Perceived Learning and Feedback of Students Following the Competency-based Clinical Rotation in Psychiatry: A Retrospective Review From Tertiary-care Teaching Institute in Central India.

Background: Competency-based medical education (CBME) offers avenues for effective psychiatry teaching to medical students. However, data concerning the feasibility, effectiveness, and students' perspectives on CBME-based clinical rotation, including psychiatry, needs to be explored in India. Therefore, this research aims to evaluate the student's learning effectiveness and feedback on the CBME-informed psychiatry posting. Methods: This cross-sectional retrospective research evaluated the 7th-semester MBBS students (n = 101, 39 [38.6%] females and 62 [71.4%] males), from a tertiary-care teaching hospital in central India, perceived change in Knowledge, Attitude, and Skill and feedback on the CBME-based clinical rotation (July-December 2023) using a mixed-method approach through an online feedback form. Results: A "considerable or marked perceived change," ranging from 70% to 97%, in the knowledge, attitude, ethical aspects, psychomotor skills, and soft skills were noted. 84%-91% of students were "satisfied/quite satisfied (or rated it good to very good)" with the pattern and content of the program, including the assessment. 37% expressed their desire to take psychiatry as an elective. Descriptive responses showed that participants felt improvement in their communication skills, knowledge about non-pharmacological interventions, opportunity to observe and present cases in the Outpatient Department, and satisfaction with the teaching and assessment methods. The need for minor changes regarding case-based formative assessment and the opportunity for more case workups were also cited. Conclusion: The CBME-informed psychiatry clinical rotation can be instrumental in improving psychiatry training and promoting mental health among students. Research involving a comparison arm, longitudinal design, and validated assessment tools can bring greater insights into the subject.

Self Directed Learning: A More Impactful Tool for Learning Tracheostomy by Medical Undergraduate?!

An educational project in medical undergraduate otorhinolaryngology teaching-learningmethodology was designed with the aimof objectively studying the impact of self-directed learning on the topic of tracheostomy, since the latter has been included by the National Medical Commission as a core-competence for students. 150 third-year medical undergraduates participated in the study. They were divided into two groups, namely A and B. Group A was guided to undertake self-directed learning on tracheostomy while Group B underwent a lecture on the sametopic. Thereafter, both the groups responded to a validated feedback performa. Both the groups were assessed before and after the teaching-learning sessions by way of validated multiple-choice questions. Seventy-eight percent of participants from Group A agreed with the fact that they had acquired adequate knowledge on tracheostomy following the self-directed learning session as compared to 93.3% of those in Group B. Lacunae in the knowledge at the end of the teaching sessions were found to be more (27.4%) in Group B as compared to Group A (22%). The results obtained through the preand post-tests found Group A students to be performing significantly better than those in Group B, indicating that self-directed learning had been a more effective method for teaching the skills of tracheostomy as compared to the conventional lecture involving a large group. Self-directed learning, when used alone for a topic like tracheostomy, is more effective than a lecture in terms of reduced lacunae in knowledge and students performance in examinations.

Mitigating Misinformation Toolkit: Addressing COVID-19 Misinformation Through Interprofessional Learning and Collaboration Using a Standardized Patient-Based Educational Module.

Introduction: Medical mis- and disinformation are on the rise and impact patient health outcomes. The complexity of modern medicine and health care delivery necessitates that care be delivered by an interprofessional team of providers well versed in addressing this increased prevalence of medical misinformation. Health professions educational curricula often lack opportunities for students to learn how to address medical misinformation, employ advanced communication techniques, and work collaboratively. Methods: Based on literature and our previous qualitative research, we created a module offering prework learning on COVID-19 and addressing misinformation through advanced communication techniques and interprofessional collaboration. After completing prework, students participated in a standardized patient encounter addressing COVID misinformation. Health professions student dyads completed a preencounter planning huddle and together interviewed a standardized patient. Students received global and checklist-based feedback from standardized patients and completed pre- and postsession self-assessments. Results: Twenty students participated (10 third-year medical, nine third-year pharmacy, one fourth-year pharmacy). Key findings included the following: Nine of 15 survey questions demonstrated statistically significant improvement, including all three questions assessing readiness to have difficult conversations and six of 10 questions assessing interprofessional collaboration and team function. Discussion: Students participating in this novel curriculum advanced their readiness to address medical misinformation, including COVID-19 vaccine disinformation, with patients and coworkers to improve health decision-making and patient care. These curricular methods can be customized for use with a range of health professions learners.

