How to teach practical skills in medicine: bridging the gap from the course to the patient, and teaching on the job

One of the disadvantages of clinical skills laboratories is the lack of “real life” scenarios which might bridge the gap between the simulated laboratory and clinical settings. While technical skills are important in learning a practical proceedure, effective communication with a patient is essential in order to competently complete the procedure. Taking “blood” from an orange is one thing; drawing blood from an 80 year old woman with dementia at 3am is another experience entirely. Various techniques have been developed which bridge the gap between the clinical skills laboratory and clinical settings, usually using simulated patients (SPs) or a simulated environment.