The Development and Validation of an Analytical Training Program for Medical Suturing

Abstract

As a result of experimental evidence on skills acquisition of industrial and dental tasks, the concept of utilizing analytical training methods in psychomotor medical education was investigated in this study on “everting square suture” technique used in plastic surgery procedures. Based on attitude questionnaires and film analysis, three simulation training models were developed and compared as to training effectiveness against the “traditional” training method (practice on a pig's foot) currently in use at a number of Medical Schools. The three proposed training models consisted of: 1. Electromechanical training simulator using the progressive parts training method. 2. Perceptual training through film viewing and fault analysis. 3. The combination of (1) and (2) above. Thirty-six medical students with no prior exposure to wound closure techniques participated as subjects. These students were randomly divided into four groups (three experimental and one control). Intergroup comparisons were attained by having subjects from the experimental groups, subsequent to training, practice on porcine skin by placing 35 sutures similar to that of the traditional group. Time, quality, heart rate variability, chin-EMG, neck-EMG and plantar skin conductance data were collected throughout the task and used as evaluation measures. Results indicate that: 1. All three experimental training methods provided for significantly better quality performance levels (from 14.2 to 177.1 percent better) than the traditional training group. Group 1 attained the highest results. 2. The subjects on the experimental traininggroup had briefer training time (ranging between 1.4 to 3.1 times less) than the “traditional” group. 3. The subjects in the experimental training groups had less psychophysiological stress during task performance than did the subjects in the conventional training group.