https://doi.org/10.4081/ecj.2023.11417
Teaching suturing skill to emergency physicians: the experience of a hands-on practical training in a laboratory simulation-based setting
Submitted: 15 April 2023
Accepted: 12 May 2023
Published: 23 June 2023
Accepted: 12 May 2023
Abstract Views: 720
PDF: 306
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Both specialists and trainees in emergency medicine are often unaware of the principles of good suturing. Hands-on training course was proposed to both members of the staff (group A) and trainees (group B) of the emergency department of our hospital. Familiarity with all aspects of the operation, pre-course 0%, postcourse 79% (group A) and 85.71% (group B) - p<0.000); clear economy of movement and maximum efficiency, pre-course 0%, post-course 73.8% (group A) and 89.80% (group B) - p<0.000; fluid moves with instruments and no awkwardness, pre-course 0%, post-course 73.8% (group A) and 89.80% (group B) - p<0.000; obviously planned course of operation with effortless flow from one move to the next, pre-course 0%, post-course 79% (group A) and 89,80% (group B) - p<0.000; strategically used assistants to the best advantage of all time, pre-course 0%, post-course 73,8% (group A) and 89,80% (group B) - p<0.000; improvement in dexterity, 79.5% of students post-course). The course was judged very useful by 94.8% of students. Attending suturing skill courses could be very useful for both trainees and specialists in emergency medicine.
Prevaldi C, Paolillo C, Locatelli C, et al. Management of traumatic wounds in the Emergency Department: position paper from the Academy of Emergency Medicine and Care (AcEMC) and the World Society of Emergency Surgery (WSES). World J Emerg Surg 2016;11:30.
DOI: https://doi.org/10.1186/s13017-016-0084-3
Davis CR, Toll Bates AS, et al. Surgical and procedural skills training at medical school - a national review. Int J Surg 2014;8:877-82.
Fincher RM, Lewis LA. Learning, experience, and self-assessment of competence of third-year medical students in performing bedside procedures. Acad Med 1994;69:291-95.
DOI: https://doi.org/10.1097/00001888-199404000-00012
Al-Jundi W, Elsharif M, Anderson M, et al. Randomized controlled trial to compare e-feedback versus “standard” face-to-face verbal feedback to improve the acquisition of procedural skill. J Surg Educ 2017;74:390-397.
DOI: https://doi.org/10.1016/j.jsurg.2016.11.011
Aparicio M, Bacao F, Oliveira T. An e-learning theoretical framework. J Educ Techno Soc 2016;19:292-307.
Decreto Ministeriale, 17 febr. 2006 published in Gazzetta Ufficiale 23 may 2006, n. 118.
Emmanuel T, Nicolaides M, Theodoulou I, et al. Suturing Skills for medical students: A sistematic review. In Vivo 2021;35:1-12.
DOI: https://doi.org/10.21873/invivo.12226
Martin JA, Regher G, Reznick R, et al. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 2017;84:273-278.
Van Tiggelen H, LeBlanc K, Campbell K, et al. Standardizing the classification of skin tears: validity and reliability testing of the International Skin Tear Advisory Panel Classification System in 44 countries. Br J Dermatol 2020;183:146-154.
DOI: https://doi.org/10.1111/bjd.18604
Van Der Baaren R, Barten DG, Van Osch F, et al. Minor traumatic injuries in the Emergency Department pre‐ and post‐implementation of an emergency care access point. J Eval Clin Pract 2023;29:32–38.
DOI: https://doi.org/10.1111/jep.13705
Stussman BJ. National Hospital Ambulatory Medical Care Survey: 1994 emergency department summary. Advance data from vital and health statistics. No. 275. Hyattsville, Md.: National Center for Health Statistics,1999. PHS;96-1250.
Davis CR, Toll EC, Bates AS, et al. Surgical and procedural skill training at medical school – a national review. Int J Surg 2014;12:877- 882.
DOI: https://doi.org/10.1016/j.ijsu.2014.05.069
Taylor I, Reed MF, Kingsnorth AN, et al. Surgery in the undergraduate curriculum report by the education and professional development committee of SARS. Bull Roy Coll Surg Engl 2005;87: 136-139.
DOI: https://doi.org/10.1308/147363505X39239
Zundel S, Meder A, Zipfel S, et al. The surgical experience of current non-surgeons gained at medical school: a survey analysis with implications for teaching today’s student. BMC Medical Education 2015;15:187-194.
DOI: https://doi.org/10.1186/s12909-015-0466-3
Denadai R, Toledo AP, Oshiiwa M, Saad-Hossne R. Acquisition of suture skills during medical graduation by instructor-directed training: A randomized controlled study comparing senior medical students and faculty surgeons. Updates Surg 2013;65:131-140.
DOI: https://doi.org/10.1007/s13304-013-0199-y
Routt E, Mansouri Y, de Moll EH, et al. Teaching the simple suture to medical students for long-term retention of skill. JAMA Dermatol 2015;151:761-765.
DOI: https://doi.org/10.1001/jamadermatol.2015.118
Wongkietkachorn A, Rhunsiri P, Boonyawong P, et al. Tutoring trainees to suture: an alternative method for learning how to suture and a way to compensate for a lack of suturing cases. J Surg Educ 2016;73:524-528.
