Abstract
BackgroundSimulation-based medical education (SBME) is a cornerstone for procedural skill training in residency education. Multiple studies have concluded that SBME is highly effective, superior to traditional clinical education, and translates to improved patient outcomes. Additionally it is widely accepted that mastery learning, which comprises deliberate practice, is essential for expert level performance for routine skills; however, given that highly structured practice is more time and resource-intensive, it is important to assess its value for the acquisition of rarely performed technical skills. The bougie-assisted cricothyroidotomy (BAC), a rarely performed, lifesaving procedure, is an ideal skill for evaluating the utility of highly structured practice as it is relevant across many acute care specialties and rare – making it unlikely for learners to have had significant previous training or clinical experience. The purpose of this study is to compare a modified mastery learning approach with deliberate practice versus self-guided practice on technical skill performance using a bougie-assisted cricothyroidotomy model.MethodsA multi-centre, randomized study will be conducted at four Canadian and one American residency programs with 160 residents assigned to either mastery learning and deliberate practice (ML + DP), or self-guided practice for BAC. Skill performance, using a global rating scale, will be assessed before, immediately after practice, and 6 months later. The two groups will be compared to assess whether the type of practice impacts performance and skill retention.DiscussionMastery learning coupled with deliberate practice provides systematic and focused feedback during skill acquisition. However, it is resource-intensive and its efficacy is not fully defined. This multi-centre study will provide generalizable data about the utility of highly structured practice for technical skill acquisition of a rare, lifesaving procedure within postgraduate medical education. Study findings will guide educators in the selection of an optimal training strategy, addressing both short and long term performance.
Highlights
Simulation-based medical education (SBME) is a cornerstone for procedural skill training in residency education
The unique challenges of postgraduate training in medicine demands that research seeks to enhance our understanding of optimal simulation-based instructional methods rather than further highlighting the benefits of hands-on practice when compared to non-simulation-based teaching [42]
While the benefits of mastery learning (ML) + Deliberate practice (DP) in simulation are promising, we should acknowledge that it is a complex intervention with a variety of elements that differ as a result of local circumstances and resource availability [2]
Summary
Simulation-based medical education (SBME) is a cornerstone for procedural skill training in residency education. There is substantial evidence that SBME is a superior training technique compared to traditional didactic methods for technical skill acquisition [1, 2] As both technology and patient care become increasingly complex, simulation-based medical education (SBME) provides a feasible alternative allowing trainees to practice without harming patients [3]. There is growing evidence that deliberate practice and mastery learning approaches to training for procedural skills can ensure expert level performance, for routine procedures [4,5,6,7]. Applying this structured approach, learners can transition as outlined in the “Dreyfus model” along a continuum of five stages: novice, advanced beginner, competent, proficient and expert [4]. Identifying the most effective and evidence-based SBME methods for rare procedures is a critical task for educators in acute care medicine [9, 10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
