Effectiveness and Challenges of Mastery Learning in Nursing Education

Seyedeh azam Sajadi, Abbas Ebadi, Morteza Khaghanizadeh


Introduction: As a large part of human resources in the health system, nurses play an important role in promoting public health. One of the ways to provide better health services is training qualified nurses, and mastery learning would be one of the effective educational approaches to realize it. Despite its numerous advantages, the implementation of mastery learning is facing challenges. This study is to examine the effectiveness and the challenges of mastery learning.

Methods: This study is a systematic review with extensive search to find articles from Persian and English databases using the keywords of “education”, “health care research”, “evaluation”, “mastery learning”, “medical education”, and “nursing education” either alone or in combination with each other in the websites of Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, Medline, Embase, PsycINFO, and SID. 138 research papers published from 2005 to 2015 in line with the research question were found. After an examination, 16 articles were included in the study. The data from the articles were summarized, classified and analyzed based on the research question.

Results: Although mastery learning increases the educational effectiveness, its implementation for reasons such as the applicability to some subjects, time consumption, learners’ various individual characteristics, talented students’ lagging behind other learners, frequent formative assessments, and frequent test-designing require more efforts both by the teacher and the learners.

Conclusion: Students raised through this method are competent students having the minimum requirements to perform their duties in the future. Therefore, proper curriculum design, introduction of this approach to teaching institutions and learners, empowerment of teachers, and pilot studies related to the solutions to address its challenges could help in exploiting this approach in theoretical and clinical education.



Mastery Learning, Nursing Education, Competency-Based Education

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farajzadeh Z, Rakhsh Khosid M, Izadpanah A, Saadatjoo S. Factors affecting quality of education from the viewpoint of graduated nurses working in Birjand hospitals, 2012. modern care j. 2014; 11 (3) :196-202. [Persian]

Abedini, S Abedini, T Aghamolaei, A Jomehzadeh, A Kamjoo, The effect of different methods of health education on knowledge, attitudes and practice of female students regarding menstrual hygiene in Bandar Abbas. Hormozgan Medical Journal 2009; 12 (4) :271-279. [Persian]

Damavandi M.E, Shekari Kashani Z. Effect of mastery learning method on performance and attitude of the weak students in chemistry. Procedia Social and Behavioral Sciences 5 (2010); 1574–1579.

Shafie N, Norainun T, Shahdanb T, Liewc M.S. Mastery Learning Assessment Model (MLAM) in Teaching and Learning Mathematics. Procedia Social and Behavioral Sciences. 2010 ; 294–298.

Haghani F, Masoomi R. Overview of learning theories and its applications in medical education. Iranian Journal of Medical Education. 2011; 10 (5) :1188-1197. [Persian]

Bohrangi MR. New patterns of teaching. 8th ed.Golchine. Pub; 2006. [Persian]

Seif A. Assessment of learning processes and products ( Old and New methods). 1th ed. Agah Pub; 2010. [Persian]

Ozden M. Improving Science and Technology Education Achievement Using Mastery Learning Model. World Applied Sciences Journal.2008; 5 (1): 62-67.

Fasihiharandi T, Soltaniarabshahi SK, Tahami SA, Mohammadalizadeh S. Viewpoints of medical students about the quality of clinical education. The journal of Qazvin Univ. of Med. Sci. 2004; 30: 4-9. [Persian].

Anbari Z, Ramezani M. The obstacles of clinical education and strategies for the improvement of quality of education at Arak University of Medical Sciences in 2008. AMUJ 2010; 13(2): 110-118. [Persian]

Baghaei R, Mohammadpour Y, Habibzade H, Rasouli D, Khalilzadeh H, Jafarizadeh H. Competency- Based Mastery Learning: A Planned clinical experience for nursing students . Journal of Nursing and Midwifery Urmia University ofMedical Science. 2011;9(4): 230 – 236. [Persian]

McGaghie WC, Fisichella PM. The science of learning and medical education. Med Educ.2014; 48(2): 106-8.

Shekari Kashani Z, Damavandi ME, Karami Gezafi A. The effect of learning and mastery of attitude , performance and intrinsic motivation of female students in learning chemistry concepts. Novine Journal of Education 2009; 6(2): 155-71. [Persian]

Siadati A. Karbaschi K. The clinical training effect on the recognition, attitude and mastery of nursing students' clinical skills at Islamic Azad University, Varamin Branch. Journal of Health Breez.2012; 1(1): 25-30. [Persian]

Rahmani A, Mohajjel Aghdam A.R, Fathi Azar E, Roshangar F . Comparison the effect of two clinical teaching models on performance of nursing students in intensive care unit.IJNMR 2008; 13(2): 81-86.

