• LoRanée Braun, Taylor Sawyer, Kathleen Smith, Angela Hsu, Melinda Behrens, Debora Chan, Jeffrey Hutchinson, Downing Lu, Raman Singh, Joel Reyes, and Joseph Lopreiato.
• 1Madigan Army Medical Center, Tacoma, WA. 2Tripler Army Medical Center, Honolulu, HI. 3Walter Reed National Military Medical Center, Bethesda, MD. 4San Antonio Uniformed Services Health Education Consortium, San Antonio, TX.
• Pediatr Crit Care Me. 2015 Feb 1; 16 (2): 131-8.

ObjectivesUsing simulation-based mastery learning, residents can be trained to achieve a predefined performance standard in resuscitation. After mastery is achieved, performance degradation occurs over time. Prior investigations have shown performance retention of 12-14 months following intensive simulation-based mastery learning sessions. We sought to investigate the duration of mastery-level resuscitation performance retention after a single 1- to 2-hour simulation-based mastery learning session.DesignRandomized, prospective trial.SettingMedical simulation laboratory.SubjectsConvenience sample of 42 pediatric residents.InterventionsBaseline resuscitation performance was determined on four standardized simulation scenarios. After determination of baseline performance, each resident repeated each scenario, as needed, until mastery-level performance was achieved. Residents were then randomized and retested 2, 4, or 6 months later. Statistical analysis on scores at baseline and retesting were used to determine performances changes from baseline and performance retention over time.Measurements And Main ResultsForty-two residents participated in the study (12 in 2 mo group, 14 in 4 mo group, and 16 in 6 mo group). At baseline, postgraduate year-3 residents performed better than postgraduate year-1 residents (p = 0.003). Overall performance on each of the four scenarios improved at retesting. The percent of residents maintaining mastery-level performance showed a significant linear decline (p = 0.039), with a drop at each retesting interval; 92% retained mastery at 2 months, 71% at 4 months, and 56% at 6 months. There was no difference in retention between postgraduate year-1, postgraduate year-2, and postgraduate year-3 residents (p = 0.14).ConclusionsResidents displayed significant improvements in resuscitation performance after a single simulation-based mastery learning session, but performance declined over time, with less than 60% retaining mastery-level performance at 6 months. Our results suggest that relatively frequent refresher training is needed after a single simulation-based mastery learning session. Additional research is needed to determine the duration of performance retention following any specific simulation-based mastery learning intervention.

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