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Diane B Wayne - One of the best experts on this subject based on the ideXlab platform.
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effect of ventricular assist device self care simulation based Mastery Learning on driveline exit site infections a pilot study
Journal of Cardiovascular Nursing, 2021Co-Authors: Jane E Wilcox, Diane B Wayne, Elaine R. Cohen, Kenzie A Cameron, Kathleen L Grady, Kerry B Shanklin, Rebecca Harap, Valentina Stosor, Denise M Scholtens, Gretchen P NonogAbstract:Background Ventricular assist device simulation-based Mastery Learning (SBML) results in better patient and caregiver self-care skills compared with usual training. Objective The aim of this study was to evaluate the effect of SBML on driveline exit site infections. Methods We compared the probability of remaining infection free at 3 and 12 months between patients randomized to SBML or usual training. Results The SBML-training group had no infections at 3 months and 2 infections at 12 months, yielding a Kaplan-Meier estimate of the probability of remaining infection free of 0.857 (95% confidence interval [CI], 0.692-1.00) at 12 months. The usual-training group had 6 infections at 3 months with no additional infections by 12 months. Kaplan-Meier estimates of remaining infection free at 3 and 12 months were 0.878 (95% CI, 0.758-1.00) and 0.748 (95% CI, 0.591-0.946), respectively. Time-to-infection distributions for SBML versus usual training showed a difference in 12-month infection rates of 0.109 (P = .07). Conclusions Ventricular assist device self-care SBML resulted in fewer 12-month infections.
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short term retention of patient and caregiver ventricular assist device self care skills after simulation based Mastery Learning
Clinical Simulation in Nursing, 2021Co-Authors: Jeffrey H Barsuk, Elaine R. Cohen, Kenzie A Cameron, Kathleen L Grady, Jane E Wilcox, Kerry B Shanklin, Rebecca Harap, Gretchen P Nonog, Diane B WayneAbstract:Abstract Background We developed a simulation-based Mastery Learning (SBML) curriculum that boosted self-care skills for patients with a ventricular assist device (VAD). In this study, we evaluated short-term skills retention. Method We assessed skill retention among patients and caregivers who participated in VAD self-care SBML at a tertiary care center. We compared discharge skills tests (immediately after completing SBML) with 1- and 3-month follow-up tests to assess skill retention. Results Fifteen patients and 15 caregivers completed discharge and follow-up testing. Skills were largely retained at 1 and 3 months. Conclusions SBML results in short-term retention of VAD self-care skills.
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impact of simulation based Mastery Learning on resident skill managing mechanical ventilators
ATS scholar, 2021Co-Authors: Clara Schroedl, Jeffrey H Barsuk, Elaine R. Cohen, Alexandra Frogameni, Lakshmi Sivarajan, Diane B WayneAbstract:Background: Caring for patients requiring mechanical ventilation is complex, and residents may lack adequate skill for managing these patients. Simulation-based Mastery Learning (SBML) is an educat...
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psychometric validation of central venous catheter insertion Mastery Learning checklist data and decisions
Simulation in healthcare : journal of the Society for Simulation in Healthcare, 2020Co-Authors: William C Mcgaghie, Diane B Wayne, Elaine R. Cohen, William Adams, Jeffrey H BarsukAbstract:INTRODUCTION Resident physicians are expected to acquire competence at central venous catheter (CVC) insertion to a Mastery standard. Valid competence decisions about resident physicians' CVC performance rely on reliable data and rigorous achievement standards. This study used data from 3 CVC simulation-based Mastery Learning studies involving internal medicine (IM) and emergency medicine (EM) residents to address 2 questions: What is the effectiveness of a CVC Mastery Learning education intervention? Are minimum passing standards (MPSs) set by faculty supported by item response theory (IRT) analyses? METHODS Pretraining and posttraining skills checklist data were drawn from 3 simulation-based Mastery Learning research reports about CVC internal jugular (IJ) and subclavian (SC) insertion skill acquisition. Residents were required to meet or exceed a posttest skills MPS. Generalized linear mixed effect models compared checklist performance from pre to postintervention. Minimum passing standards were determined by Angoff and Hofstee standard setting methods. Item response theory models were used for cut-score evaluation. RESULTS Internal medicine and EM residents improved significantly on every IJ and SC checklist item after Mastery Learning. Item response theory analyses support the IJ and SC MPSs. CONCLUSIONS Mastery Learning is an effective education intervention to achieve clinical skill acquisition among IM and EM residents. Item response theory analyses reveal desirable measurement properties for the MPSs previously set by expert faculty panels. Item response theory analysis is useful for evaluating standards for Mastery Learning interventions. The CVC Mastery Learning curriculum, reliable outcome data, and high achievement standards together contribute to reaching valid decisions about the competence of resident physicians to perform the clinical procedure.
