Mastery: The foundation of clinical competence

Patricia Green, Tracy L. Nielson, Joanna Bishop

Research output: Contribution to conferencePresentationEducationpeer-review


Historically, students undergo assessment of procedural skills (e.g., indwelling catheterisation, IV cannulation, IM
injection) during OSCE examinations. OSCE format however, provides limited sampling from the programmatic
blueprint and restricts the number of skills assessed each pre-clinical year of the medical curricula. We wanted to
ensure all students were competent in all procedures prior to their clinical years of training.
We undertook a mastery approach to teaching procedural skills. Mastery was defined as a level of expected
proficiency (and safety), such that students undertook continual assessment (at a pass or fail level) to
demonstrate achieved ‘mastery’. Assessment involved demonstration of skill proficiency using 1:1 simulated
patient encounters with written (i.e., checklist, anecdotal etc) and oral feedback provided by experienced tutors.
We established this mastery approach to teaching procedural skills during 2013 in our medical program, and less
than 2% of students have required repeat attempts to demonstrate skill proficiency. Further, students have
reported that mastery assessments are less stressful than OSCE, and the personalised approach to teaching
makes them feel competent and more confident.
Mastery approach to procedural skills provides a collaborative approach to teaching, learning and assessment
and ensures students are confident and proficient with procedural skills prior to clinical placements.
Take-home message:
The mastery approach to teaching procedural skills provides consistent and transparent assessment processes
and encourages collaboration rather than competition.
Original languageEnglish
Number of pages1
Publication statusPublished - 2016
EventThe 17th Ottawa Conference and the ANZAHPE 2016 Conference - Perth Exhibition and Conference Centre, Perth, Australia
Duration: 19 Mar 201623 Mar 2016
Conference number: 17th


ConferenceThe 17th Ottawa Conference and the ANZAHPE 2016 Conference
OtherThe continuum of healthcare professions education and assessment will be addressed, with sessions covering undergraduate, postgraduate and continuing education. The Conference provides the opportunity to focus on developments in the assessment of competence in medicine and the healthcare professions internationally by following the Ottawa streams, or to look more generally at education in the healthcare professions by following the ANZAHPE streams. All participants will have the opportunity through one joint registration to attend sessions in either stream depending on their interests and needs.

In this period of economic rationalisation of resources, increasing demands on healthcare delivery and the required provision of evidence of best utilisation of finite resources to deliver health care, what should be our expectations of our trainees and health professionals in the workplace? How can we promote and share best practice in education, in assessment and in the evaluation of our training programmes? The Conference will provide ample opportunities to present and exchange ideas and concepts with colleagues from across the world.
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