Teaching the Simple Suture to Medical Students for Long-term Retention of Skill
Teaching the Simple Suture to Medical Students for Long-term Retention of Skill
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DOI：
10.1001/jamadermatol.2015.118
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发表时间：
2015-07-01
期刊：
影响因子：
10.9
通讯作者：
Levitt, Jacob
中科院分区：
文献类型：
--
作者：
Routt, Ethan;Mansouri, Yasaman;Levitt, Jacob
重要性 简单缝合技术的教学方法差异很大，并且很少基于教育研究。已发布的数据表明，视频入门和结构化教学和评估可减少学习时间并提高技能习得。目标确定达到简单缝合熟练程度所需的练习量，并确定保留技能的最佳教学计划。设计、设置和参与者西奈山伊坎医学院几乎没有缝合经验的一年级和二年级医学生被随机分为 2 个相等的组，其中一组在第一天接受教学并进行测试一个在第 30 天进行熟练程度测试（对照组），另一个在第 1 天进行教学并在第 10、20 和 30 天进行熟练程度测试（实验组）。使用技术技能客观结构化评估方法和清单对学生进行评估。那些最初在某一天不熟练的人会立即被提示进行练习和重新测试。这个循环一直持续到当天达到熟练程度为止。该研究于 2014 年 4 月 7 日至 2014 年 6 月 30 日进行。 主要结果和措施 30 天的简单缝合熟练程度以及第一天熟练所需的平均缝合练习次数。 结果 所有学生最终均达到熟练程度。在初始培训中达到熟练程度所需的练习缝合的平均 (SD) 次数为 41 (15)。对照组学生在 30 天的初始能力测试中通过率为 0%，而实验组学生在第 30 天的通过率为 91.7% (P < .001)。在整个研究中，各组之间的教学时间、累计缝合次数或熟练程度技术技能评分的客观结构化评估没有差异。结论和相关性单次教学课程可能不足以在 30 天的选修课程中保持简单缝合的熟练程度。我们建议使用预备教学视频，然后由讲师演示来介绍该技术。带有间歇性评估和批评的独立练习可以在初始培训时获得技能并提高时间效率。学生应观看教学视频并每 10 天至少重复练习 10 次，以保持技能。
IMPORTANCE Instructional methods for the simple suture technique vary widely and are seldom based on educational research. Published data indicate that video primers and structured instruction and evaluation decrease learning time and improve skill acquisition.OBJECTIVES To determine the amount of practice needed to attain simple suture proficiency and to identify the optimal teaching schedule for retention of skill.DESIGN, SETTING, AND PARTICIPANTS First-year and second-year medical students at the Icahn School of Medicine at Mount Sinai with little to no suturing experience were randomly divided into 2 equal groups, with one being taught on day 1 and tested for proficiency on day 30 (control group) and the other being taught on day 1 and tested for proficiency on days 10, 20, and 30 (experimental group). Students were evaluated using the objective structured assessment of technical skills method and a checklist. Those initially not proficient on a given day were immediately prompted to practice and retest. This cycle continued until proficiency was achieved for that day. The study was conducted from April 7, 2014, to June 30, 2014.MAIN OUTCOMES AND MEASURES Simple suture proficiency at 30 days and the mean number of practice sutures needed for proficiency on day 1.RESULTS All students ultimately achieved proficiency. The mean (SD) number of practice sutures required to achieve proficiency at the initial training was 41 (15). Students in the control group had a 0% pass rate at the 30-day initial proficiency test, while students in the experimental group had a 91.7% pass rate at day 30 (P < .001). There were no differences in instructional time, cumulative number of sutures, or objective structured assessment of technical skills scores at proficiency between groups across the study.CONCLUSIONS AND RELEVANCE Single instructional sessions may not be sufficient to maintain simple suture proficiency over the course of a 30-day elective. We propose the use of preparatory instructional videos, followed by instructor demonstration to introduce the technique. Independent practice with intermittent evaluation and critique allows for skill acquisition and time efficiency at the initial training. Students should view instructional videos and practice at least 10 repetitions every 10 days to maintain their skill.