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promoting readiness for residency embedding simulation based Mastery Learning for breaking bad news into the medicine subinternship
Academic Medicine, 2020Co-Authors: Julia H Vermylen, William C Mcgaghie, Diane B Wayne, Elaine R. Cohen, Gordon WoodAbstract:PURPOSE It is challenging to add rigorous, competency-based communication skills training to existing clerkship structures. The authors embedded a simulation-based Mastery Learning (SBML) curriculum into a medicine subinternship to demonstrate feasibility and determine the impact on the foundational skill of breaking bad news (BBN). METHOD All fourth-year students enrolled in a medicine subinternship at Northwestern University Feinberg School of Medicine from September 2017 through August 2018 were expected to complete a BBN SBML curriculum. First, students completed a pretest with a standardized patient using a previously developed BBN assessment tool. Learners then participated in a 4-hour BBN skills workshop with didactic instruction, focused feedback, and deliberate practice with simulated patients. Students were required to meet or exceed a predetermined minimum passing standard (MPS) at posttest. The authors compared pretest and posttest scores to evaluate the effect of the intervention. Participant demographic characteristics and course evaluations were also collected. RESULTS Eighty-five students were eligible for the study, and 79 (93%) completed all components. Although 55/79 (70%) reported having personally delivered serious news to actual patients, baseline performance was poor. Students' overall checklist performance significantly improved from a mean of 65.0% (SD = 16.2%) items correct to 94.2% (SD = 5.9%; P < .001) correct. There was also statistically significant improvement in scaled items assessing quality of communication, and all students achieved the MPS at Mastery posttest. All students stated they would recommend the workshop to colleagues. CONCLUSIONS It is feasible to embed SBML into a required clerkship. In the context of this study, rigorous SBML resulted in uniformly high levels of skill acquisition, documented competency, and was positively received by learners.
Jeffrey H Barsuk - One of the best experts on this subject based on the ideXlab platform.
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short term retention of patient and caregiver ventricular assist device self care skills after simulation based Mastery Learning
Clinical Simulation in Nursing, 2021Co-Authors: Jeffrey H Barsuk, Elaine R. Cohen, Kenzie A Cameron, Kathleen L Grady, Jane E Wilcox, Kerry B Shanklin, Rebecca Harap, Gretchen P Nonog, Diane B WayneAbstract:Abstract Background We developed a simulation-based Mastery Learning (SBML) curriculum that boosted self-care skills for patients with a ventricular assist device (VAD). In this study, we evaluated short-term skills retention. Method We assessed skill retention among patients and caregivers who participated in VAD self-care SBML at a tertiary care center. We compared discharge skills tests (immediately after completing SBML) with 1- and 3-month follow-up tests to assess skill retention. Results Fifteen patients and 15 caregivers completed discharge and follow-up testing. Skills were largely retained at 1 and 3 months. Conclusions SBML results in short-term retention of VAD self-care skills.