Structured Online Systematic Review Training for Medical Students: An Elective Module in Physiology.

Background Recently, elective posting has been introduced by the National Medical Commission (NMC) of India in the undergraduate competency-based medical education (CBME) curriculum. To successfully implement it in medical colleges, facilitators (medical teachers) need to commit extra time. Hence, this study aimed to evaluate the impact of online teaching-learning methods for implementing an elective module for undergraduate medical students at Burdwan Medical College and Hospital, West Bengal, India. Methods An online module for systematic review methods was developed using the Delphi method. This module was used to train 30 medical students divided into six groups. One resident and one faculty facilitated each group. After the elective program of 15 days, program feedback and evaluation using the Kirkpatrick model were obtained from the students. Results A total of 30 undergraduate medical students with a mean age of 22.7±0.95 years participated in the study. All of them successfully conducted a systematic review per group. The students' feedback was 86.33% positive, and the project evaluation showed an 84% positive opinion. The highest score was for understanding, facilitators' knowledge, and experience. The lowest score was for the immediate applicability of the knowledge. Conclusion An online systematic review training module can be used for elective teaching-learning for final-year medical students, particularly within limited time and resource constraints. Students appreciated the module's clear objectives, appropriate complexity, and facilitators' expertise, leading to improved communication, engagement, and critical-thinking skills. Despite some limitations, these findings suggest that online learning can complement traditional methods and address logistical challenges in medical education, warranting further research on its long-term impact and broader applicability.

Multi-Stakeholder Validation of an Entrustable Professional Activities Framework for Canadian Geriatrics Residency Programs.

Background: Entrustable Professional Activities (EPAs) have become a cornerstone for an increasing number of competency-based medical education programs. Today, frameworks of EPAs are being used in most, if not all, medical specialties. These frameworks can break a discipline down to its constituting tasks, and structure the training and evaluation of residents. In 2018, The Royal College of Physicians and Surgeons of Canada created an EPA framework for Geriatric Specialty residency programs nationwide. The present study aims to evaluate this EPA framework through focus groups consisting of several stakeholder groups. Methods: Participants were recruited to be part of one of five focus groups-one for each stakeholder group of interest. The five focus groups consisted of: physician faculty, residents, allied health professionals, administrators/managers, and patients. Each focus group met once virtually over ZOOM® for no longer than 90 minutes. Meeting transcripts were iteratively coded based on emerging themes, and were compared for similarities and gaps between stakeholder perspectives. Results: Multi-stakeholder consultation yielded feedback on many specific EPAs, suggestions for new EPAs, and additional input which gave rise to four themes: (i) EPA scope, (ii) Operationalization, (iii) Interprofessional Collaboration, and (iv) Patient Advocacy. Lastly, we received their thoughts on how the framework defines Geriatrics relative to the work of Care of the Elderly physicians in Canada. Conclusions: Consulting a variety of stakeholder groups generates a robust and diverse supply of feedback that holistically augments EPA frameworks to be more practical, appropriate, socially accountable and patient-centred.

Trainee Perceptions of a Competency-Based Mid-Career Fellowship in Hospice And Palliative Medicine.

Context: The time-variable, competency-based mid-career fellowship in Hospice and Palliative Medicine (HPM) is a multicenter pilot program for physicians who want to train in HPM part-time. Objectives: This study describes the experience of the early cohort of mid-career fellows. Methods: Fellows at the seven sites were surveyed about their perceptions of the program and their confidence in subspecialty skills. Results: Surveys were sent to 13 fellows and completed by 8. All reported positive experiences with curricula, direct observation, feedback, and cross-site case reviews. Most responses were positive regarding individualized learning plans and case-stimulated reviews. Respondents reported high confidence in 9 of the 13 specialty-specific skills, including communication, caring for dying patients, and pain management. They reported less confidence with psychological and non-pain symptoms, spirituality, and prognostication. Fewer than half indicated that the process for graduation was clear. Conclusion: Physicians in the competency-based HPM fellowship report a positive experience and high confidence in subspecialty skills.

Medication Errors as a Marker of Resident Competency.

