From the Guidelines
To effectively modulate skill acquisition in medical education, I recommend implementing a simulation-based mastery learning program that incorporates deliberate practice, feedback, and evaluation to reach a mastery standard, as this approach has been shown to improve clinical performance and reduce adverse events 1.
Key Components of Simulation-Based Mastery Learning
- Deliberate practice with focused, repetitive practice sessions
- Rigorous, precise measurements and informative feedback from educational sources
- Monitoring, correction of errors, and more deliberate practice
- Evaluation to reach a mastery standard
- Advancement to another task or unit upon achieving mastery
Simulation Methods
- Living anesthetised animals, human cadavers, or low-fidelity manikins can be used for simulation training
- Cadaver simulation may be more realistic and effective in terms of learners' confidence and competence acquisition 1
- Commercially available manikins can also be used, but may be more costly
Benefits of Simulation-Based Mastery Learning
- Improves clinical performance and reduces adverse events 1
- Enhances learners' confidence and competence acquisition
- Allows for deliberate practice and feedback, which are essential for skill acquisition
- Can be tailored to individual learners' needs and abilities
Implementation
- Begin with a needs assessment to identify the skills and knowledge that need to be acquired
- Develop a simulation-based mastery learning program that incorporates deliberate practice, feedback, and evaluation
- Use a variety of simulation methods to promote adaptability and realism
- Provide immediate feedback and adjust the program as needed to ensure that learners are meeting the mastery standard
- Continuously evaluate and improve the program to ensure that it is effective in improving clinical performance and reducing adverse events 1
From the Research
Modulating Skill Acquisition in Medical Education
The process of modulating skill acquisition in medical education involves several key elements, including:
- The use of knowledge representation with pre- and postconditions attached to actions, as seen in the model introduced by 2
- The provision of instructions that explicitly state pre- and postconditions, which can lead to better and more robust performance, especially on problems that require transfer 2
- The timing of differential reinforcement, with research suggesting that delayed onset of differential reinforcement may be more efficient in skill acquisition 3
- The importance of practice quality, optimising challenge, and assessing learning in enhancing skill acquisition 4
- A multifaceted approach to career and professional development training, including one-on-one career counseling, peer-to-peer learning workshops, and community partnerships 5
Key Factors in Skill Acquisition
Some key factors that can influence skill acquisition in medical education include:
- The integration and reuse of previously known component skills, which can facilitate the acquisition of new skills 6
- The use of indexicals to reference and share necessary information across knowledge components 6
- The provision of a framework for advancing skill acquisition, such as the SAFE (Skill Acquisition for Excellence) framework 4
- The importance of individual differences, practice conditions, and instructions in shaping skill acquisition 4
Implications for Medical Education
The findings of these studies have implications for medical education, including:
- The need for instructors to provide clear and explicit instructions that facilitate the integration and reuse of previously known component skills
- The importance of optimising challenge and practice quality in enhancing skill acquisition
- The potential benefits of a multifaceted approach to career and professional development training
- The need for further research on the timing of differential reinforcement and its effects on skill acquisition in medical education 3