Proficiency Attained at the End of Practice Best Predicts Retention Performance: Support for a Competency-based Approach to Procedural Skills Training

The efficacy of competency-based versus experience- oriented training of procedural skills for health professional trainees is unclear. This study examined whether the performance level attained at the end of practice (i.e., competency criteria) or the amount of practice best predicts retention of a procedural skill. Forty two trainees learned to perform a surgical knot using video- based instruction. There were 3 groups, each of which practiced until they reached a predefined criterion time to tie the knot (10, 15, or 20 seconds). Participants returned one week later for a timed retention test. Multiple regression analysis determined whether the number of practice trials, total practice time, or criterion reached at the end of practice was most predictive of the time taken to perform the skill during retention. Multiple regression analysis showed that the only significant predictor of performance at retention was the criterion reached at the end of practice (p < 0.05). Number of practice trials was not a significant predictor of retention performance (p > 0.05). The results support the notion that competency-based training results in better learning as compared with an experience-oriented approach.