Introduction Educators continue to evaluate ways to assess resident performance in conjunction with the Accreditation Council for Graduate Medical Education (ACGME) general surgery milestones. We investigated whether the rate of medication errors could reflect general surgery resident competency. We hypothesized that the identification of increased medication errors made by general surgery residents could be a potential screening tool to identify residents who are academically at risk prior to their formal biannual milestone evaluation by the clinical competency committee. Methods This is a retrospective cohort study comparing rates of medication ordering errors against ACGME core competency scores over four years in a general surgery residency program at an academic, university-affiliated, level 1 trauma center in the Northeastern United States. Results We identified 95 general surgery residents who inputted 1,164,663 medication orders during the four years studied. There were 1,214 (0.1%) errors identified. Of those, 1,146 (94.4%) were level 3 errors, and 68 (5.6%) were level 4 errors. This represents an error rate of 1.04 errors per 1,000 medication orders. There was a statistically significant decrease in the error rate as the post-graduate year (PGY) level increased (p=0.005). However, there was no correlation between the error rate and individual ACGME milestone competency scores by PGY level. Conclusions We explored whether medication errors may be an early measurement of worsening resident performance as demonstrated by a decrease in ACGME core competency scores. However, the rate of errors did not correlate consistently with these measures. This may underscore that medication errors measure an aspect of resident performance that we do not capture with our current assessments.

Study of Efficacy of a Novel Formative Assessment Tool: Keywords Recall.

Background Formative assessment is a crucial component of a Competency-Based Medical Education curriculum. Keywords are concise representations of the central ideas and themes explored within a subject. Taking a memory test evaluates knowledge as well as improves future memory. Aim and objectives This study intended to study the efficacy of the "keywords teaching" technique and "keywords recall" after a teaching-learning session as an effective tool for formative assessment and the correlation between the performance of students in summative assessments. Materials and methods Students of first-year professional faculty of medicine students 2022-23 batch attending pre-clinical (physiology) classroom lectures aged between 18-21 years belonging to both genders who consented to voluntary participation in the study were included in the study. Scores of formative sessions by multiple choice questions, keywords recall assessment tool, and summative sessions were analyzed using paired t-tests. Scores of formative assessments and summative assessments were correlated using Pearson correlation analysis. Results Analysis showed formative assessments had a significant (P < 0.05) relationship with summative assessment performance. The study indicates a positive correlation between scores for both formative and summative assessments, highlighting the importance of formative assessment in improved academic performance. Conclusion Optimal learning can be achieved by testing that emphasizes recall retrieval practice and that is repeated at intervals over time. This study suggests that "keywords recall" after a teaching-learning session is an effective tool for formative assessment.

Conceptualization and teaching health advocacy in undergraduate medical education: a document analysis.

BACKGROUND: Health advocacy is considered to be a core competence for physicians, but it remains unclear how the health advocacy role, despite being described in overarching competency frameworks, is operationalized in undergraduate medical education (UME). This study aimed to identify how health advocacy is conceptualized and taught in undergraduate medical curricula. METHODS: We performed a qualitative analysis of curriculum documents from all eight medical schools in the Netherlands, all of which offered competency-based UME. Thematic analysis was used to code all the documents and generate themes on health advocacy conceptualization and teaching. To categorize the emerging themes, we used the framework of Van Melle et al. for evaluating the implementation of competency-based medical educational programs. RESULTS: Health advocacy was mostly conceptualized in mission statements about social responsibility of future physicians, related to prevention and promoting health. We found key concepts of health advocacy to be taught mainly in public health and social medicine courses in the bachelor stage and in community-based clerkships in the master stage. Specific knowledge, skills and attitudes related to health advocacy were taught mostly in distinct longitudinal learning pathways in three curricula. CONCLUSION: Health advocacy is conceptualized mostly as related to social responsibility for future physicians. Its teaching is mostly embedded in public health and social medicine courses and community-based settings. A wider implementation is warranted, extending its teaching to the full width of medical teaching, with longitudinal learning pathways providing a promising route for more integrative health advocacy teaching.

Evaluating Feedback Comments in Entrustable Professional Activities: A Cross-Sectional Study.