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impact of simulation based Mastery Learning on resident skill managing mechanical ventilators
ATS scholar, 2021Co-Authors: Clara Schroedl, Jeffrey H Barsuk, Elaine R. Cohen, Alexandra Frogameni, Lakshmi Sivarajan, Diane B WayneAbstract:Background: Caring for patients requiring mechanical ventilation is complex, and residents may lack adequate skill for managing these patients. Simulation-based Mastery Learning (SBML) is an educat...
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psychometric validation of central venous catheter insertion Mastery Learning checklist data and decisions
Simulation in healthcare : journal of the Society for Simulation in Healthcare, 2020Co-Authors: William C Mcgaghie, Diane B Wayne, Elaine R. Cohen, William Adams, Jeffrey H BarsukAbstract:INTRODUCTION Resident physicians are expected to acquire competence at central venous catheter (CVC) insertion to a Mastery standard. Valid competence decisions about resident physicians' CVC performance rely on reliable data and rigorous achievement standards. This study used data from 3 CVC simulation-based Mastery Learning studies involving internal medicine (IM) and emergency medicine (EM) residents to address 2 questions: What is the effectiveness of a CVC Mastery Learning education intervention? Are minimum passing standards (MPSs) set by faculty supported by item response theory (IRT) analyses? METHODS Pretraining and posttraining skills checklist data were drawn from 3 simulation-based Mastery Learning research reports about CVC internal jugular (IJ) and subclavian (SC) insertion skill acquisition. Residents were required to meet or exceed a posttest skills MPS. Generalized linear mixed effect models compared checklist performance from pre to postintervention. Minimum passing standards were determined by Angoff and Hofstee standard setting methods. Item response theory models were used for cut-score evaluation. RESULTS Internal medicine and EM residents improved significantly on every IJ and SC checklist item after Mastery Learning. Item response theory analyses support the IJ and SC MPSs. CONCLUSIONS Mastery Learning is an effective education intervention to achieve clinical skill acquisition among IM and EM residents. Item response theory analyses reveal desirable measurement properties for the MPSs previously set by expert faculty panels. Item response theory analysis is useful for evaluating standards for Mastery Learning interventions. The CVC Mastery Learning curriculum, reliable outcome data, and high achievement standards together contribute to reaching valid decisions about the competence of resident physicians to perform the clinical procedure.
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use of a simulation based Mastery Learning curriculum for neurology residents to improve the identification and management of status epilepticus
Epilepsy & Behavior, 2020Co-Authors: Jeffrey H Barsuk, Elaine R. Cohen, David H Salzman, Yara Mikhaeildemo, George Culler, Danny Bega, Jessica W Templer, Elizabeth E GerardAbstract:Abstract Background Appropriate and timely treatment of status epilepticus (SE) decreases morbidity and mortality. Therefore, skill-based training in the identification and management of SE is crucial for clinicians. Objective The objective of the study was to develop and evaluate the impact of a simulation-based Mastery Learning (SBML) curriculum to train neurology residents on the identification and management of SE. Methods We used pretest–posttest design with a retention test on SE skills for this study. Neurology residents in the second postgraduate year (PGY-2) were eligible to participate in the SE SBML curriculum. Learners completed a baseline-simulated SE skills assessment (pretest) using a 26-item dichotomous skills checklist. Next, they participated in a didactic session about the identification and management of SE, followed by deliberate skills practice. Subsequently, participants completed another skills assessment (posttest) using the same 26-item checklist. All participants were required to meet or exceed a minimum passing standard (MPS) determined by a panel of 14 SE experts using the Mastery Angoff standard setting method. After meeting the MPS at posttest, participants were reassessed during an unannounced in situ simulation session on the medical wards. We compared pretest with posttest simulated SE skills performance and posttest with reassessment in situ performance. Results The MPS was set at 88% (23/26) checklist items correct. Sixteen neurology residents participated in the intervention. Participant performance improved from a median of 44.23% (Interquartile range (IQR): 34.62–55.77) at pretest to 94.23% (IQR: 92.13–100) at the posttest after SBML (p Conclusions Our SBML curriculum significantly improved residents' SE identification and management skills that were largely retained during an unannounced simulated encounter in the hospital setting.
