Skip to main content
SpringerLink
Log in

Mastery Learning for Clinical Emergencies

  • Chapter
  • First Online:
Comprehensive Healthcare Simulation: Mastery Learning in Health Professions Education

Part of the book series: Comprehensive Healthcare Simulation ((CHS))

Abstract

Clinicians faced with acute emergencies must act together as an effective, coordinated team to provide high-quality care to individual or multiple patients. Educators who train clinicians to provide emergent care need to address specific clinical algorithms, teamwork, and communication skills. In this chapter, we discuss established national life support curricula as exemplars of the challenges faced in training healthcare professionals to a high standard when targeting thousands of learners. We discuss the recent American Heart Association resuscitation education best practice report (Cheng et al, Circulation. 138:e82–122, 2018) and how mastery learning (ML) should be a key feature in a well-designed resuscitation program. We also review our experience with ML Advanced Cardiac Life Support to demonstrate the applicability of ML to resuscitation programs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Cheng A, Nadkarni VM, Mancini MB, Hunt EA, Sinz EH, Merchant RM, et al. Resuscitation education science: educational strategies to improve outcomes from cardiac arrest: a scientific statement from the American Heart Association. Circulation. 2018;138(6):e82–122.

    Article  PubMed  Google Scholar 

  2. Cheatham ML, Smith CP, Ibrahim JA, Havron WS, Lube MW, Levy MS, et al. Orlando regional medical center responds to pulse nightclub shooting. Bull Am Coll Surg. 2016;101(11):12–9.

    PubMed  Google Scholar 

  3. Baker CC, Oppenheimer L, Stephens B, Lewis FR, Trunkey DD. Epidemiology of trauma deaths. Am J Surg. 1980 Jul;140(1):144–50.

    Article  CAS  PubMed  Google Scholar 

  4. Pepe PE, Wyatt CH, Bickell WH, Bailey ML, Mattox KL. The relationship between total prehospital time and outcome in hypotensive victims of penetrating injuries. Ann Emerg Med. 1987;16(3):293–7.

    Article  CAS  PubMed  Google Scholar 

  5. Petri RW, Dyer A, Lumpkin J. The effect of prehospital transport time on the mortality from traumatic injury. Prehosp Disaster Med. 1995;10(1):24–9.

    Article  CAS  PubMed  Google Scholar 

  6. Abella BS, Sandbo N, Vassilatos P, Alvarado JP, O’Hearn N, Wigder HN, et al. Chest compression rates during cardiopulmonary resuscitation are suboptimal: a prospective study during in-hospital cardiac arrest. Circulation. 2005;111(4):428–34.

    Article  PubMed  Google Scholar 

  7. Edelson DP, Abella BS, Kramer-Johansen J, Wik L, Myklebust H, Barry AM, et al. Effects of compression depth and pre-shock pauses predict defibrillation failure during cardiac arrest. Resuscitation. 2006;71(2):137–45.

    Article  PubMed  Google Scholar 

  8. Hunt EA, Vera K, Diener-West M, Haggerty JA, Nelson KL, Shaffner DH, et al. Delays and errors in cardiopulmonary resuscitation and defibrillation by pediatric residents during simulated cardiopulmonary arrests. Resuscitation. 2009;80(7):819–25.

    Article  PubMed  Google Scholar 

  9. Barsuk JH, Cohen ER, Nguyen D, Mitra D, O’Hara K, Okuda Y, et al. Attending physician adherence to a 29-component central venous catheter bundle checklist during simulated procedures. Crit Care Med. 2016;44(10):1871–81.

    Article  PubMed  Google Scholar 

  10. Mosley C, Dewhurst C, Molloy S, Shaw BN. What is the impact of structured resuscitation training on healthcare practitioners, their clients and the wider service? A BEME systematic review: BEME guide no. 20. Med Teach. 2012;34(6):e349–85.

    Article  PubMed  Google Scholar 

  11. Drimousis PG, Theodorou D, Toutouzas K, Stergiopoulos S, Delicha EM, Giannopoulos P, et al. Advanced trauma life support certified physicians in a non trauma system setting: is it enough? Resuscitation. 2011 Feb;82(2):180–4.

    Article  PubMed  Google Scholar 

  12. American Heart Association. Basic life support: provider manual. Dallas: American Heart Association; 2016.

    Google Scholar 

  13. American Heart Association. Advanced cardiovascular life support (ACLS) provider manual. Dallas: American Heart Association; 2016.

    Google Scholar 

  14. American Heart Association. Pediatric advanced life support (PALS) provider manual. Dallas: American Heart Association; 2016.

    Google Scholar 

  15. Donoghue AJ, Durbin DR, Nadel FM, Stryjewski GR, Kost SI, Nadkarni VM. Effect of high-fidelity simulation on pediatric advanced life support training in pediatric house staff: a randomized trial. Pediatr Emerg Care. 2009;25(3):139–44.

    Article  PubMed  Google Scholar 

  16. Weiner GM, Zaichkin J, Kattwinkel J, American Academy of Pediatrics, American Heart Association. Textbook of neonatal resuscitation. 7th ed. Elk Grove Village: American Academy of Pediatrics; 2016.

