Mastery learning for chest tube placement : application to surgery and emergency medicine interns

Abstract

Introduction: Mastery learning is an educational method that utilizes deliberate practice and supervised remediation to ensure that trainees meet proficiency in required skills. Especially in surgical and procedural training, this form of learning may be superior to traditional medical education, which typically allows for one opportunity to demonstrate proficiency. A previous study demonstrated th at skills-level-appropriate mastery learning led to higher performance and increased confidence compared to a traditional education method for chest tube placement in 4th year medical students. We sought to demonstrate skills-level-appropriate mastery learning can be replicated and achieved in general surgery and emergency medicine interns. Methods: Interns in the surgery and emergency departments at the University of Missouri participated in an elective course for level-appropriate chest tube placement skills. Learners completed a mannequin-based pretest, a didactic session, supervised deliberate practice, and a mannequin-based posttest. Remediation was provided if the mastery standard was not achieved on the posttest. Evaluation was scored using a chest tube procedure checklist validated by faculty trauma surgeons at the University of Missouri. Results: 17 interns participated in the pretest. 12 interns completed the entire course (70%). No learners (0/17) achieved mastery on the pretest. All (12/12) course completers achieved the mastery standard. Half (6/12) of the learners required remediation to achieve mastery on the posttest. Conclusion: The mastery learning method is feasible in achieving skills-level-appropriate mastery of chest tube placement in interns. Future work will include better learner capture.