INTRODUCTION: Competency-based medical education (CBME) has transformed postgraduate medical training, prioritizing competency acquisition over traditional time-based curricula. Integral to CBME are Entrustable Professional Activities (EPAs), that aim to provide high-quality feedback for trainee development. Despite its importance, the quality of feedback within EPAs remains underexplored. METHODS: We employed a cross-sectional study to explore feedback quality within EPAs, and to examine factors influencing length of written comments and their relationship to quality. We collected and analyzed 1163 written feedback comments using the Quality of Assessment for Learning (QuAL) score. The QuAL aims to evaluate written feedback from low-stakes workplace assessments, based on 3 quality criteria (evidence, suggestion, connection). Afterwards, we performed correlation and regression analyses to examine factors influencing feedback length and quality. RESULTS: EPAs facilitated high-quality written feedback, with a significant proportion of comments meeting quality criteria. Task-oriented and actionable feedback was prevalent, enhancing value of low-stakes workplace assessments. From the statistical analyses, the type of assessment tool significantly influenced feedback length and quality, implicating that direct and video observations can yield superior feedback in comparison to case-based discussions. However, no correlation between entrustment scores and feedback quality was found, suggesting potential discrepancies between the feedback and the score on the entrustability scale. CONCLUSION: This study indicates the role of the EPAs to foster high-quality feedback within CBME. It also highlights the multifaceted feedback dynamics, suggesting the influence of factors such as feedback length and assessment tool on feedback quality. Future research should further explore contextual factors for enhancing medical education practices.

Competency Based Medical Education (CBME) in India: Clinicians' Multifaceted Challenges.

In the recent past, in order to achieve our national goal of 'health for all', National Medical Commission and Government of India made competency based medical education (CBME) mandatory in all Indian medical colleges. By undergoing CBME, the Indian Medical Graduate is expected to achieve the five roles of Clinician, Communicator, Leader and Member of the health care, Professional and Lifelong learner. This article is an overview of CBME, its relevant terminologies and knowledge-gaps. The purpose is to share these changes in medical education with practicing Otolaryngologists of India. It also discusses the various challenges regarding this already- suggested implementation process for clinical academicians, which could be counterproductive to the expected national aim and goal.

Comparative Study of the Flipped Classroom and Traditional Lecture Methods in Anatomy Teaching.

Background The National Medical Commission (NMC), the regulatory body for medical education in India introduced competency-based medical education (CBME) in 2019. It is an outcome-based learner-centric approach. To implement it, active and innovative learning strategies are being introduced. A flipped classroom (FC) is one such teaching method in which learners are provided learning materials before class with active discussion during teaching sessions. This promotes critical thinking, better retention, and future clinical applicability. This study aimed to compare FC and traditional teaching methods for first-phase medical learners for the anatomy curriculum. The objectives of this study were to evaluate the effectiveness of FC viz-a viz traditional lecture method for certain topics of clinical relevance from the anatomy curriculum and assess students' perception of the FC method.  Methodology The study was conducted on 96 phase-one medical learners after obtaining approval from the Institutional Ethics Committee. After obtaining informed consent, a simple random sampling method was used to group the students into two groups. For the same topic, one group was taught with the FC method, while the other group was taught using the didactic lecture (DL) method. A crossover was done for another topic. Students were assessed by pre- and post-tests. Students' perceptions' were recorded by a pre-validated questionnaire quantified on a Likert scale. Results The difference in posttest scores for the topics taught between the two groups was found to be statistically significant. Perception regarding various aspects of the FC method was affirmative. Conclusions The results of this study indicated that FC is advantageous for students. It improves learner engagement and performance, and students' perception of the method was positive. Effective execution of this method requires detailed planning, constant motivation, and consistent efforts. Therefore, this method should be used more often for the benefit of students.

Trainee Insight into Pain Fellowship Programs: A Critical Evaluation of the Current Educational System by the APPD.

