TY - JOUR
T1 - A Cost-Effective Proficiency-Based Knot-Tying and Suturing Curriculum for Residency Programs
AU - Scott, Daniel J.
AU - Goova, Mouza T.
AU - Tesfay, Seifu T.
PY - 2007/7/1
Y1 - 2007/7/1
N2 - Background: The purpose of this study was to develop a structured open skills curriculum for knot-tying and suturing using expert-derived performance goals and to examine its feasibility, cost-effectiveness, and construct validity. Methods: Using commercially available bench models, 11 standardized tasks (ranging from 2-handed knot-tying to running subcuticular closure) were developed and scored using previously validated metrics based on time and errors. Expert performance was used to establish training endpoints and to create a video tutorial. PGY 1 residents (n = 4) were enrolled in a prospective Institutional Review Board-approved pilot study that included proctored orientation and baseline testing, self-training to proficiency, and proctored post-testing (conducted over a 4-wk period). Baseline trainee scores were compared with expert scores to evaluate construct validity. Results: The 11 tasks proved relatively robust, and excellent feedback was obtained from the trainees regarding educational benefit. Overall, trainees performed 144 ± 33 repetitions over 11 ± 2 h. Trainees achieved proficiency for 4.6% of the 11 tasks at baseline, 91% during training, and 84% at post-testing. Trainees demonstrated significant improvement from baseline to post-testing, validating skill acquisition; baseline trainee and expert performance were significantly different, confirming construct validity. Curriculum development cost $1200 and required 72 man-hours. Incremental training cost less than $12 per participant and required 8 man-hours per rotation using the video-based self-practice curriculum. In response to participant feedback, two of the 11 tasks were modified and a twelfth task was added. Conclusions: This curriculum is cost-effective, feasible within the context of residency training, educationally beneficial, and demonstrates construct validity. More widespread adoption of standardized, validated skills curricula such as this by residency programs is warranted.
AB - Background: The purpose of this study was to develop a structured open skills curriculum for knot-tying and suturing using expert-derived performance goals and to examine its feasibility, cost-effectiveness, and construct validity. Methods: Using commercially available bench models, 11 standardized tasks (ranging from 2-handed knot-tying to running subcuticular closure) were developed and scored using previously validated metrics based on time and errors. Expert performance was used to establish training endpoints and to create a video tutorial. PGY 1 residents (n = 4) were enrolled in a prospective Institutional Review Board-approved pilot study that included proctored orientation and baseline testing, self-training to proficiency, and proctored post-testing (conducted over a 4-wk period). Baseline trainee scores were compared with expert scores to evaluate construct validity. Results: The 11 tasks proved relatively robust, and excellent feedback was obtained from the trainees regarding educational benefit. Overall, trainees performed 144 ± 33 repetitions over 11 ± 2 h. Trainees achieved proficiency for 4.6% of the 11 tasks at baseline, 91% during training, and 84% at post-testing. Trainees demonstrated significant improvement from baseline to post-testing, validating skill acquisition; baseline trainee and expert performance were significantly different, confirming construct validity. Curriculum development cost $1200 and required 72 man-hours. Incremental training cost less than $12 per participant and required 8 man-hours per rotation using the video-based self-practice curriculum. In response to participant feedback, two of the 11 tasks were modified and a twelfth task was added. Conclusions: This curriculum is cost-effective, feasible within the context of residency training, educationally beneficial, and demonstrates construct validity. More widespread adoption of standardized, validated skills curricula such as this by residency programs is warranted.
KW - knot-tying and suturing curriculum
KW - simulation
KW - skill acquisition
KW - skills lab
KW - skills training
KW - surgical education
KW - suturing models
KW - technical skills
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U2 - 10.1016/j.jss.2007.02.043
DO - 10.1016/j.jss.2007.02.043
M3 - Article
C2 - 17574034
AN - SCOPUS:34250190989
VL - 141
SP - 7
EP - 15
JO - Journal of Surgical Research
JF - Journal of Surgical Research
SN - 0022-4804
IS - 1
ER -