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use of a simulation based Mastery Learning curriculum to improve ultrasound guided vascular access skills of pediatric anesthesiologists
Pediatric Anesthesia, 2020Co-Authors: Heather A Ballard, Joe Feinglass, Michelle Tsao, Alison Robles, Mitch Phillips, John Hajduk, Jeffrey H BarsukAbstract:BACKGROUND Pediatric vascular access is inherently challenging due to the small caliber of children's vessels. Ultrasound-guided intravenous catheter insertion has been shown to increase success rates and decrease time to cannulation in patients with difficult intravenous access. Although proficiency in ultrasound-guided intravenous catheter insertion is a critical skill in pediatric anesthesia, there are no published competency-based training curricula. AIMS The objective of this study was to evaluate the performance of pediatric anesthesiologists who participated in a novel ultrasound-guided intravenous catheter insertion simulation-based Mastery Learning curriculum. METHODS Pediatric anesthesia attendings, fellows, and rotating residents participated in the ultrasound-guided intravenous catheter insertion simulation-based Mastery Learning curriculum from August 2019 to February 2020. The 2-hour curriculum consisted of participants first undergoing a simulated skills pretest followed by watching a video on ultrasound-guided intravenous catheter insertion and deliberate practice on a simulator. Subsequently, all participants took a post-test and were required to meet or exceed a minimum passing standard. Those who were unable to meet the minimum passing standard participated in further practice until they could be retested and met this standard. We compared pre to post-test ultrasound-guided intravenous catheter insertion skills and self-confidence before and after participation in the curriculum. RESULTS Twenty-six pediatric anesthesia attendings, 12 fellows, and 38 residents participated in the curriculum. At pretest, 16/76 (21%) participants were able to meet or exceed the minimum passing standard. The median score on the pretest was 21/25 skills checklist items correct and improved to 24/25 at post-test (95% CI 3.0-4.0, P < .01). Self-confidence significantly improved after the course from an average of 3.2 before the course to a postcourse score of 3.9 (95% CI 0.5-0.9, P < .01; 1 = Not all confident, 5 = Very confident). CONCLUSIONS Simulation-based Mastery Learning significantly improved anesthesiologists' ultrasound-guided intravenous catheter insertion performance in a simulated setting.
William C Mcgaghie - One of the best experts on this subject based on the ideXlab platform.
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psychometric validation of central venous catheter insertion Mastery Learning checklist data and decisions
Simulation in healthcare : journal of the Society for Simulation in Healthcare, 2020Co-Authors: William C Mcgaghie, Diane B Wayne, Elaine R. Cohen, William Adams, Jeffrey H BarsukAbstract:INTRODUCTION Resident physicians are expected to acquire competence at central venous catheter (CVC) insertion to a Mastery standard. Valid competence decisions about resident physicians' CVC performance rely on reliable data and rigorous achievement standards. This study used data from 3 CVC simulation-based Mastery Learning studies involving internal medicine (IM) and emergency medicine (EM) residents to address 2 questions: What is the effectiveness of a CVC Mastery Learning education intervention? Are minimum passing standards (MPSs) set by faculty supported by item response theory (IRT) analyses? METHODS Pretraining and posttraining skills checklist data were drawn from 3 simulation-based Mastery Learning research reports about CVC internal jugular (IJ) and subclavian (SC) insertion skill acquisition. Residents were required to meet or exceed a posttest skills MPS. Generalized linear mixed effect models compared checklist performance from pre to postintervention. Minimum passing standards were determined by Angoff and Hofstee standard setting methods. Item response theory models were used for cut-score evaluation. RESULTS Internal medicine and EM residents improved significantly on every IJ and SC checklist item after Mastery Learning. Item response theory analyses support the IJ and SC MPSs. CONCLUSIONS Mastery Learning is an effective education intervention to achieve clinical skill acquisition among IM and EM residents. Item response theory analyses reveal desirable measurement properties for the MPSs previously set by expert faculty panels. Item response theory analysis is useful for evaluating standards for Mastery Learning interventions. The CVC Mastery Learning curriculum, reliable outcome data, and high achievement standards together contribute to reaching valid decisions about the competence of resident physicians to perform the clinical procedure.