    Google Scholar 

  17. American College of Surgeons. ATLS® student course manual. In: 10th ed. Chicago: American College of Surgeons; 2018.

    Google Scholar 

  18. Jayaraman S, Sethi D, Chinnock P, Wong R. Advanced trauma life support training for hospital staff. Cochrane Database Syst Rev. 2014;(8):CD004173.

    Google Scholar 

  19. Mohammad A, Branicki F, Abu-Zidan FM. Educational and clinical impact of advanced trauma life support (ATLS) courses: a systematic review. World J Surg. 2014;38(2):322–9.

    Article  PubMed  Google Scholar 

  20. Oermann MH, Kardong-Edgren SE, Odom-Maryon T. Effects of monthly practice on nursing students’ CPR psychomotor skill performance. Resuscitation. 2011;82(4):447–53.

    Article  PubMed  Google Scholar 

  21. Arthur W Jr, Bennett W Jr, Stanush PL, McNelly TL. Factors that influence skill decay and retention: a quantitative review and analysis. HHUP. 1998;11(1):57–101.

    Article  Google Scholar 

  22. McGaghie WC, Harris IB. Learning theory foundations of simulation-based mastery learning. Simul Healthc. 2018;13(3S Suppl 1):S15–20.

    Article  PubMed  Google Scholar 

  23. McGaghie WC, Issenberg SB, Barsuk JH, Wayne DB. A critical review of simulation-based mastery learning with translational outcomes. Med Educ. 2014;48(4):375–85.

    Article  PubMed  Google Scholar 

  24. Cohen ER, Feinglass J, Barsuk JH, Barnard C, O’Donnell A, McGaghie WC, et al. Cost savings from reduced catheter-related bloodstream infection after simulation-based education for residents in a medical intensive care unit. Simul Healthc. 2010 Apr;5(2):98–102.

    Article  PubMed  Google Scholar 

  25. Barsuk JH, Cohen ER, Feinglass J, McGaghie WC, Wayne DB. Unexpected collateral effects of simulation-based medical education. Acad Med. 2011;86(12):1513–7.

    Article  PubMed  Google Scholar 

  26. Wayne DB, Butter J, Siddall VJ, Fudala MJ, Wade LD, Feinglass J, et al. Mastery learning of advanced cardiac life support skills by internal medicine residents using simulation technology and deliberate practice. J Gen Intern Med. 2006;21(3):251–6.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Wayne DB, Didwania A, Feinglass J, Fudala MJ, Barsuk JH, McGaghie WC. Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: a case-control study. Chest. 2008;133(1):56–61.

    Article  PubMed  Google Scholar 

  28. Ericsson KA, Krampe RT, Tesch-Römer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev. 1993;100(3):363–406.

    Article  Google Scholar 

  29. Sawyer T, Sierocka-Castaneda A, Chan D, Berg B, Lustik M, Thompson M. Deliberate practice using simulation improves neonatal resuscitation performance. Simul Healthc. 2011 Dec;6(6):327–36.

    Article  PubMed  Google Scholar 

  30. Cordero L, Hart BJ, Hardin R, Mahan JD, Nankervis CA. Deliberate practice improves pediatric residents’ skills and team behaviors during simulated neonatal resuscitation. Clin Pediatr (Phila). 2013;52(8):747–52.

    Article  Google Scholar 

  31. Burden AR, Pukenas EW, Deal ER, Coursin DB, Dodson GM, Staman GW, et al. Using simulation education with deliberate practice to teach leadership and resource management skills to senior resident code leaders. J Grad Med Educ. 2014;6(3):463–9.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Braun L, Sawyer T, Smith K, Hsu A, Behrens M, Chan D, et al. Retention of pediatric resuscitation performance after a simulation-based mastery learning session: a multicenter randomized trial. Pediatr Crit Care Med. 2015;16(2):131–8.

    Article  PubMed  Google Scholar 

  33. Sullivan NJ, Duval-Arnould J, Twilley M, Smith SP, Aksamit D, Boone-Guercio P, et al. Simulation exercise to improve retention of cardiopulmonary resuscitation priorities for in-hospital cardiac arrests: a randomized controlled trial. Resuscitation. 2015;86:6–13.

    Article  PubMed  Google Scholar 

  34. Sutton RM, Niles D, Meaney PA, Aplenc R, French B, Abella BS, et al. Low-dose, high-frequency CPR training improves skill retention of in-hospital pediatric providers. Pediatrics. 2011;128(1):e145–51.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Niles D, Sutton RM, Donoghue A, Kalsi MS, Roberts K, Boyle L, et al. “Rolling refreshers”: a novel approach to maintain CPR psychomotor skill competence. Resuscitation. 2009;80(8):909–12.

    Article  PubMed  Google Scholar 

  36. Patocka C, Khan F, Dubrovsky AS, Brody D, Bank I, Bhanji F. Pediatric resuscitation training-instruction all at once or spaced over time? Resuscitation. 2015;88:6–11.

    Article  PubMed  Google Scholar 

  37. Bender J, Kennally K, Shields R, Overly F. Does simulation booster impact retention of resuscitation procedural skills and teamwork? J Perinatol. 2014;34(9):664–8.

