Mastery learning improves simulated central venous catheter insertion by emergency medicine teaching faculty

Area of Science:

• Medical Education
• Emergency Medicine
• Procedural Skills Assessment

Background:

• Routine competency assessments for procedural skills like central venous catheter (CVC) insertion are not standard practice beyond residency.
• Evidence indicates variable and suboptimal procedural skills among attending physicians.
• This gap necessitates evaluating and improving the skills of experienced physicians.

Purpose of the Study:

• To assess the central venous catheter (CVC) insertion skills of academic emergency medicine (EM) faculty physicians.
• To determine if a simulation-based mastery learning (SBML) intervention can enhance CVC insertion performance.
• To identify variables that predict competence in CVC insertion among EM faculty.

Main Methods:

• A pretest-posttest study design was employed, evaluating simulated CVC insertion.
• Forty-four volunteer EM faculty physicians participated at a major academic medical center.
• Performance was assessed using a 29-item checklist before and after an SBML intervention.

Main Results:

• Only 9.1% of participants met the minimum passing score on the pretest assessment.
• The SBML intervention led to a significant mean increase in assessment scores of 21.5% (p < 0.001).
• Completing postgraduate training within 5 years predicted higher pretest scores (p = 0.009); CVC insertion frequency did not.

Conclusions:

• Simulation-based mastery learning (SBML) shows promise for assessing and improving CVC insertion skills in EM faculty.
• Recent completion of postgraduate training is a significant predictor of CVC insertion competence.
• Further validation in larger, multi-institutional cohorts of EM physicians is recommended.