Michelle Schlipalius^1,2,3
Kate Reid³
1 Monash University, Melbourne, Australia
2 Monash Health, Melbourne Australia
3 The University of Melbourne, Melbourne, Australia

The apprenticeship model of medical education has been the traditional method to teach procedural skills. However, patient safety concerns, combined with a reduction in working hours, has led to fewer opportunities to acquire procedural skills through practise in the clinical environment. As medical education develops from being based on time and procedure numbers to a competency-based approach, simulation-based mastery learning (SBML) becomes essential, as it enables learners to gain competency at their own pace, without a risk to patients and is independent of opportunities available in the clinical environment(1). 

A scoping review was undertaken to address the research question “what are the outcomes of using SBML to teach healthcare professionals clinical procedural skills?” Ovid Medline, CINAHL Plus, Ovid Emcare, Pubmed and Embase were searched using the terms “simulation- based mastery learning” OR “deliberate practice and mastery learning”. From 736 initially identified articles, 70 met the inclusion criteria. The methodological quality of each article was evaluated using the Medical Education Research Study Quality Instrument (MERSQI). 

The studies were published between 2008 and 2022. Most were performed in the USA, involved post-graduate medical learners, had small participant numbers and involved a single institution. The median MERSQI score was 13.5. Studies evaluated outcomes at Kirkpatrick level one (47% of articles), two (83%), three (27%) and four (14%). Nearly all studies showed an improvement in Kirkpatrick level outcomes. Studies investigating skill retention showed that skill retention and skill decay occurred almost equally. 

The current literature suggests that SBML works!(2) The challenge is for healthcare professional learners, educators, researchers and institutions to acknowledge this, integrate SBML into their curriculums and advance research. Medical education needs to move from the old paradigm of “see one, do one, teach one” to a new era of “see one, practice many, do one”(3). 

References (maximum three) 

1. Nataraja RM, Webb N, Lopez PJ. Simulation in paediatric urology and surgery. Part 1: An overview of educational theory. J Pediatr Urol. 2018;14(2):120-4. 

2. McGaghie WC. Research opportunities in simulation-based medical education using deliberate practice. Acad Emerg Med. 2008;15(11):995-1001. 

3. Hughes PG, Crespo M, Maier T, Whitman A, Ahmed R. Ten tips for maximizing the effectiveness of emergency medicine procedure laboratories. J Am Osteopath Assoc. 2016;116(6):384-90.