Time to Refresh: Design and Evaluation of Refresher Training to Sustain Procedural Teaching Skills

Background and need for innovation: Train-the-trainer courses for procedural teaching, including gastrointestinal endoscopy, have been shown to improve trainer performance and learner outcomes. However, maintaining these gains over time is challenging. Refresher training has been proposed as a strategy to support long-term retention of procedural teaching skills; however, such training is currently lacking and its impact remains unclear.

Goal of innovation: We developed, implemented and evaluated a bespoke Training the Colonoscopy Trainers (TCT) refresher training to support sustained endoscopy teaching skills. In addition, facilitators and barriers influencing long-term retention and transfer of teaching skills were identified.

Steps taken for development and implementation of innovation: Sixteen endoscopy trainers who had previously completed the original TCT course participated in a one-on-one refresher training delivered 6–9 months after the initial training. Effectiveness was evaluated using Kirkpatrick levels 1 (reaction), 3 (behaviour) and 4 (results). Course participant interviews were thematically analysed to identify factors influencing sustained skill retention and transfer to practice.

Outcomes of innovation: Participants highly valued the refresher training. Although improvements in trainer performance were not statistically significant, post-refresher training video-analysis scores exceeded all previous measurements. Residents reported high satisfaction with supervision and perceived improvements in feedback quality and procedural guidance. Institutional support and opportunities to teach were identified as key facilitators, while time constraints were the primary barrier to sustained skill application.

Critical reflection: This study demonstrates the feasibility and added value of refresher training as part of faculty development for procedural teaching. While challenges remain regarding optimal timing and institutional support, this proof of principle highlights the potential of longitudinally embedded refresher training to advance teaching quality across medical education contexts.