Simulation-Based Mastery Learning Improves Medical Student Performance and Retention of Core Clinical Skills.
BACKGROUND
Simulation-based mastery learning (SBML) improves procedural skills among medical trainees. We employed an SBML method that includes an asynchronous knowledge acquisition portion and a hands-on skill acquisition portion with simulation to assess senior medical student performance and retention of the following 6 core clinical skills: (a) ultrasound-guided peripheral intravenous placement, (b) basic skin laceration repair, (c) chest compressions, (d) bag-valve mask ventilation, (e) defibrillator management, and (f) code leadership.


METHODS
Seven emergency medicine (EM) faculty members developed curricula, created checklists, and set minimum passing standards (MPSs) to test mastery of the 6 skills. One hundred thirty-five students on an EM clerkship were pretested on all 6 skills, viewed online videos asynchronously followed by a multiple choice computer-based skill-related quiz, received one-on-one hands-on skill training using deliberate practice with feedback, and were posttested until MPS was met. We compared pretest and posttest performance. We also retested, unannounced, a convenience sample (36%) of students from 1 to 9 months postintervention to assess skill retention.


RESULTS
All students passed each quiz. The percentage of students who reached each MPS increased significantly (P < 0.001) from pretest to posttest for all 6 clinical skills. Ninety-eight percent of the students scored at or above the MPS when retested 1 to 9 months later. There was no significant decrease in mean score for any of the 6 skills between posttest and retention testing.


CONCLUSIONS
Simulation-based mastery learning using a substantial asynchronous component is an effective way for senior medical students to learn and retain EM clinical skills. This method can be adapted to other skill training necessary for residency readiness.
From the Department of Emergency Medicine and Medical Education (T.R.), Stritch School of Medicine, Loyola University Chicago; Department of Emergency Medicine (M.P.), Feinberg School of Medicine, Northwestern University; Department of Emergency Medicine (M.M., L.O., S.L.), Stritch School of Medicine, Loyola University Chicago; Department of Informatics (A.E.H.), Center for Simulation Education (D.Q.), and Office of Clinical Research (W.A.), Health Sciences Division, Loyola University Chicago; Department of Neurology and Medical Education (G.G.), Stritch School of Medicine, Loyola University Chicago; and Department of Medical Education (W.C.M.), Feinberg School of Medicine, Northwestern University, Chicago, IL.
Trent
T
Reed
Matthew
M
Pirotte
Mary
M
McHugh
Laura
L
Oh
Shannon
S
Lovett
Amy E
AE
Hoyt
Donna
D
Quinones
William
W
Adams
Gregory
G
Gruener
William C
WC
McGaghie
D000328:Adult; D057189:Checklist; D002983:Clinical Competence; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D000066908:Simulation Training; D014741:Video Recording