BACKGROUND: Since 1992, when the Accreditation Council of Graduate Medical Education (ACGME) acknowledged pain medicine as a subspecialty, the field has experienced significant growth in its number of programs, diversity of sponsoring specialties, treatment algorithms, and popularity among applicants. These shifts prompted changes to the educational model, overseen by program directors (PDs) and the ACGME. The pool of pain fellowship applicants also changed during that period. OBJECTIVES: This study aims to investigate trainees' reasons for applying to pain medicine fellowship programs as well as the applicants' specific expectations, interests, and motivations, thereby contributing to the remodeling and universal improvement of programs across the country. STUDY DESIGN: Online survey via SurveyMonkey. The online questionnaire targeted pain fellowship applicants in 2023 and current fellows in the US. METHODS: Our study was designed by board members of the Association of Pain Program Directors (APPD). The board disseminated a survey to those who applied to ACGME Pain Medicine fellowships in 2023 as well as to existing fellows. The survey was emailed to residency and fellowship PDs for dissemination to their trainees. The participants answered a 12-question survey on their reasons for pursuing pain medicine fellowships, expectations of and beyond those fellowships, and educational adjustments. RESULTS: There were 283 survey participants (80% applicants in residency training and 20% fellows). Participants ranked basic interventional procedures and a strong desire to learn advanced procedures as the most significant factors in pursuing a pain fellowship. Most trainees (70%) did not wish to pursue a 2-year fellowship, and 50% desired to go into private practice. LIMITATIONS: The relatively small number of respondents is a limitation that could introduce sampling error. Since most of the respondents were from the fields of physical medicine and rehabilitation (PM&R) and anesthesia, the use of convenience sampling reduced our ability to generalize the results to the wider community. Furthermore, approximately 80% of the trainees were residents, who might have had less experience in or knowledge of the survey's particulars than did the fellows. CONCLUSION: This survey demonstrated that procedural volume and diversity were important factors in trainees' decisions to apply to the field of pain medicine; however, extending the duration of a pain fellowship was not an option survey participants favored. Therefore, PDs and educational stakeholders in pain fellowship training need to develop creative strategies to maintain competitive applicants' interest while they adapt to our evolving field.

Perceptions of Stakeholders and the Way Forward to Implementing the Family Adoption Programme in Medical Education: A Study From Assam, India.

Background The Family Adoption Programme (FAP) has been introduced under the competency-based medical education curriculum wherein each medical student adopts families. The objective of this study was to determine the stakeholders' perspective and to suggest measures to make it relevant for Indian medical graduates. Methodology A mixed-method study was conducted among the faculty, undergraduate students, and community using prestructured, validated instruments. The quantitative data were entered into Microsoft Excel (Microsoft Corp., Redmond, WA) and analysed, while the qualitative data were coded and analysed thematically. Results All faculty members (12, 100%), the majority of students (49, 44.30%), and the community members strongly agreed that the policy decision to introduce the FAP was 'right'. The benefits mentioned were that FAP helps improve knowledge, psychomotor skills, attitudes and communication, attitude and behaviour skills, understanding of the social structures, health status of the community, and health-seeking behaviour of the families and provides an appropriate early clinical exposure. The challenges mentioned were selecting a site, gaining cooperation from family, communication, arrangement of logistics and transportation, getting support from teachers, difficulties in managing students in the community and coordinating among faculty, staff and students. Most faculty members recommended that the FAP should be started later in the curriculum and there should be restrictions on the number of families to be adopted. The students suggested that adequate logistics be provided as well as a reduction in the number of family visits. Conclusion The programme has been welcomed by most stakeholders. It requires the necessary support from the institution authorities, prior planning of visits, judicious utilization of social media, and coordination with government field-level health workers e.g. Accreditated Social Health Activists (ASHA). A comprehensive program evaluation and formulation of a standard operating module will further strengthen the programme.

Competency based medical education implementation at the institutional level: A cross-discipline comparative program evaluation.

INTRODUCTION: As an early adopter of competency-based medical education (CBME) our postgraduate institution was uniquely positioned to analyze implementation experience data across programs, while keeping institutional factors constant. We described participants' experiences related to CBME implementation across programs derived from early program evaluation efforts within our setting. METHODS: This evaluation focused on eight residency programs at a medium-sized academic institution in Canada. Participants (n = 175) included program leaders, faculty, and residents. The study consisted of 3 phases: (1) describing intended implementation; (2) documenting enacted implementation; and (3) comparing intended with enacted implementation to inform adaptations. Each program's findings were summarized in technical reports which were then analyzed thematically. Cross program data were organized by themes. RESULTS: Six themes were identified. All groups emphasized the need for ongoing refinement of CBME resulting from shared tensions such as increased assessment burden. However, there were some disparate CBME-related experiences between programs such as the experience with entrustable professional activities, the interpretation of retrospective entrustment anchors, and quality of feedback. CONCLUSION: We detected several cross-program successes and important challenges related to CBME. Our experience can inform other programs engaging in implementation and evaluation of CBME.

Evaluating the Impact of Faculty Development Programs in Generating Self-Efficacy and Competency Among Medical Teachers in India.

