Abstract | December 19, 2022

Improved Confidence and Clinical Application: The Effects of a Longitudinal Suture Curriculum for Medical Students

Presenting Author: Connor Shewmake, BA, Medical Student, 3rd Year, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas

Coauthors: Connor Shewmake, BA, College of Medicine, MS3, University of Arkansas for Medical Sciences, Little Rock, AR; Olivia Speed, MD, Department of Otolaryngology Head and Neck Surgery, PGY1, University of Arkansas for Medical Sciences, Little Rock, AR; Sarah Gammill, MD, Department of Surgery, PGY3, Louisiana State University, New Orleans, LA; Larry D. Hartzell, MD, Department of Otolaryngology Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR; Carol Thrush, EdD, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR; Kevin D Phelan, PhD, Department of Neurobiology & Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR; Michael Golinko, MD, Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN; Avi Bhavaraju, MD, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR.

Learning Objectives

  1. Discuss the impact of a focused, longitudinal curriculum dedicated to teaching basic suturing skills to medical students.

Background: The ability to competently suture is an expected skill for graduating medical students, but many graduates report feeling unprepared to perform this skill. This study aimed to improve student confidence, increase skill retention, and improve readiness for third-year clerkships by implementing a novel, mandatory, 7.5-hour longitudinal suturing skills curriculum across the first two years of medical school.

 

Methods: A mandatory 7.5-hour longitudinal curriculum was implemented throughout the first two years of medical school at a large academic health center in the mid-south. Pre-test (n=167) and post-test (n=148) assessments were collected in the first year of the curriculum (2017-18), and follow-up assessment in 2020 after their first clinical year (n=82). Two-tailed t-test analyses were utilized to compare pre-post and follow-up results with significance set at p<0.05.

 

Results: Statistically significant improvement from pre-curriculum to post-test was observed in student confidence in performing three basic skills: proper instrument position, simple interrupted suture, and instrument ties (p<0.05). These pre-post confidence gains were sustained (p<0.05) at the follow-up assessment following third-year clerkships (p<0.05). At follow-up, students also reported the curriculum prepared them to suture wounds during their clerkships at least somewhat (10%), moderately (23%), very (54%), or completely (12%). Most (83%) also reported successfully suturing patient wounds during third-year clerkships without needing significant direction/guidance. 

 

Conclusions:  We found that a longitudinal suture curriculum with dedicated faculty involvement can improve student confidence in suturing and overall preparedness for third-year clerkships. Although the study is limited to ratings of student confidence and self-reported performance as well as some attrition of responses at post-test and follow-up, the findings highlight the importance of a focused curriculum dedicated to teaching basic suturing skills. Our findings also contribute to the limited body of work examining longitudinal surgical skills development for medical students.

 

References:

  1. Emmanuel T, Nicolaides M, Theodoulou I, Yoong W, Lymperopoulos N, Sideris M. Suturing Skills for Medical Students: A Systematic Review. In Vivo. 2021 Jan-Feb;35(1):1-12. doi: 10.21873/invivo.12226. PMID: 33402444; PMCID: PMC7880767.
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