Simulation-based mastery learning in gastrointestinal endoscopy training

Abstract

Simulation-based mastery learning (SBML) is an emerging form of competency-based training that has been proposed as the next standard method for procedural task training, including that in gastrointestinal endoscopy. Current basic gastrointestinal endoscopy training relies on the number of procedures performed, and it has been criticized for its lack of objective standards that result in variable skills among trainees and its association with patient safety risk. Thus, incorporating simulators into a competency-based curriculum seems ideal for gastrointestinal endoscopy training. The curriculum for SBML in gastrointestinal endoscopy is currently being developed and has promising potential to translate into the clinical performance. Unlike the present apprenticeship model of "see one, do one, teach one," SBML integrates a competency-based curriculum with specific learning objectives alongside simulation-based training. This allows trainees to practice essential skills repeatedly, receive feedback from experts, and gradually develop their abilities to achieve mastery. Moreover, trainees and trainers need to understand the learning targets of the program so that trainees can focus their learning on the necessary skills and trainers can provide structured feedback based on the expected outcomes. In addition to learning targets, an assessment plan is essential to provide trainees with future directions for their improvement and ensure patient safety by issuing a passing standard. Finally, the SBML program should be planned and managed by a specific team and conducted within a developed and tested curriculum. This review discusses the current state of gastrointestinal endoscopy training and the role of SBML in that field.

Keywords: Competency-based education; Curriculum; Education; Endoscopy; Mastery learning; Simulation training.

Figure 1

Stages in simulation-based mastery learning. Simulation-based mastery learning begins with a pretest to assess trainees’ initial knowledge and abilities. Subsequently, trainees will undergo simulation based-training with formative assessment to direct their training. Lastly, trainees will be evaluated for competency through summative assessment (posttest) according to the minimum passing standards. Trainees who pass the test can advance to the next stage of training, while those who do not pass must receive additional training and practice until they meet the minimum passing standards.