ICRE recently connected with Dr. William C. McGaghie and Dr. Diane B. Wayne around how a mastery model and deliberate practice can improve residency training. This issues and more will be explored in their October 20 ICRE workshop, “Mastery learning of clinical skills”.
What is “the mastery model” of education?
The mastery model occurs when education outcomes are uniform but time is allowed to vary. Learners are allowed to take as much time as is needed to reach predetermined minimum passing standards. Once these standards are reached, learners move on to the next set of learning objectives. The mastery model involves deliberate practice, feedback from instructors and rigorous assessment. Simulation-based education is a good fit with mastery learning because it provides the setting (classroom) and tools (simulators) to allow such individualized learning and assessment.
What advantages does this offer over traditional educational strategies?
Traditional strategies in medical education involve learning at the bedside. While clinical training is important for skill development, it is not predictable. Trainees may learn incorrectly or not receive exposure to certain skills or conditions. Multiple examples in the medical literature show the limits of traditional training as even experienced physicians display gaps in clinical skills. Finally, the traditional model potentially exposes patients to harm from unskilled trainees. Mastery learning ensures that a minimum level of proficiency is met before the skill is attempted on patients.
Recognizing that ICRE is months away, what are some of the themes your session will explore?
We will define mastery learning and present our rationale why it is superior to traditional models. We will highlight how mastery learning fits with new education paradigms such as milestone-based education. We will present our experience with intern “bootcamp” used for residents in multiple specialties at our institution. This program ensures that all trainees have defined skills prior to beginning clinical training. Finally, we will demonstrate several key examples of mastery learning programs that have positively impacted patient care quality.
Are there limitations when generalizing performance in a highly controlled simulator environment to variable clinical practice?
Clearly not all skills have been rigorously evaluated. However, we will show examples from skills as varied as communication with patients, patient handoffs, ICU clinical skills and invasive procedures.
What sort of resource requirements would be needed to implement this model into a program?
Use of the mastery model requires significant institutional commitment to attaining high levels of achievement in medical learners. Faculty must have resources to develop and implement curricula, set standards and assess performance rigorously. However, early studies of procedural skills have shown that mastery learning reduces iatrogenic complications and is cost effective.
Visit the ICRE website to view the complete online program or register.