Simulation-Based Mastery Learning for Cranial Nerve Physical Exam Skill Acquisition

Area of Science:

• Medical Education
• Physician Assistant Training
• Clinical Skills Assessment

Background:

• Variability in core clinical skills among medical graduates is a long-standing concern.
• Simulation-based mastery learning (SBML) offers a structured approach to ensure consistent learner proficiency.
• This study introduces a novel SBML application for cranial nerve examination in physician assistant (PA) education.

Purpose of the Study:

• To implement and evaluate SBML for teaching and assessing cranial nerve physical examination skills in PA students.
• To compare the effectiveness of SBML with traditional training methods for these skills.
• To assess the impact of SBML on student self-efficacy.

Main Methods:

• A rigorous SBML intervention involving pretesting, objective setting, deliberate practice with feedback, and post-testing.
• Students retrained and retested until a minimum passing standard (MPS) was met.
• Retention testing at 6 weeks and measurement of student self-efficacy before and after the intervention.

Main Results:

• Initially, 0% of PA students met the MPS; post-intervention, 97.1% passed the initial test, and 100% achieved mastery.
• At 6 weeks, 91% retained mastery-level skills.
• The SBML cohort significantly outperformed the historical cohort (96.15% vs. 75.54%; P < .001), with improved student self-efficacy.

Conclusions:

• SBML enables PA students to achieve high competence and confidence in cranial nerve examination skills.
• The SBML approach demonstrates effective and durable skill retention compared to traditional methods.
• SBML is an effective educational strategy for clinical skills training, ensuring high proficiency and learner satisfaction.