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promoting readiness for residency embedding simulation based Mastery Learning for breaking bad news into the medicine subinternship
Academic Medicine, 2020Co-Authors: Julia H Vermylen, William C Mcgaghie, Diane B Wayne, Elaine R. Cohen, Gordon WoodAbstract:PURPOSE It is challenging to add rigorous, competency-based communication skills training to existing clerkship structures. The authors embedded a simulation-based Mastery Learning (SBML) curriculum into a medicine subinternship to demonstrate feasibility and determine the impact on the foundational skill of breaking bad news (BBN). METHOD All fourth-year students enrolled in a medicine subinternship at Northwestern University Feinberg School of Medicine from September 2017 through August 2018 were expected to complete a BBN SBML curriculum. First, students completed a pretest with a standardized patient using a previously developed BBN assessment tool. Learners then participated in a 4-hour BBN skills workshop with didactic instruction, focused feedback, and deliberate practice with simulated patients. Students were required to meet or exceed a predetermined minimum passing standard (MPS) at posttest. The authors compared pretest and posttest scores to evaluate the effect of the intervention. Participant demographic characteristics and course evaluations were also collected. RESULTS Eighty-five students were eligible for the study, and 79 (93%) completed all components. Although 55/79 (70%) reported having personally delivered serious news to actual patients, baseline performance was poor. Students' overall checklist performance significantly improved from a mean of 65.0% (SD = 16.2%) items correct to 94.2% (SD = 5.9%; P < .001) correct. There was also statistically significant improvement in scaled items assessing quality of communication, and all students achieved the MPS at Mastery posttest. All students stated they would recommend the workshop to colleagues. CONCLUSIONS It is feasible to embed SBML into a required clerkship. In the context of this study, rigorous SBML resulted in uniformly high levels of skill acquisition, documented competency, and was positively received by learners.
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Mastery Learning of team skills
2020Co-Authors: Aashish K Didwania, Erin D Unger, Debi Mitra, William C McgaghieAbstract:Teamwork and leadership skill training are critically important aspects of medical education. This chapter describes the evolution of education curricula for health professions team-based skill development leading to the potential application of simulation-based (SB) Mastery Learning. The chapter starts with our interview of Apollo 13 commander Captain James Lovell who sets the stage for Mastery Learning of team skills by sharing the rigorous training his team received for space flight nearly 50 years ago. The chapter then defines effective healthcare teams, briefly speaks to the science of team science, lists healthcare teams in a variety of professions, and identifies evidence-based team training principles. The next chapter section covers team training for effective healthcare moving from principles to strategies, team training in operation, and the lifespan of team training. The chapter finishes with concluding remarks.
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Mastery Learning milestones and entrustable professional activities
2020Co-Authors: Eric Holmboe, David H Salzman, Joshua L Goldstein, William C McgaghieAbstract:Competency-based medical education (CBME) has developed strong roots in many professional education systems worldwide. The CBME movement is driven by concern and evidence of significant challenges in the quality and safety of healthcare. Medical education can be viewed as a translational science intervention because the competencies acquired by learners must transfer directly to the care of patients and families. Mastery Learning specifically incorporates this critical outcomes-based philosophy into its design and application. Milestones and entrustable professional activities (EPAs) have emerged as developmental educational strategies and approaches to advance the implementation of CBME. However, implementation of competencies through milestones and EPAs has been challenging and is still in its infancy.
