Simulation‐based mastery learning for intrathecal baclofen pump management in physical medicine and rehabilitation: A pilot study

Abstract

AbstractBackgroundSimulation‐based mastery learning (SBML) has demonstrated superiority as a procedural learning method. Implementation of SBML in Physical Medicine and Rehabilitation (PM&R) education has not been described and there is a paucity of literature regarding standardized procedural learning in this specialty.ObjectiveTo evaluate if implementation of intrathecal baclofen pump management SBML affects knowledge, attitudes, and skills in PM&R residents.DesignPretest–posttest design.SettingAcademic rehabilitation hospital.ParticipantsTwenty‐two PM&R residents.InterventionsParticipants engaged in SBML steps: pre‐test, demonstration of proper technique, deliberate practice, and a post‐test.Main Outcome MeasuresAbility to achieve minimum passing score, quiz scores, and survey scores. Pre‐ and post‐test results were compared using Wilcoxon signed‐rank tests. Post graduate year (PGY)‐3 and PGY‐4 resident results were compared using Mann–Whitney U tests.ResultsBased on institutional expert consensus, a simulation procedural checklist was created with a minimum passing score set at correctly performing 30 of 31 items. On pre‐test, no learners achieved the minimum passing score (22.5, interquartile range [IQR] 17.0–23.0). Initial post‐test score for all learners was 30 (IQR 29.8–31.0). Six learners required additional attempts to reach mastery as defined by reaching the minimum passing score. Quiz scores significantly improved from 9 to 11 (pre‐test IQR 9–10; post‐test IQR 10–11; p < .05). Confidence in procedure significantly improved (pre‐test 2.7/5.9, IQR 2.2–3.8; post‐test 4.1/5.0, IQR 3.7–4.5; p < .01). Likelihood to perform procedure in future practice did not change (pre‐test 2.2, IQR 1.0–3.8; post‐test 3.0, IQR 1.0–4.0; p = .89).ConclusionSBML is an effective tool to improve multiple domains of learning in PM&R residents.