Over the past few days I have been increasingly engaged sector dialogue about the difference between drilling and training in the medical education. We talk a lot about resuscitation training when we often mix the two together to get the same output.

I would presume that it is probably helpful to define the two – training is the process of acquiring new knowledge, skills, or attitudes through instruction, practice, or feedback; drilling is the process of repeating a specific skill or task until it becomes automatic, fluent, or effortless.

The question is which is the right focus for resuscitation and specifically could you drill the human factors elements that seem to be so crucial to the effectiveness of our performance in this high acuity, low occurrence situations.

In my experience training supports learning of the theoretical and practical aspects, such as anatomy, physiology, diagnosis, treatment, and procedures. Drilling is about mastering the skills or tasks that are critical for performance, such as CPR, intubation, suturing, or surgical techniques. Both training and drilling can improve the quality and safety of patient care, as well as the confidence and competence of medical professionals.

If the argument is accepted that drilling should occupy the largest footprint for developing teams and clinicians in the field of resuscitation then it would follow that the correct tools to achieve this are required. This means that we need to have manikins that are robust, reliable and provide sufficient fidelity to achieve the desired output of the drills.

There is clearly a place for simulation suites but it is also necessary that all healthcare organisations facilitate in-situ clinical simulations that are focused on the drilling principle. It is here that the medical education space should look to sectors such as the military who drill in real world environments with the tools that they will actually employ.

Patients and their families now demand safe care that is focused on improving outcomes and resuscitation should be no different. There is the need for thought leaders in this field to come together to ensure we have the right balance of training and drilling and effective tools to do both.