In modern medical education, strategies are shifting toward outcome-oriented models, with the objective of cultivating medical professionals with high clinical competence[8]. This transition is supported by policy documents such as the State Council's Opinion on Deepening Medical Education Collaboration and Further Promoting Medical Education Reform and Development, which emphasizes the importance of deepening medical education system reform and specifies the requirements for improving medical students' ability to solve practical clinical problems. Faced with this challenge, a consensus is emerging in contemporary medical education: it is crucial to introduce medical students to clinical practice earlier and to do so more efficiently[9, 10]. The transition from basic theoretical learning to clinical apprenticeship marks a shift in medical identity, which for students is often rapid, challenging, and may even involve a loss of direction[11, 12]. However, the optimal timing for medical students to start clinical exposure and the most effective methods to use to learn and improve clinical skills remain unanswered questions[13]. Various medical schools are exploring solutions through practical experience, but there is still a lack of sufficient scientific research support in this field.
Nanjing Medical University's integrated clinical medicine program (Tianyuan Class) is designed for students with exceptional learning and comprehension abilities in clinical specialties. However, as indicated by the pretest results, even Tianyuan Class students exhibit various errors when facing complex real clinical scenarios and issues with aseptic technique operations. Using Tianyuan Class students as research subjects, this study designed a simulated course module content and teaching plan titled "Basic Aseptic Operation Pass-through Practice" to explore the construction of a mastery learning course based on simulation, focusing on addressing the "transition crisis" between the early clinical learning stage and the clinical training stage for medical students. The results of two posttests showed that the aseptic technique training course based on mastery learning enabled all 29 interns to master the aseptic technique training.
Mastery learning is an educational strategy of which the ultimate goal is to ensure that all learners achieve the same level of skill mastery, not only reaching the allowable competency level within the set training time but also involving repeated deliberate practice until all learners reach the predetermined competency level (with the addition of requirements regarding the minimum standard for passing)[3, 14]. In mastery learning, continuous feedback and assessment are crucial for interns to understand and correct errors[15]. Teachers provide timely, specific feedback to help interns understand areas in which they excel and those in which they need improvement. Incorporating techniques such as video demonstrations and simulation training into the course helps interns better understand and simulate aseptic technique operations, ensuring that each intern has sufficient practical opportunities to apply the knowledge learned in actual clinical practice. Additionally, by analyzing real cases and conducting scenario simulations, teachers can enable interns to apply theoretical knowledge to practice and understand the importance and application of aseptic techniques in actual clinical settings. Furthermore, teamwork plays an important role in aseptic technique learning. Through group discussions and peer assessments, knowledge and skills are shared, allowing interns not only to learn from others but also to practice communication and collaboration skills in a team environment, which are crucial for successful teamwork in future clinical settings.
This course module emphasizes the application of mastery learning in aseptic technique training, which means that teaching should focus not only on imparting theoretical knowledge but also on practical skill development. Teachers should design step-by-step learning modules to ensure that each intern fully masters each step before proceeding to the next learning stage. Furthermore, this course module is low-cost, easy to replicate, and effective, providing a bridge for medical students from the early clinical learning stage to the clinical training stage. This module can be adapted to many different groups of medical students, serve as a prerequisite for other medical simulation education modules that require correct use of aseptic techniques, and it can also be used in residency training programs to help interns transition to the resident stage and adapt to new environments.
The aseptic technique training course based on mastery learning mainly demonstrates the following effects: (1) enhancing students' grasp of aseptic concept: after adopting teaching practices based on mastery learning, repeated stimulation and feedback in the process of deliberate practice quickly transform students' theoretical understanding of aseptic principles into a framework that may be applied to practical thinking; (2) deepening students’ understanding of aseptic principles: as a basic norm for surgical operations, aseptic principles pervade every clinical scenario, and simulating actual clinical environments helps students understand theoretical knowledge; and (3) increasing classroom interest and cultivating a habit of active inquiry: traditional teaching is often rigid and dull, involving low levels of student interest and shallow memorization processes, while this teaching method reduces the distance between teachers and students, attracting student attention, stimulating the desire for active inquiry, encouraging active thinking and problem solving in the interactive process, and cultivating the ability for autonomous learning.