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Mastery Learning continuing professional education and maintenance of certification
2020Co-Authors: Clara Schroedl, Graham T Mcmahon, William C McgaghieAbstract:This chapter addresses Mastery Learning in health professions education contexts of continuing professional education (CPE) and maintenance of certification (MOC). These are new applications of the Mastery Learning model, extending lessons learned from their application in undergraduate and graduate medical education. The chapter begins with a section about challenges in current methods of health professions CPE and MOC. It continues with a detailed discussion about CPE and MOC: rationale, evidence of effectiveness, evolution, requirements, how CPE and MOC differ from undergraduate and postgraduate education, driving self-awareness, and lessons learned. A following section covers the relevance, application, and potential of the Mastery Learning model to CPE and MOC. This section uses a clinical example about education for veno-venous extracorporeal membrane oxygenation (ECMO) among medical intensive care providers. The chapter concludes with a brief discussion about future directions for Mastery Learning approaches to CPE in the health professions.
Elaine R. Cohen - One of the best experts on this subject based on the ideXlab platform.
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effect of ventricular assist device self care simulation based Mastery Learning on driveline exit site infections a pilot study
Journal of Cardiovascular Nursing, 2021Co-Authors: Jane E Wilcox, Diane B Wayne, Elaine R. Cohen, Kenzie A Cameron, Kathleen L Grady, Kerry B Shanklin, Rebecca Harap, Valentina Stosor, Denise M Scholtens, Gretchen P NonogAbstract:Background Ventricular assist device simulation-based Mastery Learning (SBML) results in better patient and caregiver self-care skills compared with usual training. Objective The aim of this study was to evaluate the effect of SBML on driveline exit site infections. Methods We compared the probability of remaining infection free at 3 and 12 months between patients randomized to SBML or usual training. Results The SBML-training group had no infections at 3 months and 2 infections at 12 months, yielding a Kaplan-Meier estimate of the probability of remaining infection free of 0.857 (95% confidence interval [CI], 0.692-1.00) at 12 months. The usual-training group had 6 infections at 3 months with no additional infections by 12 months. Kaplan-Meier estimates of remaining infection free at 3 and 12 months were 0.878 (95% CI, 0.758-1.00) and 0.748 (95% CI, 0.591-0.946), respectively. Time-to-infection distributions for SBML versus usual training showed a difference in 12-month infection rates of 0.109 (P = .07). Conclusions Ventricular assist device self-care SBML resulted in fewer 12-month infections.
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short term retention of patient and caregiver ventricular assist device self care skills after simulation based Mastery Learning
Clinical Simulation in Nursing, 2021Co-Authors: Jeffrey H Barsuk, Elaine R. Cohen, Kenzie A Cameron, Kathleen L Grady, Jane E Wilcox, Kerry B Shanklin, Rebecca Harap, Gretchen P Nonog, Diane B WayneAbstract:Abstract Background We developed a simulation-based Mastery Learning (SBML) curriculum that boosted self-care skills for patients with a ventricular assist device (VAD). In this study, we evaluated short-term skills retention. Method We assessed skill retention among patients and caregivers who participated in VAD self-care SBML at a tertiary care center. We compared discharge skills tests (immediately after completing SBML) with 1- and 3-month follow-up tests to assess skill retention. Results Fifteen patients and 15 caregivers completed discharge and follow-up testing. Skills were largely retained at 1 and 3 months. Conclusions SBML results in short-term retention of VAD self-care skills.
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impact of simulation based Mastery Learning on resident skill managing mechanical ventilators
ATS scholar, 2021Co-Authors: Clara Schroedl, Jeffrey H Barsuk, Elaine R. Cohen, Alexandra Frogameni, Lakshmi Sivarajan, Diane B WayneAbstract:Background: Caring for patients requiring mechanical ventilation is complex, and residents may lack adequate skill for managing these patients. Simulation-based Mastery Learning (SBML) is an educat...
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development and evaluation of a simulation based Mastery Learning maintenance of certification course
Gerontology & Geriatrics Education, 2021Co-Authors: Sara M Bradley, Debi Mitra, Katherine Obrien, Lee A Lindquist, Emily M Jones, Theresa A Rowe, Dwayne Dobschuetz, Angela Christine Argento, Craig Leonard, Elaine R. CohenAbstract:Background/Objectives: To develop and evaluate a post-acute care simulation-based Mastery Learning (SBML) continuing medical education (CME)/maintenance of certification (MOC) procedure course.Desi...
