Teaching Procedural Skills: A Structured, Evidence-Informed Framework for Clinician-Educators Across Resource Settings.

Procedural competence is central to safe clinical practice, yet the teaching of procedural skills remains largely unstructured in most clinical environments. Most clinicians are trained to perform procedures, not to teach them, and many rely on informal apprenticeship models that inadequately account for how novices acquire complex skills. This paper proposes the Structured Procedural Mastery (SPM) Framework, a practical, evidence-informed approach to teaching procedural skills grounded in cognitive load theory, deliberate practice, motor learning science, and stage-based models of skill acquisition. Organized around three teaching phases - preparing to teach, teaching with deliberate progression, and consolidating learning - the framework provides a step-by-step pathway applicable to any clinical procedure, from straightforward to complex, and adaptable across resource settings. Simulation is addressed not as a technology requirement but as a structured practice environment accessible in both well-resourced and resource-limited contexts. Practical tools for faculty are included as appendices. The SPM Framework aims to give clinician-educators a clear, evidence-informed structure for translating procedural expertise into effective teaching, with particular relevance for clinical training environments in sub-Saharan Africa and other low- and middle-income country (LMIC) settings where faculty development resources are constrained.