An Effective, Low Cost, Do-it-Yourself Suture and Knot Tying Training Kit for the Novice Learner

Abstract

Introduction Too Err is Human: Building a Safer Health System is a seminal report that highlights how improved training and objective assessment are key to reducing medical errors. The purpose of this study is to design a low cost, do-it-yourself (DIY) suture and knot tying training kit that enhances the novice learner’s basic surgical skills and to evaluate the efficacy of this training kit. Materials and Methods: Pre-medical and medical students from the University of Hawaii were administered a pretest to evaluate their two-handed knot tying and simple interrupted suturing with instrument tie using an objective scoring system. Then, subjects were shown an instructional video and allowed to practice using a low-cost, DIY training kit. A posttest was administered in the same format as the pretest. The primary outcome was subject confidence level, and secondary outcomes were time and quality of suturing and knot tying. Results: 20 subjects were recruited. After using the training kit, mean confidence levels increased for two-handed knot tying (1.55 vs. 7.15, p<0.0001), suturing (1.75 vs. 6.95, p<0.0001), and instrument tie (1.50 vs. 6.95, p<0.0001). Mean time to complete two-handed knot tying (116.03 vs. 52.85 seconds, p<0.0001) and simple interrupted suturing with instrument tie (300.00 vs. 181.05 seconds, p<0.0001) both decreased. Mean quality of both knot tying (0 vs. 4.25, p<0.0001) and simple interrupted suturing with instrument tie (0 vs. 13.1, p<0.0001) increased. Conclusions: This low-cost, DIY suture and knot tying training kit increased the confidence and basic surgical skills of the novice learner.