A Simple Curriculum for Teaching Transfixion Stitches Using a Low-Fidelity Model and Following Gagne's Instructional Design [ID: 1377582

Abstract

INTRODUCTION: Surgical training is often carried out through observation and practice in the clinical setting. Gagne's model of instructional design is an organized method of teaching motor skills. The purpose of the study is to evaluate the feasibility and effectiveness of using Gange's model to improve surgical knowledge on transfixation stitches used during hysterectomy on a low-fidelity pelvic model trainer. METHODS: A simple teaching curriculum for transfixation stitches was developed following Gange's model. A thought-provoking clinical vignette was presented and followed by clear learning objectives. Prerequisite knowledge was tested using a quiz. Stimulus material included relevant anatomy, instruments used in a hysterectomy, and steps of an abdominal hysterectomy. Learning guidance was provided in the form of diagrams and videos of various transfixation stitches. Learners practiced on low-fidelity pelvic models with supervision by faculty members. At the end, learners repeated the knowledge test and provided feedback. Comparisons were made between pretest and posttest scores using Fisher exact test and chi-square test as appropriate for nominal variables, and Mann-Whitney test for continuous variables. RESULTS: The simulation was performed by 18 participants (n=18). There was significant improvement in test scores after completing the simulation (59.6±21.8% versus 89.3±9.7%, P<.0001). Additionally, the number of transfixation stitches each learner was familiar with increased significantly after the simulation (0 interquartile range [IQR] [0–1] versus 4 IQR [2–4], P<.0001). CONCLUSION: These findings suggest that using Gagne's model of instructional design on a low-fidelity pelvic model trainer in a low-stress environment can help improve surgical skill education. Our experience demonstrates that simulation training can be organized without much time or resource and help build lasting surgical skills.