Academic medicine : journal of the Association of American Medical Colleges
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Translational educational outcomes have been defined as starting in simulation laboratories (T1) and moving downstream to improved patient care practices (T2), patient outcomes (T3), and cost/other value outcomes (T4). The authors conducted a realist synthesis review of the literature to evaluate the translational effect of simulation-based mastery learning (SBML) principles beyond the laboratory. They also sought to address future directions in SBML to improve patient care processes and outcomes and, thus, the quality of health care delivery. ⋯ Findings suggest health professions education conducted using SBML methodology can improve patient care processes and outcomes. Further research is needed to understand the translational impact of SBML for nontechnical skills, including teamwork, and skill retention.
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Dissemination of a medical education innovation, such as mastery learning, from a setting where it has been used successfully to a new and different medical education environment is not easy. This article describes the uneven yet successful dissemination of a simulation-based mastery learning (SBML) curriculum on central venous catheter (CVC) insertion for internal medicine and emergency medicine residents across medical education settings. The dissemination program was grounded in implementation science principles. ⋯ Contextual information about the drivers and barriers that affected the SBML CVC curriculum dissemination is presented. This work demonstrates that dissemination of mastery learning curricula, like all other medical education innovations, will fail without active educational leadership, personal contacts, dedication, hard work, rigorous measurement, and attention to implementation science principles. The article concludes by presenting a set of lessons learned about disseminating an SBML CVC curriculum across different medical education settings.
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As a part of a special collection in this issue of Academic Medicine, which is focused on mastery learning in medical education, this Perspective describes how the expert-performance approach with deliberate practice is consistent with many characteristics of mastery learning. Importantly, this Perspective also explains how the expert-performance approach provides a very different perspective on the acquisition of skill. Whereas traditional education with mastery learning focuses on having students attain an adequate level of performance that is based on goals set by the existing curricula, the expert-performance approach takes an empirical approach and first identifies the final goal of training-namely, reproducibly superior objective performance (superior patient outcomes) for individuals in particular medical specialties. ⋯ He uses the research to generate suggestions for improved training of medical students and professionals. Two strategies-designing learning environments with libraries of cases and creating opportunities for individualized teacher-guided training-should enable motivated individuals to acquire a full set of refined mental representations. Providing the right resources to support the expert-performance approach will allow such individuals to become self-regulated learners-that is, members of the medical community who have the tools to improve their own and their team members' performances throughout their entire professional careers.
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Guidelines for reporting several types of medical studies have been described in the literature. However, there are no current guidelines to report studies on mastery learning curriculum development and trainee evaluation in medical education. Such guidelines will be important because medical education is moving toward a competency-based model. ⋯ The ReMERM guidelines highlight the importance of developing rigorous curricula that embody reliable measures which yield valid decisions about achievement among medical learners. These guidelines should improve the quality of reporting and help educators, authors, peer reviewers, journal editors, and readers to better understand and evaluate mastery learning research. With this shift to competency-based medical education, the ReMERM guidelines should help meet medical educators' needs to achieve these new goals.