title: Mastery Learning of Video Laryngoscopy Using the Glidescope in the Emergency Department.
abstract: BACKGROUND
  According to the Accreditation Council for Graduate Medical Education emergency medicine requirements established before the popularity of video laryngoscopy (VL) use, 35 intubations are necessary for graduation. Our study aimed to establish a mastery-learning model for a skill set very different (VL) from direct laryngoscopy (DL) and to determine the number of attempts needed to achieve mastery with VL.
  
  
  METHODS
  With the use of a randomized, controlled crossover study design, two learner groups underwent baseline testing intubating a mannequin using VL. Afterward, the intervention group received a mastery training intervention. After training, learners were required to repeat the procedure until achievement of 100% on the checklist for two consecutive attempts was achieved. After 3 months, both groups returned for retesting, and the control group received the same mastery training as the intervention group. Both groups returned for final testing after another 3 months.
  
  
  RESULTS
  The intervention arm had an improvement in performance versus the control arm at 3 months of total time (P < 0.05). Both groups had an improvement within their groups' checklist scores at 3 months after training (P < 0.05), and within the intervention arm, this effect was sustained at 6 months (P < 0.05). There was no significant difference in the mean required attempts to demonstrate mastery (overall, 2.5; intervention, 2.75; control 2.25; P = 0.28).
  
  
  CONCLUSIONS
  Simulation-based mastery-learning produces skill enhancement with VL that is resistant to decay across 6 months. Furthermore, although a small number of attempts are needed to achieve mastery, clinical experience did not substitute as a proxy for skill acquisition. This mastery-learning model provides skill sets that are not otherwise obtained in the clinical curriculum in a 3-month period.
authors.affiliation: From the Section of Emergency Medicine (J.A.), Department of Medicine, University of Chicago Medical Center, Chicago; and Division of Emergency Medicine (J.N., J.D., E.W.), and Center for Biomedical Research Informatics (B.L.), NorthShore University HealthSystem, Evanston, IL; Cedars-Sinai Medical Center (M.D.Y.); and Kaiser-Southern California Permanente Medical Group (J.O.), Los Angeles, CA.
authors.forename: James
authors.initials: J
authors.lastname: Ahn
authors.forename: Michael D
authors.initials: MD
authors.lastname: Yashar
authors.forename: Jared
authors.initials: J
authors.lastname: Novack
authors.forename: Joey
authors.initials: J
authors.lastname: Davidson
authors.forename: Brittany
authors.initials: B
authors.lastname: Lapin
authors.forename: Jose
authors.initials: J
authors.lastname: Ocampo
authors.forename: Ernest
authors.initials: E
authors.lastname: Wang
mesh_terms: D057189:Checklist; D002983:Clinical Competence; D018592:Cross-Over Studies; D004636:Emergency Service, Hospital; D006801:Humans; D007828:Laryngoscopy / Q000193:education* / Q000295:instrumentation*; D008348:Manikins; D000066908:Simulation Training; D014741:Video Recording