visit Google Play for Android devices
OR
• iTunes store for Apple devices
Step 2
• Search for Safe Delivery App

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 Safe Delivery App Features

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Coaching
A purposeful, results-oriented, relationship-
centered interaction between preceptor and preceptee
to promote goal achievement.
Involves
✓Observation
✓Interaction with student
✓Active listing
✓Questioning
✓Giving feedback

12/25/2023 GN 18
 1. Mindful presence
• This involves attentiveness during interactions with
acceptance and non-judgmental communication.
2. Authentic communication
Pillars of coaching • Open and honest communication that honors both
people is essential.
3. Self-awareness
• One goal of precepting is to facilitate self-awareness
and self-direction of the preceptee through self-care
and self-reflection.
4. Sacred space
• The preceptee should always feel that the relationship
is sacred and that the space created is physically and
emotionally safe with clear boundaries.
Essential elements to be considered
during coaching

o Let the student re-demonstrate what is done by the instructor

o Make sure they use/follow the skill checklist
o Allow students to practice until they perform the skill
correctly
o Help students perform the skill in context (during the
scenario, simulation, or actual patient situation)
o Ensure students are performing medically acceptable
behaviors
o If a major gap is observed, the instructor repeats the
demonstration

12/25/2023 GN 20
 • The learners’ performance is an essential part of skills acquisition
Providing
• A preceptee-driven method, such as Pendleton’s feedback model, is
constructive useful to ensure that the learner reflects first on their performance
feedback • Levels of feedback are determined by phases of competency

12/25/2023 GN 21
 Providing constructive feedback
Interrupt and correct the wrong behavior in beginings to
prevent mastery of the wrong technique

Allow students to reflect on their performance based on the

skill checklist

Let them identify and correct their own mistakes

Encourage to reinforce the correct behaviors

Provide constructive feedback

12/25/2023 GN 22
Practice with feedback

Before practice session

 Review the skill with the students, including the steps that will be
emphasized
 Provide the opportunity for students to ask if they have any
questions before they begin.
 Remind the students to refer competency-based learning tools (if
available) during the practice session.
Practice with feedback

DURING PRACTICE SESSION

 Observing and Interact with students as they practice.
❖ Listening
❖Asking questions (factual, justifying , hypothetical, alternative and
checking questions)

 Convey positive feedback by facial expression when appropriate

 Record note about learners’ performance on the learning tool /checklist

during the observations
 Practice with feedback
After the practice session
 Give feedback immediately after practice (timely)
 Ask students how they felt about their performance ( asking them what they believed
they did well and what they would like to improve)
 Notes areas where student perform well and areas where need improvement using
competency-based learning tool (checklist)
 Tell student specifically what they did well (positive feedback)
 Tell specifically areas to be improved (constructive )
 Set goal for additional practice (if needed )
 End feedback with words of encouragement
 Constructive Feedback Tips
• Can be provided in the presence of the patient
• Keep the feedback simple and relaxed; too much feedback may alarm
the patient
• Detailed feedback can be given away from the patient setting
• Too much praise may cause the patient to wonder
• It is important to give positive feedback to keep learner’s confidence
• Avoid embarrassing the learner
• Keep a neutral face and gesture
• Do not go into lengthy explanations; save that for the post-practice
feedback session
• Ask a simple, straightforward question about the procedure itself
• If learner make mistakes that can potentially harm the patient, step in
and take over the procedure if needed
• learners

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Demonstration
(60 min)
Making a paper box
• Introducing the skill
• Demonstrate the skill following
the Whole-part-whole approach;
coach and give feedback
• Summarize the demonstration

12/25/2023 GN 27
 CHECKLIST FOR Donning on and off Clean Gloves
STEP/TASK CASES
SKILL/ACTIVITY PERFORMED SATISFACTORILY

Satisfactory: Performs the step or task according to the standard procedure or guidelines.
Unsatisfactory: Unable to perform the step or task according to the standard procedure or guidelines
Not Observed: Step or task not performed by participant during evaluation by trainer
1. Wash hands.
1. Remove any sharp jewelry.
1. Don gloves, using thumb and forefinger to hold each glove.
1. To remove, use thumb and forefinger again and pull away so that
when glove is removed it is inside out.
1. Remove second glove the same way, folding the first glove into the
second one so they can be disposed in one unit.
1. Wash hands.
SKILL/ACTIVITY PERFORMED SATISFACTORILY
 • Teaching of procedural skills through the use of
Frameworks, observation and provision of feedback,
Summary with opportunities for repeated practice assists in the
learners’ acquisition and retention of skills

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12/25/2023 GN 30