Background:
Teaching clinical skills is nowadays frequently taking place in skills labs using surrogate models. We further developed this approach by integrating approved training principles such as learning by doing, learning by copying, learning by repetition, learning by experiencing success, learning by understanding and learning by self-correcting own errors into a new concept. The key feature of this concept is the video and image documentation of each exercise as a basis for a self- analysis of process and result quality following the principles of the PDCA-cycle.

Material and Methods:
Every training round of exercises was videotaped and the result foto-documented.
The students were instructed to perform a detailed criteria-based analysis of his process and result quality and to set defined personal goal for the next repetition of the exercise.

Result:
The new learning concept was applied in 9 teaching groups with up to 18 students each. Implementation of the concept, especially the result and process documentation as well as the selfanalysis based on the PDCA-cycle was applied successfully. Most students reached a high performance quality even upon the first try. Interestingly the result quality did not correlate with the time needed for the exercise. The training success had a lasting effect as demosnrated upon a facultative test 3 months later.

Conclusion:
The new concept was time consuming, but well accepted by the students and resulted in a high and long-lasting process and result quality. In the long run resources for patient care should be saved when training students according to this concept prior to performing tasks in the operating theater. These resources should be allocated for further refining innovative teaching concepts.