Developing and Assessing Mastery Competencies in Physiology

Dr. Benjamin Bloom is most widely remembered for his role in developing and writing The Taxonomy of Educational Objectives (Bloom, 1956) for the cognitive domain. In his later years Bloom shifted his focus to the concept of mastery learning, believing that students who learn only a portion of the required material would be unable to advance appropriately (Bloom, 1974). The concept of mastery has gained a foothold in disciplines where complete comprehension and understanding of the material is needed. For example, this is widely used in the military where fighter pilots are required to master material rather than simply gain a passing score. It would seem that, for the medical student, important concepts in physiology demand this same attention. Medical students who gain a passing score but failed to master basic principles will find it difficult, if not impossible, to develop the more advanced critical skills required when diagnosing and treating a patient’s condition.

Educators must also consider the learning environment when addressing these issues.  In a recent book, The Narcissism Epidemic: Living in the Age of Entitlement, (Twenge & Campbell, 2013) researchers highlighted the inability of students to self-evaluate their knowledge and understanding. Many claimed to know authors, painters, and factual information even though the individuals and events never existed. The authors relate this to the syndrome of, “everyone-gets-a-trophy” mentality where mediocrity is rewarded. Claiming to know the words of the Star-Spangled Banner is easy while seated in the bleachers — performing it solo in the middle of the gym floor is a different matter. Learning to work as part of a medical team is a very important attribute; however, diagnosis and treatment requires competencies including individual critical thinking skills and knowledge.  Just as the Air Force finds it important for a student pilot to achieve mastery — we should require students to master basic competencies before placing patients’ lives in their hands.

Pedagogical techniques such as team-based learning, problem-based learning, and the flipped classroom approach provide opportunities to teach both content and critical thinking skills with a student-centered approach. Enhancing these techniques so that students will have the opportunity to master these important competencies is an essential part of our task as educators. This same logic can be applied to our educational system at all levels. Anders Ericsson’s results have demonstrated that 10 years or 10,000 hours of deliberate practice is required to become an expert.  This strongly suggests that we should stress mastery of important competencies during the K-12 years and continue this focus in undergraduate college courses (Ericsson, 1990).  The importance of emphasizing such learning techniques is reemphasized in the more recent book, Talent is Overrated (Geoff, 2010).

Teaching content specific critical thinking is difficult and assessing mastery is even more challenging—but one worthy of our unified attention. Questions we should answer include:

1) what content and critical thinking skills should be mastered at each level of training?

2) what are the most appropriate pedagogical techniques for each student group?

3) how can we most appropriately assess mastery of these competencies?

Answers to these and related questions will not come easily and small successes will most likely materialize during the journey that will alter the route we take to reach the final destination.  Thus physiology educators and their colleagues in particular need to continue to be working on how to help various levels of students learn competencies and how to assess their mastery.





Herb Janssen received his baccalaureate degree from Midwestern State University. He later was awarded a Masters of Education at Texas Tech University. His doctorate degree in Physiology was obtained at Texas Tech University Health Science Center-Lubbock. After finishing his degree, he became Director of Research in the Department of Orthopaedic Surgery at TTUHSC. His physiology teaching activities have included presentations to students taking undergraduate animal physiology, engineering students, allied health students, medical students, graduate students, residents and fellows.
Herb Janssen’s interest in education started during his undergraduate years where he completed a K-12 teaching certificate. This training proved most useful when he became the assistant chair in orthopedics surgery and was instrumental in designing class activities for the physiology program. Herb remains involved in K-12 education through activities with local school districts. He serves on advisory boards for several health magnet schools in the local area. He also provides presentations to physiology classes in these advanced high schools.
He has received a number of teaching awards from students and colleagues over his teaching career. In 2012 he received the Master Teacher Award from IAMSE and was named the Arthur C Guyton Educator of the Year in 2014.


One thought on “Developing and Assessing Mastery Competencies in Physiology”

Thank you for this blog post Herb. I am sure most of us have experienced students who want the highest scores and assume the material is behind them as they move on to the next chapter. I find this happens often as I teach some physiology principles that were introduced in Principles of Biology to freshman and are then taught at a higher level to juniors and seniors in Animal Physiology. As educators we assume they recall what they learned and can then challenge them to master the information. Yet in reality we often have to backtrack and review before moving forward. I can only hope as we find new ways to present the important material that needs to be built on students will soon acknowledge that they indeed have to master the material not just know it for the test.

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