Learn, See, Practice, Prove, Do, Maintain for Procedural Skill Training

Journal Club Article: Sawyer, T., White, M., Zaveri, P., Chang, T., Ades, A., French, H., … & Kessler, D. (2015). Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicineAcademic Medicine90(8), 1025-1033.


A few pedagogical steps beyond the ‘see one, do one, teach one’ approach to education and utilising simulation for training and skills development in a safe environment.


improve procedural skill training and will ultimately improve medical care and patient safety


Conducted a systematic review on the question “What is the best framework for teaching procedural skills in medicine?

Highlight constructivist approach of novice to expert paradigm and taxonomy of learning. The progression of the development of expertise in procedural and psychomotor skills.

Procedural Skill Development

Six-step pedagogical framework for procedural skills training:

  1. Learn: acquires requisite cognitive knowledge. “Teaching and learning procedural skills can be divided into two phases: the cognitive phase and the psychomotor phase.”
  2. See: observe the procedure
  3. Practice: in simulation to develop psychomotor skill acquisition
  4. Prove: Competence assessed by simulation-based mastery
  5. Do:  perform the procedure independently
  6. Maintain: combination of clinical practice and further simulation training if procedure is low frequency.

Formative feedback is also an essential component, especially step 3 during the practice phase.