Mastery Learning Improves Simulated Distal Radius Fracture Management by Emergency Medicine Teaching Faculty

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  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.