Simulation-based Mastery Learning Improves Emergency Medicine Residents' Ability to Perform Temporary Transvenous...

Area of Science:

• Medical Education
• Emergency Medicine
• Cardiology

Background:

• Temporary transvenous cardiac pacing (TVP) is an infrequently performed but critical procedure in emergency medicine.
• Previous studies indicate suboptimal performance of TVP by emergency medicine residents and physicians.
• A simulation-based mastery learning (SBML) curriculum was developed to address these performance gaps.

Purpose of the Study:

• To design and implement an SBML curriculum for TVP.
• To evaluate the impact of the SBML curriculum on emergency medicine residents' TVP performance.

Main Methods:

• An expert panel established a minimum passing standard (MPS) using the Mastery Angoff approach for a 30-item TVP checklist.
• Emergency medicine residents were assessed using a high-fidelity task trainer and the checklist.
• Residents who failed to meet the MPS received targeted feedback, video review, and deliberate practice sessions until mastery was achieved.

Main Results:

• The MPS was set at 93.3% (28 out of 30 items).
• Mean checklist scores significantly improved from baseline (13.4) to initial post-testing (27.5) (P < 0.01).
• All residents who did not meet the MPS after initial testing achieved it after one additional 30-minute practice session.

Conclusions:

• The SBML curriculum led to significant improvements in TVP performance among emergency medicine residents.
• The training effectively reduced score variability, indicating more consistent and proficient skill acquisition.
• SBML is a viable and effective strategy for teaching infrequently performed, critical procedures in emergency medicine.