title: A critical review of simulation-based mastery learning with translational outcomes.
abstract: OBJECTIVE
  This article has two objectives. Firstly, we critically review simulation-based mastery learning (SBML) research in medical education, evaluate its implementation and immediate results, and document measured downstream translational outcomes in terms of improved patient care practices, better patient outcomes and collateral effects. Secondly, we briefly address implementation science and its importance in the dissemination of innovations in medical education and health care.
  
  
  METHODS
  This is a qualitative synthesis of SBML with translational (T) science research reports spanning a period of 7 years (2006-2013). We use the 'critical review' approach proposed by Norman and Eva to synthesise findings from 23 medical education studies that employ the mastery learning model and measure downstream translational outcomes.
  
  
  RESULTS
  Research in SBML in medical education has addressed a range of interpersonal and technical skills. Measured outcomes have been achieved in educational laboratories (T1), and as improved patient care practices (T2), patient outcomes (T3) and collateral effects (T4).
  
  
  CONCLUSIONS
  Simulation-based mastery learning in medical education can produce downstream results. Such results derive from integrated education and health services research programmes that are thematic, sustained and cumulative. The new discipline of implementation science holds promise to explain why medical education innovations are adopted slowly and how to accelerate innovation dissemination.
authors.affiliation: Ralph P Leischner Jr, MD Institute for Medical Education, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: McGaghie
authors.forename: Saul B
authors.initials: SB
authors.lastname: Issenberg
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Barsuk
authors.forename: Diane B
authors.initials: DB
authors.lastname: Wayne
mesh_terms: D002983:Clinical Competence; D003162:Competency-Based Education / Q000379:methods*; D003198:Computer Simulation; D004059:Diffusion of Innovation; D004501:Education, Medical / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D017145:Models, Educational; D017063:Outcome Assessment, Health Care; D058996:Quality Improvement; D057170:Translational Research, Biomedical