    Article  CAS  PubMed  Google Scholar 

  38. Kurosawa H, Ikeyama T, Achuff P, Perkel M, Watson C, Monachino A, et al. A randomized, controlled trial of in situ pediatric advanced life support recertification (“pediatric advanced life support reconstructed”) compared with standard pediatric advanced life support recertification for ICU frontline providers∗. Crit Care Med. 2014;42(3):610–8.

    Article  PubMed  Google Scholar 

  39. Garcia-Jorda D, Walker A, Camphaug J, Bissett W, Spence T, Martin D-A, et al. Bedside chest compression skills: performance and skills retention in in-hospital trained pediatric providers. A simulation study. J Crit Care. 2018;50:132–7.

    Article  PubMed  Google Scholar 

  40. Moazed F, Cohen ER, Furiasse N, Singer B, Corbridge TC, McGaghie WC, et al. Retention of critical care skills after simulation-based mastery learning. J Grad Med Educ. 2013;5(3):458–63.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Eppich WJ, Hunt EA, Duval-Arnould JM, Siddall VJ, Cheng A. Structuring feedback and debriefing to achieve mastery learning goals. Acad Med. 2015;90(11):1501–8.

    Article  PubMed  Google Scholar 

  42. Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005;27(1):10–28.

    Article  PubMed  Google Scholar 

  43. Sandars J. The use of reflection in medical education: AMEE guide no. 44. Med Teach. 2009;31(8):685–95.

    Article  PubMed  Google Scholar 

  44. Watling C, Driessen E, van der Vleuten CPM, Lingard L. Learning from clinical work: the roles of learning cues and credibility judgements. Med Educ. 2012;46(2):192–200.

    Article  PubMed  Google Scholar 

  45. Rudolph JW, Simon R, Raemer DB, Eppich WJ. Debriefing as formative assessment: closing performance gaps in medical education. Acad Emerg Med. 2008;15(11):1010–6.

    Article  PubMed  Google Scholar 

  46. Edmondson A. Psychological safety and learning behavior in work teams. Adm Sci Q. 1999;44(2):350.

    Article  Google Scholar 

  47. Yeung J, Meeks R, Edelson D, Gao F, Soar J, Perkins GD. The use of CPR feedback/prompt devices during training and CPR performance: a systematic review. Resuscitation. 2009;80(7):743–51.

    Article  PubMed  Google Scholar 

  48. Kirkbright S, Finn J, Tohira H, Bremner A, Jacobs I, Celenza A. Audiovisual feedback device use by health care professionals during CPR: a systematic review and meta-analysis of randomised and non-randomised trials. Resuscitation. 2014;85(4):460–71.

    Article  PubMed  Google Scholar 

  49. Cheng A, Overly F, Kessler D, Nadkarni VM, Lin Y, Doan Q, et al. Perception of CPR quality: influence of CPR feedback, just-in-time CPR training and provider role. Resuscitation. 2015;87:44–50.

    Article  PubMed  Google Scholar 

  50. Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, et al. Pediatric resident resuscitation skills improve after “rapid cycle deliberate practice” training. Resuscitation. 2014;85(7):945–51.

    Article  PubMed  Google Scholar 

  51. Devine LA, Donkers J, Brydges R, Perelman V, Cavalcanti RB, Issenberg SB. An equivalence trial comparing instructor-regulated with directed self-regulated mastery learning of advanced cardiac life support skills. Simul Healthc. 2015;10(4):202–9.

    Article  PubMed  Google Scholar 

  52. Kane MT. Validating the interpretations and uses of test scores. J Educ Meas. 2013;50(1):1–73.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Northwestern University Feinberg School of Medicine, Departments of Surgery and Medical Education, Chicago, IL, USA

    Nabil Issa

  2. Northwestern University Feinberg School of Medicine, Departments of Emergency Medicine and Medical Education, Chicago, IL, USA

    David H. Salzman

  3. Northwestern University Feinberg School of Medicine, Departments of Pediatrics and Medical Education, Chicago, IL, USA

    Mark Adler

Authors
  1. Nabil Issa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David H. Salzman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mark Adler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nabil Issa .

Editor information

Editors and Affiliations

  1. Northwestern University Feinberg School of Medicine, Departments of Medical Education and Preventive Medicine, Chicago, IL, USA

    William C. McGaghie

  2. Northwestern University Feinberg School of Medicine, Departments of Medicine and Medical Education, Chicago, IL, USA

    Jeffrey H. Barsuk

  3. Northwestern University Feinberg School of Medicine, Departments of Medicine and Medical Education, Chicago, IL, USA

    Diane B. Wayne

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Issa, N., Salzman, D.H., Adler, M. (2020). Mastery Learning for Clinical Emergencies. In: McGaghie, W., Barsuk, J., Wayne, D. (eds) Comprehensive Healthcare Simulation: Mastery Learning in Health Professions Education. Comprehensive Healthcare Simulation. Springer, Cham. https://doi.org/10.1007/978-3-030-34811-3_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-34811-3_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-34810-6

  • Online ISBN: 978-3-030-34811-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation