An enhanced approach to simulation-based mastery learning: optimising the educational impact of a novel, National Postgraduate Medical Boot Camp

Abstract

Background Simulation-based mastery learning (SBML) is an effective, evidence-based methodology for procedural skill acquisition, but its application may be limited by its resource intensive nature. To address this issue, an enhanced SBML programme has been developed by the addition of both pre-learning and peer learning components. These components allowed the enhanced programme to be scaled up and delivered to 106 postgraduate doctors participating in a national educational teaching programme. Methods The pre-learning component consisted of an online reading pack and videos. The peer learning component consisted of peer-assisted deliberate practice and peer observation of assessment and feedback within the SBML session. Anonymised pre- and post-course questionnaires were completed by learners who participated in the enhanced programme. A mixture of quantitative and qualitative data was obtained. Results Questionnaires were distributed to and completed by 50 learners. Both sections of the pre-learning component were highly rated on the basis of a seven-point Likert scale. The peer learning component was also favourably received following a Likert scale rating. Peer observation of the performance and assessment process was rated similarly by first and second learners. The thematic analysis of the reasons for which peer-assisted deliberate practice was considered useful showed that familiarisation with equipment, the rehearsal of the procedure itself, the exchange of experiences and sharing of useful tips were important. The thematic analysis of the reasons why peer observation during ‘performance, assessment and feedback’ was useful highlighted that an ability to compare a peer’s performance to their own and learning from observing a peer’s mistakes were particularly helpful. Conclusion The SBML programme described has been enhanced by the addition of pre-learning and peer learning components which are educationally valued and allow its application on a national scale.

The impact of simulation-based mastery learning, booster session timing and clinical exposure on confidence in intercostal drain insertion: a survey of internal medicine trainees in Scotland

“…The SBML pathway in this context involves study of pre-learning materials and peer assisted deliberate practice, followed by a checklist-based summative assessment to ensure the passing standard is reached [ 23 ]. Practical procedures covered using SBML include ICD insertion, lumbar puncture, ascitic drain insertion and central venous access [ 23 ].…”

“…The SBML pathway in this context involves study of pre-learning materials and peer assisted deliberate practice, followed by a checklist-based summative assessment to ensure the passing standard is reached [ 23 ]. Practical procedures covered using SBML include ICD insertion, lumbar puncture, ascitic drain insertion and central venous access [ 23 ]. ICD insertion (guidewire technique) is formally assessed at both IMT1 boot camp and IMT2 skills day, using an identical checklist-based process encompassed within a two hour session.…”

“…Simulation-based mastery learning (SBML) is a robust, evidence-based teaching methodology designed to improve the acquisition of procedural skills, with the aim of supporting all learners to achieve an agreed standard [ 22 , 23 ]. The premise of SBML is that all learners can achieve the same level of competence, but that different time periods or repeated application of deliberate practice may be required [ 22 ].…”

Postgraduate medical procedural skills: attainment of curricular competencies using enhanced simulation-based mastery learning at a novel national boot camp

“…Building upon the established USA-based SBML methodology, the Medical Education Directorate of NHS Lothian has implemented an enhanced SBML pathway. 12,13 The initial NHS Lothian adapted programme removed the pre-test component and teaching during the session, and replaced this with asynchronous pre-learning resources. These materials provide the learner with procedural and conceptual (technical and non-technical) knowledge prior to physical rehearsal of the skill and must be completed prior to the SBML procedural skills laboratory session.…”

“…The enhanced blended principles of SBML methodology included the established asynchronous prelearning, but also introduced synchronous peer-assisted deliberate practice immediately prior to assessment and peer learning observation in a 2:1 learner to teacher ratio at each station. 12 The enhanced SBML was piloted in the boot camp to deliver mastery learning in four procedural skills: lumbar puncture (LP), ascitic aspiration and drain (ascitic procedures), and intercostal drain (ICD) to all Scottish medical trainees. To our knowledge, this is the first use of SBML in any UK national postgraduate initiative.…”