Simulation in healthcare : journal of the Society for Simulation in Healthcare · 2026
Mastery Learning Improves Simulated Distal Radius Fracture Management by Emergency Medicine Teaching Faculty.
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Pokrajac Nicholas, Gisondi Michael A, Jensen Alexandria, Roszczynialski Kelly N, Preiksaitis Carl, Dixon William
Аннотация
BACKGROUND: Emergency medicine (EM) physicians must be competent in managing distal radius fractures, yet training gaps exist. This study evaluated academic EM physician proficiency in managing a simulated distal radius fracture and the impact of a simulation-based mastery learning (SBML) intervention.
METHODS: We conducted a pretest-posttest study of board-certified or board-eligible EM physicians at a university-based training hospital between August and December 2023. Four trained facilitators assessed participants on distal radius fracture management using a task trainer and a 41-item checklist with a minimum passing standard (MPS) of 37/41 (90.2%). The SBML intervention included baseline assessment, individualized feedback, deliberate practice, and reassessment.
RESULTS: Fifty-one physicians participated in the pretest, with a median score of 32/41 (78.0%) and 10 (19.6%) achieving the MPS initially. Of the 20 participants who completed the posttest, 19 (95%) achieved the MPS after SBML intervention. The intervention resulted in a significant mean score improvement of 8.4 points (95% confidence interval: 6.92-9.78; P < 0.01). Only performing a distal radius fracture reduction in the past year significantly predicted higher pretest performance (3.3 points higher, P = 0.04). Participant comfort with all aspects of distal radius fracture management significantly improved after SBML.
CONCLUSIONS: Academic EM physicians demonstrated performance gaps in distal radius fracture management that were effectively addressed by SBML. Few clinical experience metrics predicted performance, suggesting a need for targeted educational interventions to maintain skills in this important procedural area.
METHODS: We conducted a pretest-posttest study of board-certified or board-eligible EM physicians at a university-based training hospital between August and December 2023. Four trained facilitators assessed participants on distal radius fracture management using a task trainer and a 41-item checklist with a minimum passing standard (MPS) of 37/41 (90.2%). The SBML intervention included baseline assessment, individualized feedback, deliberate practice, and reassessment.
RESULTS: Fifty-one physicians participated in the pretest, with a median score of 32/41 (78.0%) and 10 (19.6%) achieving the MPS initially. Of the 20 participants who completed the posttest, 19 (95%) achieved the MPS after SBML intervention. The intervention resulted in a significant mean score improvement of 8.4 points (95% confidence interval: 6.92-9.78; P < 0.01). Only performing a distal radius fracture reduction in the past year significantly predicted higher pretest performance (3.3 points higher, P = 0.04). Participant comfort with all aspects of distal radius fracture management significantly improved after SBML.
CONCLUSIONS: Academic EM physicians demonstrated performance gaps in distal radius fracture management that were effectively addressed by SBML. Few clinical experience metrics predicted performance, suggesting a need for targeted educational interventions to maintain skills in this important procedural area.