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Does simulation-based mastery learning for residents related to obstetric hemorrhage improve their knowledge and retention?

Objective: To estimate the effectiveness of a state mandated obstetric hemorrhage program and deliberate practice in improving residents’ knowledge acquisition and retention.

Study Design: 23 residents (12 Ob/Gyn and 11 family medicine) were given a 25-question test designed by the state to assess knowledge of obstetrical hemorrhage management (pre-test). This was followed by one hour of didactic education and a half-hour of simulation training. A post-test consisting of the same 25 questions was given immediately afterward and 6 months later. A criterion of 21 correct answers defined mastery according to a standard-setting procedure. Residents who failed to achieve this were given electronic access to the initial didactic material and re-tested at weekly intervals until they achieved mastery level. All residents were encouraged to review the curriculum and practice skills.

Results: Immediate post-test scores improved compared with pre-test scores (20.1 vs. 16.4, p = 0.0001), with eleven residents (48%) achieving mastery. Nine out of the 12 remaining residents (75%) reached mastery level within 3 attempts. At final 6-month assessment, knowledge acquired initially was not diminished (20.7 vs. 20.1, p = 0.54), and the residents who achieved mastery and engaged in deliberate practice scored higher, though this was not statistically significant (20.9 vs. 18.7, p = 0.43).

Conclusion: Completion of a state mandated didactic and simulation program and the opportunity for deliberate practice are associated with sustained improvements in the obstetrical hemorrhage knowledge of Ob/Gyn and family practice residents.

Topics: 2013, Resident, Residency Director, Residency Coordinator, Patient Care, GME, Simulation, Standardized Patient, Maternal-Fetal Medicine,