Bridging the procedures skill gap from medical school to residency: a simulation-based mastery learning curriculum

Area of Science:

• Medical Education
• Emergency Medicine
• Simulation-Based Learning

Background:

• The transition from medical student to intern presents an educational gap, particularly in procedure-heavy specialties like emergency medicine.
• Core Entrustable Professional Activities for entering residency outline basic procedural expectations, which may not suffice for advanced skills needed in emergency medicine.
• A disconnect exists between undergraduate and graduate medical education regarding procedural competency for graduating medical students.

Purpose of the Study:

• To develop a simulation-based mastery learning curriculum for emergency medicine residents.
• To enhance procedural competency in central venous catheter placement and endotracheal intubation for medical students before graduation.
• To bridge the educational gap in essential procedural skills for entering emergency medicine interns.

Main Methods:

• A simulation-based mastery learning curriculum was developed for ultrasound-guided internal jugular central venous catheter placement and endotracheal intubation.
• Twenty-five medical students participated, undergoing baseline assessment, deliberate practice, and post-test assessments using standardized checklists.
• Minimum passing scores were pre-established for competency assessment in both procedures.

Main Results:

• No students met the baseline competency standard for either procedure prior to the curriculum.
• All 25 students demonstrated procedural competency by the end of the three-hour curriculum.
• A second post-test showed 16% and 28% of students achieved minimum passing scores for central venous catheter and endotracheal intubation, respectively.

Conclusions:

• Simulation-based mastery learning effectively enhanced procedural competency for central venous catheter placement and endotracheal intubation in medical students.
• The curriculum successfully prepared students for high-risk procedures required during emergency medicine residency.
• Three instructional hours were sufficient to achieve basic procedural competence in these critical skills before medical school graduation.