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psychometric validation of central venous catheter insertion Mastery Learning checklist data and decisions
Simulation in healthcare : journal of the Society for Simulation in Healthcare, 2020Co-Authors: William C Mcgaghie, Diane B Wayne, Elaine R. Cohen, William Adams, Jeffrey H BarsukAbstract:INTRODUCTION Resident physicians are expected to acquire competence at central venous catheter (CVC) insertion to a Mastery standard. Valid competence decisions about resident physicians' CVC performance rely on reliable data and rigorous achievement standards. This study used data from 3 CVC simulation-based Mastery Learning studies involving internal medicine (IM) and emergency medicine (EM) residents to address 2 questions: What is the effectiveness of a CVC Mastery Learning education intervention? Are minimum passing standards (MPSs) set by faculty supported by item response theory (IRT) analyses? METHODS Pretraining and posttraining skills checklist data were drawn from 3 simulation-based Mastery Learning research reports about CVC internal jugular (IJ) and subclavian (SC) insertion skill acquisition. Residents were required to meet or exceed a posttest skills MPS. Generalized linear mixed effect models compared checklist performance from pre to postintervention. Minimum passing standards were determined by Angoff and Hofstee standard setting methods. Item response theory models were used for cut-score evaluation. RESULTS Internal medicine and EM residents improved significantly on every IJ and SC checklist item after Mastery Learning. Item response theory analyses support the IJ and SC MPSs. CONCLUSIONS Mastery Learning is an effective education intervention to achieve clinical skill acquisition among IM and EM residents. Item response theory analyses reveal desirable measurement properties for the MPSs previously set by expert faculty panels. Item response theory analysis is useful for evaluating standards for Mastery Learning interventions. The CVC Mastery Learning curriculum, reliable outcome data, and high achievement standards together contribute to reaching valid decisions about the competence of resident physicians to perform the clinical procedure.
Aimee K Gardner - One of the best experts on this subject based on the ideXlab platform.
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simulation based Mastery Learning significantly reduces gender differences on the fundamentals of endoscopic surgery performance exam
Surgical Endoscopy and Other Interventional Techniques, 2018Co-Authors: Matthew E Ritter, Matthew Lineberry, Daniel A Hashimoto, Denise W Gee, Angela A Guzzetta, Daniel J Scott, Aimee K GardnerAbstract:Analysis of the Fundamentals of Endoscopic Surgery (FES) performance exam showed higher scores for men than women. Gender differences have been reduced with task-specific practice. We assessed the effect of simulation-based Mastery Learning (SBML) on FES performance exam differences by gender. Forty-seven surgical trainees [29 men (m), 18 women (w)] completed a SBML curriculum and were assessed by FES. Fourteen trained on the GI Mentor 2, 18 on the Endoscopy Training System, and 15 using the Surgical Training for Endoscopic Proficiency curriculum. Performance of male and female trainees was compared. On the pre-training assessment, there were large differences between genders in FES pass rates (m 77%, w 15%, p < 0.001), total scores (m 69 ± 11, w 50 ± 12; p < 0.001), and in four of five FES sub-task scores (Navigation, m 73 ± 19, w 55 ± 22, p = 0.02; Loop reduction, m 34 ± 29, w 14 ± 22, p = 0.02; Retroflexion, m 81 ± 17, w 47 ± 27, p < 0.001; Targeting, m 89 ± 10, w 66 ± 23, p = 0.002). No differences were discernible post training (Pass rate, m 100%, w 94%, p = 0.4; Total score, m 77 ± 8, w 72 ± 12, p = 0.2; Navigation, m 91 ± 13, w 80 ± 13, p = 0.009; Loop reduction, m 49 ± 26, w 46 ± 36, p = 0.7; Retroflexion, m 82 ± 18, w 81 ± 15, p = 0.9; Targeting, m 92 ± 15, w 86 ± 12, p = 0.12). Time needed to complete curricula was not discernably different by gender (m 3.8 ± 1.7 h, w 5.0 ± 2.6 h, p = 0.17). Gender-based differences are nearly eliminated through task-specific SBML training. This lends further evidence to the validity argument for the FES performance exam as a measure of basic endoscopic skills.
