C2B - 03: COMPETENCY-BASED SKILLS ASSESSMENT IN GRADUATING MEDICAL STUDENTS: A MASTERY LEARNING MODULE FOR STERILE TECHNIQUE
Allison A Blumenfeld, BS, Andrew J Velic, BS, Elizabeth K Bingman, MS, Kristin L Long, MD, William D Aughenbaugh, MD, Sarah A Sullivan, PhD, Amy E Liepert, MD; University of Wisconsin School of Medicine and Public Health

Introduction: The educational method of Mastery Learning hold promise for use in Internship Preparatory Course (IPC) modules. Mastery Learning is defined by all learners achieving a predetermined Mastery Standard through deliberate practice and assessment. Achievement of this Mastery Standard may allow for competency certification prior to internship matriculation. We hypothesize that the use of a Mastery Learning Sterile Technique Module during an IPC would lead to 100% of learners achieving Mastery and furthermore, increase learner confidence and decrease learner anxiety during performance of simulated sterile technique.

Methods: 41 graduating medical students entering surgical or emergency medicine internships completed a two-week IPC that included a Mastery Learning Sterile Technique Module. The module included a low fidelity model that learners prepped and draped while demonstrating proper gowning and gloving technique. Learners demonstrated baseline skills with a Pre-test. Over the next 3-5 days, learners watched a didactic online video and participated in supervised deliberate practice sessions. Learners then completed a Post-test. If learners did not achieve Mastery on the Post-test, they received remediation and were retested. Test performance was evaluated by faculty physicians using a Mastery Checklist validated by a panel of multidisciplinary experts.

Immediately after the Pre-test and Post-test, learner anxiety was measured with the Short Form State Anxiety Inventory and learner confidence was measured with the Cato Confidence Scale. Paired t-tests were used to analyze differences in learner confidence and anxiety from Pre-test to Post-test.

Results: Zero of the 41 learners achieved Mastery on the Pre-test. 66%(27) of the learners achieved Mastery on their first attempt of the Post-test. All learners who received remediation (14) achieved Mastery on their second Post-test attempt. 100% of learners achieved Mastery by the completion of the Mastery Module. Comparing Pre-test to first Post-test, learner confidence increased (Mean+SD; 2.96+.71 vs 3.32+.78; p<.001) and anxiety decreased (9.63+4.33 vs 8.63+3.7; p=.084). 

Conclusion: Implementation of a Mastery Learning Module during an Internship Preparatory Course in a large group of graduating medical students is possible. We showed 100% Mastery achievement as well as decreased anxiety and increased confidence while performing simulated sterile technique in our learner population with this method.