An education theory-based method to teach a procedural skill.

OBJECTIVE To determine the effectiveness of an education theory-based method to teach students to place and tie a simple interrupted stitch. DESIGN A teaching intervention before-after trial. SETTING Dermatology department, academic university. PARTICIPANTS Fourth-year medical students and dermatology residents. MAIN OUTCOME MEASURES Scores on a 12-criterion grading instrument before and after instruction. RESULTS The scores for medical students and residents in each class showed significant improvement. The mean score for all participants (N = 23) rose by 24% after instruction (P< .001). Scores in 9 of the 12 graded performance areas improved significantly after instruction, including scores in tissue damage/teeth marks (P<.001), needle dulled/bent (P< .001), needle loaded properly and knots square (P = .01), throws done correctly (P = .01), stitch tension and needle entry/exit angle (P = .02), amount of suture used (P = .03), and correct number of throws (P = .04). In addition, participants' confidence increased significantly after instruction (P<.001). No difference was noted between men and women in preinstruction vs postinstruction score improvement. CONCLUSIONS This teaching method can be effectively used to teach students to place and tie a simple interrupted stitch. Once validated and expanded, it may prove useful in shortening and standardizing procedural skill training and in objectively documenting competency.

[1]  J. Hamdorf,et al.  Acquiring surgical skills , 2000, The British journal of surgery.

[2]  W. McGaghie,et al.  Simulation technology for health care professional skills training and assessment. , 1999, JAMA.

[3]  M. Raibert,et al.  Measuring and developing suturing technique with a virtual reality surgical simulator. , 1999, Journal of the American College of Surgeons.

[4]  D A Rogers,et al.  A virtual reality module for intravenous catheter placement. , 1999, American journal of surgery.

[5]  M. Tuggy,et al.  Virtual Reality Flexible Sigmoidoscopy Simulator Training: Impact on Resident Performance , 1998, The Journal of the American Board of Family Medicine.

[6]  J. Sackier Evaluation of technical surgical skills , 1998, Surgical Endoscopy.

[7]  G. Fried,et al.  The effect of practice on performance in a laparoscopic simulator , 1998, Surgical Endoscopy.

[8]  G. Regehr,et al.  Computer-assisted learning versus a lecture and feedback seminar for teaching a basic surgical technical skill. , 1998, American journal of surgery.

[9]  G. Fried,et al.  Development of a model for training and evaluation of laparoscopic skills. , 1998, American journal of surgery.

[10]  R. Steadman,et al.  Patient simulator competency testing: ready for takeoff? , 1998, Anesthesia and analgesia.

[11]  Max D. Miller EDUCATION, TRAINING, AND PROFICIENCY OF PROCEDURAL SKILLS , 1997 .

[12]  R. Reznick,et al.  Testing technical skill via an innovative "bench station" examination. , 1997, American journal of surgery.

[13]  R. Reznick,et al.  Objective structured assessment of technical skill (OSATS) for surgical residents , 1997, The British journal of surgery.

[14]  D. Maclellan,et al.  Formal teaching of basic surgical skills. , 1995, The Australian and New Zealand journal of surgery.

[15]  F. Ling,et al.  COMPUTER‐ASSISTED VIDEO EVALUATION OF SURGICAL SKILLS , 1995, Obstetrics and Gynecology.

[16]  H Leclère,et al.  Learning surgical technical skills. , 1995, Canadian journal of surgery. Journal canadien de chirurgie.

[17]  H. Ellis Teaching surgeons to stitch. , 1993, The Australian and New Zealand journal of surgery.

[18]  A A Giachino,et al.  Objective comparison of manual dexterity in physicians and surgeons. , 1989, Canadian journal of surgery. Journal canadien de chirurgie.

[19]  B. Goldstein,et al.  The use of live pigs in the surgical training of dermatology residents. , 1989, The Journal of dermatologic surgery and oncology.

[20]  S. Seki Techniques for better suturing , 1988, The British journal of surgery.

[21]  S. Seki,et al.  Accuracy of suture placement , 1987, The British journal of surgery.

[22]  A. L. Schueneman,et al.  Neuropsychologic predictors of operative skill among general surgery residents. , 1984, Surgery.

[23]  T. Tromovitch Beginning dermatologic surgery: an essay. , 1975, The Journal of dermatologic surgery.

[24]  J. Kopta,et al.  An approach to the evaluation of operative skills. , 1971, Surgery.

[25]  Boyle De,et al.  Tie and suture training board. , 1968 .

[26]  J. Sackier Evaluation of technical surgical skills. Lessons from minimal access surgery. , 1998, Surgical endoscopy.

[27]  M. Miller,et al.  Office procedures. Education, training, and proficiency of procedural skills. , 1997, Primary care.

[28]  A. Lossing,et al.  A prospective controlled trial of teaching basic surgical skills with 4th year medical students. , 1992, Medical teacher.

[29]  D. E. Boyle,et al.  Tie and suture training board. , 1968, Surgery.