This study was one of the few studies in Iran that conducted on the effect of symbolic-based mastery learning on the clinical skills in undergraduate nursing students.
The results of this study indicated that the mean score of skills in the control group before (22.04 ± 1.22) and after the training program (27.29 ± 1.17) was statistically significant (P < 0.05). Also, the mean scores of skills scale in the intervention group before the intervention (25.4 ± 1.27
) and after the intervention (35.4 ± 0.46) were statistically significant (p < 0.05). The results of this study showed that mastery learning is more effective than the traditional method in achieving clinical skills.
For empowering the nursing students, the use of new and practical teaching methods in clinical settings is essential. Also, mastery learning is considered as a new paradigm in medical education . In this study, BSc nursing students educated five basic nursing skills by mastery approach because there is little in nursing literature about the program based on mastery models, especially in clinical applications.
Educators tried the students to acquire the knowledge and skills to become competent nurses, and mastery models developed it.
Barusk reported the implementation of the mastery learning for physical examination skills increased the nursing student's knowledge and skills scores .
He indicated that mastery learning promoted the general competency of the students. The findings of the study by Tang showed mastery learning intervention caused to increase nurses' clinical competencies. . Besides, Schroedl reported the mastery learning method is useful to identify the professional competence of nursing practice .
This finding was in line with the results of the present study. Contrary to other teaching methods, in this method, the instructor knows the deficiencies of the students, and the students know that they have enough time to learn the skills . This method is applicable to establish the criteria for measuring competencies. In this study, acquiring competency was based on skills scale.
Also, This teaching method can be used to determine students' learning needs . According to this study, in each stage of intervention, the instructor identified students’ learning problems and retested him/her. Also, Students who initially fail to demonstrate ability, receive additional opportunities to study and to re-evaluate.
Repeated assessments of students at given intervals caused to improve the quality of education, and the students are active in the learning process .
But, Roberts et al indicated the main challenge of this approach is time-consuming due to the organization of various tests and the high volume of nursing education contents . One of the challenges expressed by the instructor in this study was time-consuming. Also, they stated implementation was challenging with a large number of nursing students and the limitations of the Clinical Skills laboratory facilities.
In another study, Mohd Hasril concluded that Mastery learning strategies compared to traditional mastery models are significantly associated with increased learning in vocational training. Trainees mentioned who have received faster feedbacks are more successful. . In this study, the trainees received their feedback immediately after each skill do. Received feedback by the nursing students caused the student identify his/her deficiencies.
Because of giving the feedback along the teaching process, the students gain the skills of high quality. According to experiences of instructors, some students have anxiety then they receive the feedback. Thus, scientific and psychological support to the students improves their clinical skills. By evaluating this model and examining its strengths and weaknesses, provided a platform for different students to apply it in various educational settings.
This study was done in the nursing department of Kerman University of medical science alone, and this caused limitations to the generalizability of the study data to some extent.
Also, it is suggested that the effect of mastery learning on self-esteem, satisfaction, and competency of students will be assessed.