CAEP GEMeS | Simulation-based medical education (SBME) with mastery learning: Does it lead to higher quality learning and patient care?

In Great Evidence in Medical education Summary (GEMeS) by Stephen MillerLeave a Comment

Marco is a second year resident who is on call overnight. One of his patients goes into a cardiac arrest, and Marco is called to run the code blue. It’s the first time he is in charge and unfortunately the code runs clumsily. The interpersonal communication is unclear and the CPR quality is subpar. Later, the patient needs a central line and Marco fails to properly insert the catheter. When Marco reflects on the experience he recognizes that he needs more practice running codes. He asks his program director whether regular sessions in the simulation lab can be arranged. His program director asks, “Is it worth the time and resources?” 

Increasingly, residency training programs across the country have invested significant effort into introducing and improving simulation programs. Perhaps nowhere has this effort been more concentrated than in Emergency Medicine, where proficiency in the exercise is celebrated with national competitions. To justify the resources, simulation programs need to be more than just “fun” or a checkmark for outside evaluators–they also require objective evidence for improving trainee skill and reducing patient complications. This “Great Evidence in Medical education Summary” (GEMeS – pronounced “gems”) was originally posted by the CAEP EWG GEMeS Team on November 14, 2014 and answers the question: “Can simulation-based medical education (SBME) with mastery learning provide higher quality learning outcomes and result in improvements in patient care and patient safety?” A PDF version is available here.

Educational Question or Problem:

Can simulation-based medical education (SBME) with mastery learning provide higher quality learning outcomes and result in improvements in patient care and patient safety?

Bottom Line on Simulation-Based Mastery Learning

Yes. A critical review of the literature reveals evidence showing that when selected skills and procedures are learned via SBME with attention to mastery learning, there are translational outcomes that lead to improved safety in performing selected skills and procedures, in addition to improvements in patient care techniques and improved patient outcomes. This can be a powerful pedagogical method.

DETAILS SIMULATION-BASED MED ED WITH MASTERY LEARNING
Reference
McGaghie, W. C., Issenberg, S. B., Barsuk, J. H., & Wayne, D. B. (2014).
Study Design
This is a qualitative synthesis of SBME that have reported translational science research over a 7-year period (2006-2013). A critical review approach was undertaken. This approach reviews a variety of literature and identifies well established knowledge. It identifies gaps in understanding, and suggests some means for the further understanding of these gaps. It differs from a systematic review in that it does not purely rely on numbers and data, but assesses context, and educational interventions from the most compelling studies that satisfy the search terms and strategy.
Funding sources
This work was supported in part by the Gordon Center for Research in Medical Education at the University of Miami Miller School of Medicine.
Setting
Institute for Medical Education, Loyola University Chicago, Stritch School of Medicine; Gordon Center for Research in Medical Education at the University of Miami Miller School of Medicine; Department of Medicine, Feinburg School of Medicine, Northwestern University.
Level of Learning
UGME, PGME, CPD
Why is it relevant to Emergency Medicine Education?
Simulation has become a staple as a learning method in teaching both faculty and learners in emergency medicine, as well as other disciplines. With an increased focus on patient safety and reducing patient harms, it is important that the techniques we utilize have translational outcomes that support the time, effort, and cost that these teaching methods demand.
Synopsis of Study
This is a qualitative synthesis of SBME that have reported translational science research over a 7-year period (2006-2013). A critical review approach was undertaken. This approach reviews a variety of literature and identifies well established knowledge. It identifies gaps in understanding, and suggests some means for the further understanding of these gaps. It differs from a systematic review in that it does not purely rely on numbers and data, but assesses context, and educational interventions from the most compelling studies that satisfy the search terms and strategy.

What have been your experiences with simulation at your institution? Share or comment below!

More About the CAEP GEMeS

This post was originally authored for the Canadian Association of Emergency Physicians (CAEP) Great Evidence in Medical Education Summaries (GEMeS) project sponsored by the CAEP Academic Section’s Education Working Group and edited by Drs. Teresa Chan and Julien Poitras. CAEP members receive GEMeS each month in the CAEP Communiqué. CanadiEM will be reposting some of these summaries, along with a case/contextualizing concept to highlight some recent medical education literature that is relevant to our nation’s teachers.
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Stephen Miller

Stephen Miller

Dr. Stephen Miller is a full-time assistant professor of Emergency Medicine and is cross-appointed to the Division of Medical Education at Dalhousie University. He holds a Masters of Health Professions Education where he developed his interest in simulation-based medical education.
Daniel Ting

Daniel Ting

Daniel Ting is an Emergency Physician and Clinical Instructor at the University of British Columbia, based in Vancouver. He is the Editor-in-Chief of CanadiEM and a Decision Editor at the Canadian Journal of Emergency Medicine. He completed the CanadiEM Digital Scholarship Fellowship in 2017-18.
Daniel Ting
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