Teaching and learning clinical skills is complex in many ways and for many reasons. This plenary focuses on clinical skills with a strong psychomotor component. However, skills are rarely required as a component but as a whole – embedded in clinical practice. I will explore contemporary educational approaches to psychomotor skills development. Although my focus is on the present, I will reflect on recent history before sharing best evidence that supports the development of psychomotor skills.

The origins of contemporary models will be considered briefly such as the 5-level Dave taxonomy with progressive stages of Imitation, Manipulation, Precision, Articulation, and Naturalization. I then move to the work of Sawyer et al who propose an evidence-based pedagogical framework for procedural skill training.

The 6-step pedagogical framework: Learn, See, Practice, Prove, Do, and Maintain will be illustrated. In the Prove phase, simulation is used by trainees to demonstrate competency prior to performing the procedure on a patient (Do). I will make reference to the research programme on simulation-based mastery learning led by McGaghie at Northwestern and the popularised theoretical notion of deliberate practice (Ericsson, 2015). Finally, I’ll offer some ideas from Nicholls et al (2014) considering ‘complex’ procedures.