29. A Suturing Evolution: From MS1 to Intern Skill Level after 2-week Intervention

Abstract

Background: Suture training is a critical component of the medical school curriculum, serving as the first opportunity to learn proper technique. Commonly students are taught in one-time suturing workshops. However, these workshops are minimally effective, because skill acquisition requires repetitive and deliberate practice over an extended time period. The purpose of this project was to create an at-home, self-directed suture training package consisting of a 3D printed suture pad, instructional videos, and materials. By providing this at-home training package to first year medical students, we hypothesized that their suturing skills would dramatically improve and become equal to the skills of incoming surgical interns. Methods: Our plastic surgery department’s 3D printing lab developed a 10cm x 5cm x 2cm mold. Different textures of silicone were poured into the mold and dyed with pigment to simulate the layers of skin, fat, and muscle. We then created a 20-minute instructional video that covers simple interrupted, horizontal mattress and vertical mattress suturing. Seventeen MS1 students were recruited to participate. On day zero, they completed 3 drills, where they had 10 minutes to complete either simple interrupted, horizontal mattress or vertical mattress sutures. Photos were taken of the final product providing a baseline skill assessment. Students then received our training package (suturing trainer, video, tools and sutures) for 2 weeks. After two weeks they repeated the 3 drills. To serve as a control, 16 general surgery interns completed the same drills. For grading, two surgeons looked at blinded photos and assessed how many “acceptable” sutures were placed for each given drill. This number determined participants’ scores. Results: For all three drills, the students’ baseline scores were worse than the interns. After 2 weeks the students demonstrated statistically significant improvement from their baseline. Additionally, after 2 weeks, the post-intervention students were as good as the interns. Conclusion: We created an at-home suturing training package. By giving MS1 students access to this curriculum for 2 weeks, they improved to the skill level of general surgery interns. This strengthens the argument that suturing skill acquisition requires deliberate practice over an extended period of time.