In medical training there is a lack of simulation based activities including procedural labs. Suturing is a critical skill for trainees to master in the emergency department. However, supervised practice is needed prior to suturing a real patient for the first time. This innovation allows early trainees to master suturing while on shift, using easy to find materials, which increases procedural competency and confidence. This activity allows the teacher to assess and correct the trainees procedural skills prior to attempting to suture a real patient.
Name of innovation
- This Do-It-Yourself Suture Kit Station incorporates easy to find materials available in every emergency department, allowing early trainees to master suturing prior to suturing real patients.
Learners targeted
- Medical students and early trainees who need suture practice
General group size
- One-on-one student training is ideal, but can have multiple students who can practice using multiple suturing stations
- If teacher unable to instruct while on shift, trainees can be shown a suture training video and practice alongside the video
Materials needed
- Blue chuck pad
- Paper/cloth tape
- Scalpel
- Suture material
- Suture kit
More detailed description of the activity and how it was run
- Make the DIY Suture Kit Station (see above video):
- Place a thick chuck pad on a flat sturdy surface.
- Apply cloth tape to the entire surface of the chuck, and tape over the chuck. This is now the suturing pad.
- Use a scalpel to make an incision to the pad.
- Use the back blunt end of the scalpel to ‘fluff’ up incision edges to make laceration.
- Use a laceration repair kit and suture to close the laceration.
- Instruct the trainee on proper suturing technique on the suture station (or show a suture training video)
- Have the trainee continue practicing until adequate comfort and proficiency level is achieved
- Suture real patient!
Lessons learned, especially with regard to increasing resident and program buy in
- Procedural skills require much repetition to gain proficiency. This is best done with video tutorials, supervision, and deliberate practice.
- Practicing in a simulated environment greatly improves skill and confidence in real clinical practice.
Educational theory behind the innovation including specifics/styles of teaching involved
- Simulation practice increases procedural competency.
- Practicing on shift allows trainees to reach the number of repetitions required to gain mastery in suturing, Routt [1] showed that the number of repetitions required to gain proficiency was 41 times.
- Competency in suturing is required even when cases are low. Wongkietachorn et al. demonstrated that tutoring suturing improves the trainees’ skillset. A practice suture kit helps improve retention for real-life scenarios [2].
Pearls
- This DIY suture pad station technique is easily available and inexpensive.
- To improve suturing techniques and enhance skill retention, medical students and early trainees need to learn with guided supervision on simulated task trainers.
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References
- Routt E, Mansouri Y, de Moll EH, Bernstein DM, Bernardo SG, Levitt J. Teaching the Simple Suture to Medical Students for Long-term Retention of Skill. JAMA Dermatol. 2015 Jul;151(7):761-5. doi: 10.1001/jamadermatol.2015.118. PMID: 25785695.
- Wongkietkachorn A, Rhunsiri P, Boonyawong P, Lawanprasert A, Tantiphlachiva K. 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 May-Jun;73(3):524-8. doi: 10.1016/j.jsurg.2015.12.004. Epub 2016 Feb 20. PMID: 26907573.
Author information
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