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simulation based Mastery Learning for endoscopy using the endoscopy training system a strategy to improve endoscopic skills and prepare for the fundamentals of endoscopic surgery fes manual skills exam
Surgical Endoscopy and Other Interventional Techniques, 2018Co-Authors: Matthew E Ritter, Zachary A Taylor, Kathryn R Wolf, Brenton R Franklin, Sarah B Placek, James R Korndorffer, Aimee K GardnerAbstract:Introduction The fundamentals of endoscopic surgery (FES) program has considerable validity evidence for its use in measuring the knowledge, skills, and abilities required for competency in endoscopy. Beginning in 2018, the American Board of Surgery will require all candidates to have taken and passed the written and performance exams in the FES program. Recent work has shown that the current ACGME/ABS required case volume may not be enough to ensure trainees pass the FES skills exam. The aim of this study was to investigate the feasibility of a simulation-based Mastery-Learning curriculum delivered on a novel physical simulation platform to prepare trainees to pass the FES manual skills exam.
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simulation based Mastery Learning for endoscopy using the endoscopy training system a strategy to improve endoscopic skills and prepare for the fundamentals of endoscopic surgery fes manual skills exam
Surgical Endoscopy and Other Interventional Techniques, 2018Co-Authors: Matthew E Ritter, Zachary A Taylor, Kathryn R Wolf, Brenton R Franklin, Sarah B Placek, James R Korndorffer, Aimee K GardnerAbstract:The fundamentals of endoscopic surgery (FES) program has considerable validity evidence for its use in measuring the knowledge, skills, and abilities required for competency in endoscopy. Beginning in 2018, the American Board of Surgery will require all candidates to have taken and passed the written and performance exams in the FES program. Recent work has shown that the current ACGME/ABS required case volume may not be enough to ensure trainees pass the FES skills exam. The aim of this study was to investigate the feasibility of a simulation-based Mastery-Learning curriculum delivered on a novel physical simulation platform to prepare trainees to pass the FES manual skills exam. The newly developed endoscopy training system (ETS) was used as the training platform. Seventeen PGY 1 (10) and PGY 2 (7) general surgery residents completed a pre-training assessment consisting of all 5 FES tasks on the GI Mentor II. Subjects then trained to previously determined expert performance benchmarks on each of 5 ETS tasks. Once training benchmarks were reached for all tasks, a post-training assessment was performed with all 5 FES tasks. Two subjects were lost to follow-up and never returned for training or post-training assessment. One additional subject failed to complete any portion of the curriculum, but did return for post-training assessment. The group had minimal endoscopy experience (median 0, range 0–67) and minimal prior simulation experience. Three trainees (17.6%) achieved a passing score on the pre-training FES assessment. Training consisted of an average of 48 ± 26 repetitions on the ETS platform distributed over 5.1 ± 2 training sessions. Seventy-one percent achieved proficiency on all 5 ETS tasks. There was dramatic improvement demonstrated on the mean post-training FES assessment when compared to pre-training (74.0 ± 8 vs. 50.4 ± 16, p < 0.0001, effect size = 2.4). The number of ETS tasks trained to proficiency correlated moderately with the score on the post-training assessment (r = 0.57, p = 0.028). Fourteen (100%) subjects who trained to proficiency on at least one ETS task passed the post-training FES manual skills exam. This simulation-based Mastery Learning curriculum using the ETS is feasible for training novices and allows for the acquisition of the technical skills required to pass the FES manual skills exam. This curriculum should be strongly considered by programs wishing to ensure that trainees are prepared for the FES exam.