A Mastery Learning Module on Sterile Technique to Prepare Graduating Medical Students for Internship.

Introduction: Sterile technique is a basic technical skill used for a number of bedside procedures. Proper use of sterile technique improves patient safety by reducing infection risk. Methods: We applied the principles of mastery learning to develop a simulation-based mastery learning module for sterile technique that was used as part of a 2-week internship preparatory course for fourth-year medical students. Forty-one medical students entering surgical or emergency medicine internships completed the module. Learners demonstrated baseline skills with a pretest, watched a didactic online video, participated in supervised deliberate practice sessions, and then completed a posttest. Physicians evaluated performance using a nine-item mastery checklist validated by a multispecialty panel of board-certified physicians. Learners who did not demonstrate mastery by correctly performing all nine checklist items received formative feedback and repeated the posttest as needed until mastery was achieved. Results: No learners demonstrated mastery of sterile technique during pretesting. A total of 100% of learners demonstrated mastery of sterile technique during either their first or second attempt of the posttest. The learners reported statistically significantly higher levels of confidence at the end of the module. Discussion: Our module highlights the skills gap that exists in the transition from undergraduate to graduate medical education and offers a cheap, effective, and easily reproducible curriculum for sterile technique that could be widely adopted for many learner populations.

Proficiency development for graduating medical students, using skills-level-appropriate mastery learning versus traditional learning for chest tube placement: Assessing anxiety, confidence, and performance.

BACKGROUND: Mastery learning is an effective educational tool to assess basic procedural skill proficiency and may also be beneficial for more complex skills along the continuum of surgical training. In addition, anxiety and confidence have effects on cognitive and decision-making performance, both in educational and clinical settings. This study evaluates anxiety and confidence in a skills-level-appropriate mastery learning module for chest tube insertion in graduating medical students. METHODS: A 2-week intern preparatory course was held 2 consecutive years, with 10 and 14 students, respectively. Learners completed a pretest on day 1, didactic session and supervised deliberate practice followed by a Posttest on day 4, and a retention test on day 10. Year one used a traditional educational methodology, and year two provided for remediation as per mastery learning methodology. The chest tube scoring checklist was validated by faculty trauma surgeons to reflect an intern-appropriate skills level. Before and after each test, learners reported state anxiety. Immediately after each test, learners also completed a confidence scale. RESULTS: No learners in either year achieved mastery on the pretest. A total of 40% of the learners achieved the mastery standard on the posttest in year one. All (100%) of the learners achieved the mastery standard after the posttest in year two. Overall, after state anxiety decreased significantly in both years, confidence increased significantly in year two. CONCLUSION: A skills-level-appropriate mastery learning module resulted in higher performance and increased confidence compared with a traditional education model for chest tube placement for incoming surgical interns.