DOI: https://doi.org/10.1016/j.jsurg.2015.12.004
O’Connor R, McGraw L, Killen M. A computer-based training module for suturing self-directed basic. Med Teacher 2009;20:203-06.
DOI: https://doi.org/10.1080/01421599880922
Ganier F, De Vries P. Are instructions in video format always better than photographs when learning manual techniques? The case of learning how to do sutures. Learn Instr 2016;44:87-96.
DOI: https://doi.org/10.1016/j.learninstruc.2016.03.004
Nousiainen M, Brydges R, Backstein D, at al. A Comparison of expert instruction and computer-based video training in teaching fundamental surgical skills to medical students. Surgery 2008;143:539-544.
DOI: https://doi.org/10.1016/j.surg.2007.10.022
Wright AS, McKenzie J, Tsigonis A, et al. A structured self-directed basic skills curriculum results in improved technical performance in the absence of expert faculty teaching. Surgery 2021;151:808-14.
DOI: https://doi.org/10.1016/j.surg.2012.03.018
Denadai R, Oshiiwa M, Saad-Hossne R. Does bench model fidelity interfere in the acquisition of suture skills by novice medical students? AMB Rev Assoc Med Bras 2012;58:600-06.
DOI: https://doi.org/10.1590/S0104-42302012000500019
Bauer F, Rommel N, Kreutzer K, et al. A novel approach to teaching surgical skills to medical students using an ex vivo animal training model. J Surg Educ 2014;71:459-65.
DOI: https://doi.org/10.1016/j.jsurg.2014.01.017
Bennett SR, Morris SR, Mirza S. Medical students teaching medical students surgical skills: The benefits of peer-assisted learning. J Surg Educ 2018;75:1471-74.
DOI: https://doi.org/10.1016/j.jsurg.2018.03.011
Denadai R, Saad-Hossne R, Oshiiwa M, Bastos EM. Training on synthetic ethylene-vinyl acetate bench model allows novice medical students to acquire suture skills. Acta Cir Bras 2012;27:271-78.
DOI: https://doi.org/10.1590/S0102-86502012000300012
Martin JA, Regehr G, Reznick R, et al. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 1997;84:273-78.
DOI: https://doi.org/10.1046/j.1365-2168.1997.02502.x
Alameddine MB, Englesbe MJ, Waits SA. A video-based coaching intervention to improve surgical skill in fourth-year medical students. J Surg Educ 2018;75:1475-79.
DOI: https://doi.org/10.1016/j.jsurg.2018.04.003
Bekele A, Wondimu S, Firdu N, et al. Trends in retention and decay of basic surgical skills: Evidence from Addis Ababa university, Ethiopia: A prospective case-control cohort study. World J Surg 2019;43:9-15.
DOI: https://doi.org/10.1007/s00268-018-4752-1
Gershuni V, Woodhouse J, Brunt LM. Retention of suturing and knot-tying skills in senior medical students after proficiency-based training: Results of a prospective, randomized trial. Surgery 2013;154:823-29.
DOI: https://doi.org/10.1016/j.surg.2013.07.016
Preece R, Dickinson EC, Sheriff M, et al. Peer-assisted teaching of basic surgical skill. Med Educ Online 2015;20:27579.
DOI: https://doi.org/10.3402/meo.v20.27579
Jensen AR, Wright AS, Levy AE, et al. Acquiring basic surgical skills: is a faculty mentor really needed? Am J Surg 2009;197:82-88.
DOI: https://doi.org/10.1016/j.amjsurg.2008.06.039
Rooney DM, Hungness ES, DaRosa DA, Pugh CM. Can still coaches be used to assess resident performance in the skill laboratory? Surgery 2012;151:796-802.
DOI: https://doi.org/10.1016/j.surg.2012.03.016
Porte MC, Xeroutis G, Raznick RK, Dubrowsky A. Verbal feedback from an expert is more effective than self -accessed feedback about motion efficiency in learning new surgical skills. Am J Surg 2007;193:105-11
DOI: https://doi.org/10.1016/j.amjsurg.2006.03.016
Brydges R, Carnahan H, Dubrovsky A. Assessing suturing skill in a self-guided learning setting: absolute simmettry error. Adv Health Sci Educ Theor Pract 2009;14:685-95.
DOI: https://doi.org/10.1007/s10459-008-9151-1
Gurjao da Silva AP, Rios R JE, Conceicao DeOM, et al. The alternative model of silicone for experimental simulation of suture of living tissue in the teaching of surgical technique. Acta Chir Bras 2019; 34e201900410.
DOI: https://doi.org/10.1590/s0102-865020190040000010
How to Cite
Manno, A., Pascale, M. M., Santoro, M. C., Saviano, A., Benicchi, A., Gabrielli, M., Covino, M., & Franceschi, F. (2023). Teaching suturing skill to emergency physicians: the experience of a hands-on practical training in a laboratory simulation-based setting. Emergency Care Journal, 19(2). https://doi.org/10.4081/ecj.2023.11417
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
