Impact of Simulation-based Mastery Learning on Resident Skill Managing Mechanical Ventilators

Area of Science:

• Medical Education
• Critical Care Medicine
• Simulation-Based Training

Background:

• Managing patients on mechanical ventilation is complex, and resident physicians often lack sufficient skills.
• Traditional training methods may not adequately prepare residents for complex ventilator management.
• Simulation-based mastery learning (SBML) is an educational model proven to enhance clinical skills and reduce complications.

Purpose of the Study:

• To evaluate the effectiveness of SBML compared to traditional training for teaching mechanical ventilator management skills to residents.
• To determine if SBML can equip residents with the necessary competencies for safe management of ventilated patients.

Main Methods:

• Developed an SBML curriculum with a 47-item skills checklist for ventilator management across different lung physiologies.
• Assigned residents to either SBML or traditional training groups; SBML group underwent pretesting, a focused training session with deliberate practice, and posttesting until mastery.
• Compared posttest performance of SBML-trained residents with end-of-rotation test scores of traditionally trained residents.

Main Results:

• SBML-trained residents showed significant improvement from a pretest mean score of 51.4% to a final mastery score of 92.5% (P < 0.001).
• A minimum passing standard (MPS) of 87% was established; 42% of SBML residents needed multiple attempts to achieve mastery.
• Traditionally trained residents achieved a mean score of 60.9% at rotation completion, significantly lower than SBML residents' mastery level.

Conclusions:

• Simulation-based mastery learning is an effective strategy for training residents in mechanical ventilator management.
• SBML curricula can enhance traditional training, improving residents' ability to safely manage mechanically ventilated patients.
• Implementing SBML may lead to better patient outcomes by ensuring higher competency levels in critical care trainees.