Mastery Learning and the Forgetting curve

When the learner becomes the master how long does it last?

A focus of mastery learning is to enhance learning, with a goal or minimising variations due to learning styles and rates, i.e. 'asynchronous learning', targeting specific and measurable behaviours facilitating feedback and feed-forward mechanisms. The goals of this are to a develop a more positive learning culture and boosting learner confidence.

Core principles include:

  1. Initial testing of target skills

  2. Defined / specific learning objectives

  3. Share appropriate learning resources for engagement to help reach objectives

  4. Decide minimal passing grades for each objective

  5. Provide immediate feedback to learners testing minimal passing grade defined

  6. Demonstrate proficiency before progressing further through curriculum

  7. Consider repetition/reinforcement as required until achieved

  8. Repeat assessment as needed until mastery achieved

  9. Time for the above may vary but the outcomes will be uniform (while a positive it is also a negative)

This follows the premise of deliberate practice with requires highly motivated learners with good concentration and engagement with a task which is appropriate difficulty to allow focused, repetitive practice allowing mastery learning to occur to provide constant improvement. But the key caution being that repetition for repetition sake is pointless, repetition with deliberate practice towards a goal with specific targets and change results in greater change.

Mastery learning is dependent on multiple elements including:
Healthcare System - Curriculum Integration - Instructor Training - Learner Motivations - Training Resources
If any of the above elements is sub-optimal, the intervention will have a lesser impact.

So why Mastery learning and deliberate, repetitive practice? That comes down to the challenges of the combating the 'Forgetting Curve'

The premise for this is that any intervention / learning event will be more difficult to recall in the following days, however, it becomes easier when the information is built upon pre-existing knowledge & skills, and therefore repetition helps to maker the memory stronger.

More learning resources are available below:


  1. Simulation, Mastery Learning and Healthcare -

  2. Simulation-Based Mastery Learning Improves Medical Student Performance and Retention of Core Clinical Skills -

  3. Mastery Learning: A Paradigm Shift in Health Professions Education -

  4. Simulation in healthcare education: A best evidence practical guide. AMEE Guide No. 82 -

  5. Mastery Learning in Medical Simulation -

  6. Mastery Learning - It Is Time for Medical Education to Join the 21st Century -

  7. The promise and challenge of mastery learning -

  8. The Mastery Learning Medical Education Pathway -

  9. Mastery Learning with Deliberate Practice in Medical Education -

  10. What is the Forgetting Curve -

  11. How to Learn Effectively in Medical School: Test Yourself, Learn Actively, and Repeat in Intervals -

  12. A steep 'forgetting' curve -

  13. LITFL - Learning by Spaced Repetition -


  15. Replication and Analysis of Ebbinghaus’ Forgetting Curve -

  16. Learning curves and long-term outcome of simulation-based thoracentesis training for medical students -

  17. Cornell versus Ebbinghaus: