Rapid Cycle Deliberate Practice: a modern simulation strategy

Abstract

AIMS: To describe, through a literature review, the structure, effectiveness, advantages and disadvantages of a novel strategy in simulation-based training named Rapid Cycle Deliberate Practice.

METHODS: The literature review was conducted from June to September 2017. We searched for the terms “Rapid Cycle Deliberate Practice”, “Deliberate Practice”, “Rapid Cycle”, and equivalent terms in Spanish and Portuguese, filtered for studies in human beings and for publications from January 2014 (when the term was coined) to August 2017, in the following databases: MEDLINE, Web of Science, Scopus and Scielo.

RESULTS: Of the 264 articles found from the selected terms in our initial research, four studies were selected for this review. In Rapid Cycle Deliberate Practice, clinical cases are simulated in cycles progressively more complex, repeated until the acquisition of skills by the team of participants; when the objectives are reached, a new cycle begins, with more difficult tasks needed. This method offers multiple opportunities for skill practice, automation of skills and direct feedback. It presents a series of advantages over traditional simulation, like higher participants’ satisfaction and better performance in key-outcomes in cardiopulmonary arrest scenarios. It has some disadvantages: limited discussion of complex or behavioral scenarios and difficult time control of each cycle, which are limited by team performance.

CONCLUSIONS: In Rapid Cycle Deliberate Practice, teams participate in a simulation scenario with repetitive practice until mastery of desired skills. This strategy leans on established techniques like mastery learning and deliberated practice. While having some disadvantages, like limited discussion of complex or behavioral scenarios and difficult time control, with proper planning and a good training of facilitators this method may be an excellent tool to increase learning with simulation.