Background Maintaining the quality of teaching across India is a challenge. Teachers are equally responsible for patient care and administration. The importance of training medical teachers under the various faculty development programs (FDPs) is well accepted. A mechanism to evaluate the competencies acquired by medical teachers after attending FDPs becomes equally important. In the present study, we evaluate the impact of the various FDPs on medical teachers. Methodology A cross-sectional study was conducted for one year among 50 medical teachers attending FDPs. Ethical clearance was taken from the Institutional Ethical Committee. For quantitative data collection, the questionnaire was validated by the Scientific Approval Committee of the Institute. The study questionnaire was filled in by the participants just before and three months after attending FDPs. For qualitative data collection, in-depth Interviews (IDIs) using the Kirkpatrick model of learning evaluation were conducted. Descriptive statistics were presented as frequencies and percentages. The thematic areas of self-efficacy and teaching competency before and after FDPs were tested using the chi-square test. P-values <0.05 were considered significant. Results There was a significant increase in self-efficacy (300 vs. 426, p = <0.0001) and teaching competency (456 vs. 608, p = <0.0001) in the domains of teaching difficult students and motivating students for innovative projects. Improvement in communication skills and ability to engage the students were noteworthy in teaching competency. IDIs revealed that FDPs are essential for the efficient delivery of the competency-based medical curriculum. Conclusions FDPs play a key role in bringing about significant improvement in generating self-efficacy and teaching competencies among medical teachers. FDPs may be incorporated into the postgraduate medical curriculum itself.

Competency-based medical education: Connecting training outcomes to patient care.

Competency-based medical education (CBME) is a patient-centered and learner-focused approach to education where curricula are delivered in a manner tailored to the individuals' learning needs, and assessment focuses on ensuring trainees achieve requisite and clearly specified learning outcomes. Despite calls to focus assessment on what matters for patients. In this article, the authors explore one aspect of this next era: the use of electronic health record clinical performance indicators, such as Resident-Sensitive Quality Measures (RSQMs) and TRainee Attributable and Automatable Care Evaluations in Real-time (TRACERs), for learner assessment. They elaborate on both the promise and the potential limitations of using such measures in a program of learner assessment.

The State of Mastery Learning in Pediatric Graduate Medical Education: A Scoping Review.

Objective: The aim of this study was to characterize the state of mastery learning interventions, identify gaps in current approaches, and highlight opportunities to improve the rigor of ML in pediatric graduate medical education (GME) training programs. Methods: In October 2022, we searched Ovid, PubMed, Scopus, and ERIC. Two reviewers independently screened 165 citations and reviewed the full manuscripts of 20 studies. We developed a modified data abstraction tool based on the Recommendations for Reporting Mastery Education Research in Medicine (ReMERM) guidelines and extracted variables related to mastery learning curricular implementation and design and learner assessment. Results: Eleven studies of ML approaches within pediatric GME were included in the full review, with over half published after 2020. ML interventions were used to teach both simple and complex tasks, often in heterogeneous learner groups. While deliberate practice and feedback were consistently reported features of ML in pediatrics, opportunities for improvement include clearly defining mastery, conducting learning over multiple sessions, presenting sufficient validity evidence for assessment tools, adhering to rigorous standard setting processes, and reporting psychometric data appropriate for ML. Conclusion: In pediatric GME, ML approaches are in their infancy. By addressing common shortcomings in the existing literature, future efforts can improve the rigor of ML in pediatric training programs and its impact on learners and patients.

While mastery learning is a well-described, effective educational intervention utilized in multiple medical specialties, we perceived a relative lack of published studies on mastery learning in pediatric graduate medical education. Mills-Rudy's team searched the current literature to identify gaps in mastery learning approaches in pediatrics training and to highlight ways to improve the rigor of mastery learning in pediatric training programs. Their search yielded 11 studies of mastery learning approaches in pediatric graduate medical education. They identified major gaps in curriculum development and implementation as well as learner assessment. Opportunities to improve mastery learning in pediatrics include clearly defining mastery, conducting learning over several sessions, presenting sufficient validity evidence for assessment tools, adhering to rigorous standard setting processes, and reporting psychometric data appropriate for mastery learning. Future mastery learning interventions in pediatrics can address these gaps to improve the rigor of mastery learning in pediatric training programs.