This month’s journal club, written by Denham Ward, MD, PhD, is a little different – only one page! The November issue of Academic Medicine featured several articles on Mastery Learning. The last page in Academic Medicine (called creatively, “AM Last Page”) is Mastery Learning With Deliberate Practice in Medical Education by William C. McGaghie, PhD, professor of medical education, Jeffrey H. Barsuk, MD, MS, associate professor of medicine, and Diane B. Wayne, MD, vice dean of education and professor of medicine, Northwestern University Feinberg School of Medicine.

Mastery Learning with deliberate practice has been applied most often in medical education using simulation. The basic concept is that all learners in a cohort achieve a predefined level of mastery of a skill and not just learn and practice a skill for a predetermined length of time. The length of time in the Mastery Learning paradigm is the variable not the degree of accomplishment. The concept of Mastery Learning fits well with the current educational imperatives of competencies, milestones and entrustable professional activities (EPAs).

There are several complementary features in Mastery Learning (middle flow chart): A baseline assessment (pretest) to diagnosis the gap between current and mastery performance; a curriculum of educational activities of increasing difficulty focused on predefined outcome based learning objectives; feedback within the curriculum; a posttest requiring learners to meet minimum passing standards (MPS, which can also better stand for mastery passing standards); and advancement to the next educational unit only when MPS is met otherwise continued practice or study on the current unit until the MPS is met.

  • While Mastery Learning has been most often applied in simulation for procedural skills, how do you think it can be applied in other situations?
  • Could this paradigm be useful as a format for teaching and assessing each of the EPAs in your specialty?
  • What problems do you see in implementing a Mastery Learning curriculum within the traditional time-based medical education environment?

For further reading see the cluster of articles in the Nov 2015, vol 90(11) issue of Academic Medicine.

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