title: Retention of pediatric resuscitation performance after a simulation-based mastery learning session: a multicenter randomized trial.
abstract: OBJECTIVE
  Using simulation-based mastery learning, residents can be trained to achieve a predefined performance standard in resuscitation. After mastery is achieved, performance degradation occurs over time. Prior investigations have shown performance retention of 12-14 months following intensive simulation-based mastery learning sessions. We sought to investigate the duration of mastery-level resuscitation performance retention after a single 1- to 2-hour simulation-based mastery learning session.
  
  
  METHODS
  Randomized, prospective trial.
  
  
  METHODS
  Medical simulation laboratory.
  
  
  METHODS
  Convenience sample of 42 pediatric residents.
  
  
  METHODS
  Baseline resuscitation performance was determined on four standardized simulation scenarios. After determination of baseline performance, each resident repeated each scenario, as needed, until mastery-level performance was achieved. Residents were then randomized and retested 2, 4, or 6 months later. Statistical analysis on scores at baseline and retesting were used to determine performances changes from baseline and performance retention over time.
  
  
  RESULTS
  Forty-two residents participated in the study (12 in 2 mo group, 14 in 4 mo group, and 16 in 6 mo group). At baseline, postgraduate year-3 residents performed better than postgraduate year-1 residents (p = 0.003). Overall performance on each of the four scenarios improved at retesting. The percent of residents maintaining mastery-level performance showed a significant linear decline (p = 0.039), with a drop at each retesting interval; 92% retained mastery at 2 months, 71% at 4 months, and 56% at 6 months. There was no difference in retention between postgraduate year-1, postgraduate year-2, and postgraduate year-3 residents (p = 0.14).
  
  
  CONCLUSIONS
  Residents displayed significant improvements in resuscitation performance after a single simulation-based mastery learning session, but performance declined over time, with less than 60% retaining mastery-level performance at 6 months. Our results suggest that relatively frequent refresher training is needed after a single simulation-based mastery learning session. Additional research is needed to determine the duration of performance retention following any specific simulation-based mastery learning intervention.
authors: 1Madigan Army Medical Center, Tacoma, WA. 2Tripler Army Medical Center, Honolulu, HI. 3Walter Reed National Military Medical Center, Bethesda, MD. 4San Antonio Uniformed Services Health Education Consortium, San Antonio, TX.
authors: LoRanée
authors: L
authors: Braun
authors: Taylor
authors: T
authors: Sawyer
authors: Kathleen
authors: K
authors: Smith
authors: Angela
authors: A
authors: Hsu
authors: Melinda
authors: M
authors: Behrens
authors: Debora
authors: D
authors: Chan
authors: Jeffrey
authors: J
authors: Hutchinson
authors: Downing
authors: D
authors: Lu
authors: Raman
authors: R
authors: Singh
authors: Joel
authors: J
authors: Reyes
authors: Joseph
authors: J
authors: Lopreiato
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002983:Clinical Competence; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007396:Internship and Residency / Q000379:methods*; D016015:Logistic Models; D008297:Male; D010372:Pediatrics / Q000193:education*; D011446:Prospective Studies; D012151:Resuscitation; D012153:Retention, Psychology; D013997:Time Factors; D014481:United States