Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2006 Mar;21(3):251-6.
doi: 10.1111/j.1525-1497.2006.00341.x.

Mastery learning of advanced cardiac life support skills by internal medicine residents using simulation technology and deliberate practice

Diane B Wayne  1 , John Butter, Viva J Siddall, Monica J Fudala, Leonard D Wade, Joe Feinglass, William C McGaghie
Affiliations
Multicenter Study

Mastery learning of advanced cardiac life support skills by internal medicine residents using simulation technology and deliberate practice

Diane B Wayne et al. J Gen Intern Med. 2006 Mar.

Abstract

Background: Internal medicine residents must be competent in advanced cardiac life support (ACLS) for board certification.

Objective: To use a medical simulator to assess postgraduate year 2 (PGY-2) residents' baseline proficiency in ACLS scenarios and evaluate the impact of an educational intervention grounded in deliberate practice on skill development to mastery standards.

Design: Pretest-posttest design without control group. After baseline evaluation, residents received 4, 2-hour ACLS education sessions using a medical simulator. Residents were then retested. Residents who did not achieve a research-derived minimum passing score (MPS) on each ACLS problem had more deliberate practice and were retested until the MPS was reached.

Participants: Forty-one PGY-2 internal medicine residents in a university-affiliated program.

Measurements: Observational checklists based on American Heart Association (AHA) guidelines with interrater and internal consistency reliability estimates; deliberate practice time needed for residents to achieve minimum competency standards; demographics; United States Medical Licensing Examination Step 1 and Step 2 scores; and resident ratings of program quality and utility.

Results: Performance improved significantly after simulator training. All residents met or exceeded the mastery competency standard. The amount of practice time needed to reach the MPS was a powerful (negative) predictor of posttest performance. The education program was rated highly.

Conclusions: A curriculum featuring deliberate practice dramatically increased the skills of residents in ACLS scenarios. Residents needed different amounts of training time to achieve minimum competency standards. Residents enjoy training, evaluation, and feedback in a simulated clinical environment. This mastery learning program and other competency-based efforts illustrate outcome-based medical education that is now prominent in accreditation reform of residency education.

PubMed Disclaimer

References

    1. American Board of Internal Medicine. Requirements for certification in internal medicine. [July 7, 2005]. Available at http://www.abim.org/cert/policiesim.shtm#6.
    1. Cummins RO, Sanders A, Mancini E, Hazinski MF. In-hospital resuscitation: a statement for healthcare professionals from the American Heart Association Emergency Cardiac Care Committee and the Advanced Cardiac Life Support, Basic Life Support, Pediatric Resuscitation, and Program Administration Subcommittees. Circulation. 1997;95:2211–2. - PubMed
    1. Kaye W, Mancini ME, Rallis SF. Advanced cardiac life support refresher course using standardized objective-based mega code testing. Crit Care Med. 1987;15:55–60. - PubMed
    1. O'Steen DS, Kee CC, Minick MP. The retention of advanced cardiac life support knowledge among registered nurses. J Nurs Staff Dev. 1996;12:66–72. - PubMed
    1. Moser DK, Dracup K, Guzy PM, Taylor SE, Breu C. Cardiopulmonary resuscitation skills retention in family members of cardiac patients. Am J Emer Med. 1990;8:498–503. - PubMed

Publication types