1. Skill to be achieved are to be divided
Microskill
Skill to be achieved are to be divided

2. Steps of Microskill learning
Step-1: confirm prerequisite learning
Step-2: Say the Objectives
Step-3: Demonstrate the materials required for learning
Step-4: Divide the whole task into several smaller
Step-5: Allow them to practice
Step-6: Seek assessment
Step-7: Provide feedback
Step-8: Conclusion

3. A skill is the ability to act appropriately in response to the specific demands of the situation

4. Classification of skills
Cognitive or intellectual
Prescribe treatment
Appraise an article from a journal
Predict prognosis of a patient
Psychomotor
Urethral catheterization
Identify the murmur
Differentiate leprosy and fungal infection
Differentiate common peroneal with tibial nerve
Communication
Convince a patient undergo a procedure
Break bad news
Discharge certificate demonstration

5. Paradigm shift of skill learning
Student know this so he will perform this
Student performs this so he is master of this
Student successfully completed in skill station so he --
Knows, performs, go through organized course, competent and lastly
( Logbook,portfolio,recertification, research, publication)

6. Facilitation of Skill learning
Explaining the skill and theory, its relevance, components and uses.
Demonstrating the skill using the correct steps and pointing out common mistakes
Allowing practice in a graded fashion first in a contrived situation( simulation) and after a measure of competence is achieved in a real situation.

7. Effectiveness and Efficiency
The effectiveness and the efficiency of a learning experience have an inverse relationship to each other. The efficiency of a learning experience depends on the amount of resources invested and it tends to decrease as the effectiveness of the learning experience increases. Organising a class where student hears a description of a skill , such as the steps of performing a hydrocoele operation in a lecture is a very efficient learning experience as 100 students could be instructed in an hour.

8. Effectiveness and Efficiency
However it is not as effective a method as performing a hydrocoele operation on a patient . The latter is a very effective learning experience but is not efficient as only one student can be trained at a time using a patient. This call for contrived ways of skill learning such as learning with simulations, using manikins and in skill laboratories.

9. Simulations, Manikins, laboratories
Simulations are similar things in controlled situation either biological or partly biological
Manikins are completely artificial or prosthetics specially designed for a particular task.
Skill labs are places where a learner can practice several times under an organised module.

10. Dale,s cone of experience
Perform in
real situation
Perform in
Controlled situation
Observes live action
Observes recorded action or
others action
Repeats the steps in words
Read , hear or see the procedure

11. Dreyfus model of skill acquisition
Novice
Rigid adherence to taught rules or plans
Little situational perception
No discretionary judgement
Advanced Beginner
Guidelines for action based on attributes
Situational perception still limited
All attributes and aspects are treated separately
Competent
Coping with crowdedness
Conscious deliberate planning
Standarized and routinized procedures
Proficient
Sees situation holistically
Sees what is most important in a situation
Percieves deviation from the normal pattern
Decision making less labored
Expert
No longer relies on rules , guidelines or maxims
Intuitive grasp of situations based on deep tacit understanding
Vision of what is possible

12. RCOG levels of Competence Model
Observes
Observes the clinical activity performed by a colleague
Level-2
Assists
Assists a colleague perform the clinical activity
Level-3
Direct supervision
Performs the activity under direct supervision of a senior colleague
Level-4
Indirect Supervision
Perform the activity with indirect supervision of a senior colleague
Level-5
Independent
Performs the entire activity without need for supervision

13. Thanks