Sutton Roberts D, Ingram RR, Flack SA, Jones Hayes R.Implementation of mastery learning in nursing education. J Nurs Educ. 2013 ;52(4):234-7.

Norozi H, mohsenizadeh S, jafary suny H, ebrahimzadeh S. The Effect of Teaching Uning a Blend of Collaborative and Mastery of Learning Models, on Learning of Vital Signs: An Experiment onNursing and Operation Room Students of Mashhad University of Medical Sciences. Iranian Journal of Medical Education. 2011; 11 (5) :544-553. [Persian]

Guskey, T. R. Closing the achievement gap: Revisiting Benjamin S. Bloom’s “learning for mastery.” Journal of Advanced Academics. 2007; 19: 8–31.

Wambugu PW, Changeiywo JM. Effects of Mastery Learning Approach on Secondary School Students’ Physics Achievement. Eurasia Journal of Mathematics, Science & Technology Education, 2008; 4(3): 293-302.

Wayne DB, Butter J, Siddall VJ, Fudala MJ, Wade LD, Feinglass J, McGaghie WC .Mastery Learning of Advanced Cardiac Life Support Skills by Internal Medicine Residents Using Simulation Technology and Deliberate Practice. J Gen Intern Med. 2006;21(3):251-6.

Rahmani A, Mohajjelaghdam A, Fathiazar E, Roshangar F. The Effect of Adapted Model of Mastery Learning on Cognitive and Practical Learning of Nursing Students Iranian Journal of Medical Education, 2008; 7 (2) :267-277 [Persian]

Barsuk JH, Cohen ER, Caprio T, McGaghie WC, Simuni T, Wayne DB. Simulation-based education with mastery learning improves residents' lumbar puncture skills. Neurology. 2012;79(2):132-7.

Patow CA. Medical simulation makes medical education better and safer. Health Manag Technol. 2005 ;26(12): 39-40.

Barsuk JH1, Ahya SN, Cohen ER, McGaghie WC, Wayne DB. Mastery learning of temporary hemodialysis catheter insertion by nephrology fellows using simulation technology and deliberate practice. Am J Kidney Dis. 2009;54(1):70-76.

Wayne DB, Butter J, Siddall VJ, Fudala MJ, Wade LD, Feinglass J, McGaghie WC. Making July safer: simulation-based mastery learning during intern boot cAMP. Acad Med. 2013 Feb;88(2):233-9

Barsuk JH, Cohen ER, Caprio T, McGaghie WC, Simuni T, Wayne DB. Simulation-based education with mastery learning improves residents' lumbar puncture skills. Neurology 2012;79(2):132-7.

Barsuk JH, Cohen ER, McGaghie WC, Wayne DB. Long-Term Retention of Central Venous Catheter Insertion Skills After Simulation-Based Mastery Learning. Acad Med. 2010;85(10 Suppl):S9-12.

Mohd Hasril A, Fathin Liyana Z. The Effects of a Mastery Learning Strategy on KnowledgeAcquisition Among Aboriginal Students: An Experimental Approach. International Journal of Vocational Education and Training Research. 2015; 1(2): 22-26.

Seif A. Educational psychology. 13th ed. Agah Pub; 2005. [Persian]

Gentile JR. Assessing fundamentals in every course through mastery learning. New Directions for Teaching and Learning; 2004(100): 15-20.

Jain S , Nasrin N. Improving Student Achievement through Mastery Learning. Sunanda Jain and Nasrin. Asian Journal of Multidisciplinary Studies, 3(4) April, 2015

Guey C-c, Cheng Y-y, Shibata S. A triarchal instruction model: integration of principles from Behaviorism,Cognitivism, and Humanism. Procedia - Social and Behavioral Sciences. 2010;9:105-118.

Guey C-c, Cheng Y-y, Shibata S. A triarchal instruction model: integration of principles from Behaviorism, Cognitivism, and Humanism. Procedia - Social and Behavioral Sciences. 2010;9:105-118.

ShafeiPour Motlaq F,Yarmohammadian MA. A Model to Evaluate Factors Influencing Perceived Responsive Curriculum in Smart Schools. Research in Curriculum Planning 2011; 2 (28 and 29) :72-83.[Persian]

Kazu I Y, Kazu H, Ozdemir O. The Effects of Mastery Learning Model on the Success of the Students Who Attended “Usage of Basic Information Technologies” Course. Educational Technology & Society 2005, 8 (4), 233-243.

Cook DA, Brydges R, Zendejas B, Hamstra SJ, Hatala R.Mastery learning for health professionals using technology-enhanced simulation: a systematic review and meta-analysis.Acad Med. 2013; 88(8): 1178-86.


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