Making july safer: Simulation-based mastery learning during intern boot camp

Elaine R. Cohen, Jeffrey H. Barsuk, Farzad Moazed, Timothy Caprio, Aashish Didwania, William C. McGaghie, Diane B. Wayne*

*Corresponding author for this work

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Purpose: Patient care quality worsens during academic year turnover. Incoming interns' uneven clinical skills likely contribute to this phenomenon, known as the "July effect." The aim of this study was to evaluate the impact of a simulation-based mastery learning (SBML) boot camp on internal medicine interns' clinical skills. METHOD: This was a cohort study of an SBML intervention at Northwestern University. In 2011, 47 interns completed boot camp; 109 interns (from 2009 and 2010) who did not participate in boot camp were historical controls. Boot-camp-trained interns participated in three days of small-group teaching sessions, deliberate practice, and individualized feedback. Primary outcome measures were performance of boot-camp-trained interns and historical controls on five parts of a clinical skills examination (CSE). Assessments included recognition of physical examination findings (cardiac auscultation), performance of procedures (paracentesis and lumbar puncture), management of critically ill patients (intensive care unit skills), and communication with patients (code status discussion). Boot camp participants were required to meet or exceed a minimum passing standard (MPS) before beginning their internship. RESULTS: Boot-camp-trained interns all eventually met or exceeded the MPS and performed significantly better than historical control interns on all skills (P < .01), even after controlling for age, gender, and USMLE Step 1 and 2 scores (P < .001). The authors detected no relationship between CSE scores and age, gender, prior experience, self-confidence, or USMLE Step 1 and 2 scores. CONCLUSIONS: An SBML boot camp allows for individualized training, assessment, and documentation of competence before interns begin providing medical care.

Original languageEnglish (US)
Pages (from-to)233-239
Number of pages7
JournalAcademic Medicine
Volume88
Issue number2
DOIs
StatePublished - Feb 2013

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Clinical Competence
Learning
examination
simulation
learning
Patient Care
Heart Auscultation
internship
gender
self-confidence
Paracentesis
turnover
patient care
medical care
small group
Spinal Puncture
performance
documentation
Internship and Residency
Internal Medicine

ASJC Scopus subject areas

  • Education

Cite this

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abstract = "Purpose: Patient care quality worsens during academic year turnover. Incoming interns' uneven clinical skills likely contribute to this phenomenon, known as the {"}July effect.{"} The aim of this study was to evaluate the impact of a simulation-based mastery learning (SBML) boot camp on internal medicine interns' clinical skills. METHOD: This was a cohort study of an SBML intervention at Northwestern University. In 2011, 47 interns completed boot camp; 109 interns (from 2009 and 2010) who did not participate in boot camp were historical controls. Boot-camp-trained interns participated in three days of small-group teaching sessions, deliberate practice, and individualized feedback. Primary outcome measures were performance of boot-camp-trained interns and historical controls on five parts of a clinical skills examination (CSE). Assessments included recognition of physical examination findings (cardiac auscultation), performance of procedures (paracentesis and lumbar puncture), management of critically ill patients (intensive care unit skills), and communication with patients (code status discussion). Boot camp participants were required to meet or exceed a minimum passing standard (MPS) before beginning their internship. RESULTS: Boot-camp-trained interns all eventually met or exceeded the MPS and performed significantly better than historical control interns on all skills (P < .01), even after controlling for age, gender, and USMLE Step 1 and 2 scores (P < .001). The authors detected no relationship between CSE scores and age, gender, prior experience, self-confidence, or USMLE Step 1 and 2 scores. CONCLUSIONS: An SBML boot camp allows for individualized training, assessment, and documentation of competence before interns begin providing medical care.",
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Making july safer : Simulation-based mastery learning during intern boot camp. / Cohen, Elaine R.; Barsuk, Jeffrey H.; Moazed, Farzad; Caprio, Timothy; Didwania, Aashish; McGaghie, William C.; Wayne, Diane B.

In: Academic Medicine, Vol. 88, No. 2, 02.2013, p. 233-239.

Research output: Contribution to journalArticle

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AU - Cohen, Elaine R.

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AU - McGaghie, William C.

AU - Wayne, Diane B.

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