Are we talking about practice? A randomized study comparing simulation-based deliberate practice and mastery learning to self-guided practice.

Autor: Petrosoniak A; Division of Emergency Medicine, Department of Medicine, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada. petro82@gmail.com., Sherbino J; McMaster Education Research, Innovation and Theory (MERIT) Program, McMaster University, Hamilton, ON, Canada.; Division of Education and Innovation, Department of Medicine, McMaster University, Hamilton, ON, Canada.; Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada., Beardsley T; College of Medicine-Jacksonville, University of Florida, Gainesville, FL, USA., Bonz J; Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA., Gray S; Division of Emergency Medicine, Department of Medicine, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada.; Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada., Hall AK; Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.; Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada., Hicks C; Division of Emergency Medicine, Department of Medicine, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada., Kim J; Division of Emergency Medicine, Department of Medicine, Western University, London, ON, Canada., Mastoras G; Division of Emergency Medicine, Department of Medicine, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada., McGowan M; Division of Emergency Medicine, Department of Medicine, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada., Owen J; Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada., Wong AH; Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA., Monteiro S; McMaster Education Research, Innovation and Theory (MERIT) Program, McMaster University, Hamilton, ON, Canada.; Division of Education and Innovation, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Jazyk: angličtina
Zdroj: CJEM [CJEM] 2023 Aug; Vol. 25 (8), pp. 667-675. Date of Electronic Publication: 2023 Jun 16.
DOI: 10.1007/s43678-023-00531-0
Abstrakt: Objectives: Simulation-based technical skills training is now ubiquitous in medicine, particularly for high acuity, low occurrence (HALO) procedures. Mastery learning and deliberate practice (ML + DP) are potentially valuable educational methods, however, they are resource intensive. We sought to compare the effect of deliberate practice and mastery learning versus self-guided practice on skill performance of the rare, life-saving procedure, a bougie-assisted cricothyroidotomy (BAC).
Methods: We conducted a multi-center, randomized study at five North American emergency medicine (EM) residency programs. We randomly assigned 176 EM residents to either the ML + DP or self-guided practice groups. Three blinded airway experts independently evaluated BAC skill performance by video review before (pre-test), after (post-test) and 6-12 months (retention) after the training session. The primary outcome was post-test skill performance using a global rating score (GRS). Secondary outcomes included performance time and skill performance at the retention test.
Results: Immediately following training, GRS scores were significantly higher as mean performance improved from pre-test, (22, 95% CI = 21-23) to post-test (27, 95% CI = 26-28), (p < 0.001) for all participants. However, there was no difference between the groups on GRS scores (p = 0.2) at the post-test or at the retention test (p = 0.2). At the retention test, participants in the ML + DP group had faster performance times (66 s, 95% CI = 57-74) compared to the self-guided group (77 s, 95% CI = 67-86), (p < 0.01).
Conclusions: There was no significant difference in skill performance between groups. Residents who received deliberate practice and mastery learning demonstrated an improvement in skill performance time.
(© 2023. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).)
Databáze: MEDLINE
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