Retention of pediatric resuscitation performance after a simulation-based mastery learning session: a multicenter randomized trial

Pediatr Crit Care Med. 2015 Feb;16(2):131-8. doi: 10.1097/PCC.0000000000000315.


Objectives: Using 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.

Design: Randomized, prospective trial.

Setting: Medical simulation laboratory.

Subjects: Convenience sample of 42 pediatric residents.

Interventions: Baseline 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 results: Forty-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).

Conclusions: Residents 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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analysis of Variance
  • Clinical Competence*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Internship and Residency / methods*
  • Logistic Models
  • Male
  • Pediatrics / education*
  • Prospective Studies
  • Resuscitation*
  • Retention, Psychology*
  • Time Factors
  • United States