Do One Then See One: Sequencing Discovery Learning and Direct Instruction for Simulation-Based Technical Skills Training.

PURPOSE

When teaching technical skills, educators often include a mix of learner self-regulation and direct instruction. Appropriate sequencing of these activities-such as allowing learners a period of discovery learning prior to direct instruction-has been shown in other domains to improve transfer of learning. This study compared the efficacy of learners trying a novel simulated suturing task before formal instruction (Do then See) versus the more typical sequence of formal instruction, followed by practice (See then Do) on skill acquisition, retention, and transfer.

METHOD

In 2015, first-year medical students (N = 36) were randomized into two groups to learn horizontal mattress suturing. The See then Do group had access to instructors before independent practice, whereas the Do then See group explored the task independently before accessing instructors. Participants were assessed at the transition between interventions, and as training ended. Skill retention, and transfer to a novel variation of the suturing task, were assessed after one week. Performance was scored on a five-point global rating scale by a blinded rater.

RESULTS

The groups did not differ significantly on immediate posttest or retention test (F[1,30] = 0.96, P < 0.33). The Do then See group (N = 16) outperformed the See then Do group (N = 16) on the transfer test; 2.99 versus 2.52 (F[1,28] = 10.14, P < 0.004, η(2) = 0.27).

CONCLUSIONS

Sequencing discovery learning before direct instruction appeared to improve transfer performance in simulation-based skills training. Implications for future research and curricular design are discussed.