Shifting the Curve: Mastery Learning to Teach Nerve Conduction Studies in PM&R Residency

Abstract

Nerve conduction studies (NCS) are a commonly performed procedure and a core competency for Physical Medicine and Rehabilitation (PM&R) residents. Nerve conduction studies are complex to learn and no standardized training protocols exist across PM&R programs. The aim of this study is to standardize training and assessment of resident proficiency in NCS skills and to evaluate the impact of an educational intervention on skills development. This was a repeated measures design wherein 36 PM&R residents underwent a pretest, followed by a mastery-learning-based intervention, including deliberate practice. Residents were then expected to meet or exceed a minimum passing score at post-test. Performance improved from a median score of 4.5/66 on the pretest to a median score of 63/66 on the posttest. 33/36 residents achieved the minimum passing score on the first attempt; three residents required additional deliberate practice and met the minimum passing score on the second attempt. A curriculum featuring deliberate practice dramatically increased checklist scores of residents performing NCS. This mastery learning program shows a reliable and reproducible method to achieve procedural competency within a PM&R residency program and can shift the curve to allow residents to immediately start performing NCS at the start of their clinical experience.