Comparison of Veterinary Student Ability to Learn 1‐Handed and 2‐Handed Techniques for Surgical Knot Tying

Thomas, Angharad C.J.; Hayes, G. M.; Demetriou, Jackie

doi:10.1111/vsu.12323

Cited by 3 publications

(2 citation statements)

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“…Other studies on surgical learning note that surgical skills improve with practice; however, that improvement is usually based on duration of each attempt rather than the mechanical quality of the product ( Compton et al, 2019 ; Asadayoobi, Jaber & Taghipour, 2021 ; Gilmer et al, 2015 ). Improvement in hand tie scores was noticed over three practice periods when students practiced tying two-handed ties for 15 min intervals and then were filmed making three attempts at hand ties ( Thomas, Hayes & Demetriou, 2015 ). Time to knot completion was not measured in this study because the instructors wanted trainees to focus on technique and knot appearance rather than speed.…”

Section: Discussionmentioning

confidence: 99%

“…Because knot tying is a fundamental surgical skill, the construction of square knots using instrument and hand ties is taught to students and other trainees in basic surgical courses ( Thomas, Hayes & Demetriou, 2015 ). Repetition is expected to improve knot tying skills and quality of knots produced by novice trainees, but fatigue during the learning process may negatively affect performance ( Thomas, Hayes & Demetriou, 2015 ; Compton et al, 2019 ; Asadayoobi, Jaber & Taghipour, 2021 ). Instructors do not know how much practice is needed to solidify knot tying skills so that strong, secure knots are tied consistently.…”

Section: Introductionmentioning

confidence: 99%

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Does quality of novice hand-tied square knots improve with repetition during a single training session?

Tobias

Mulon

Daniels

et al. 2022

PeerJ

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Background Knot tying is a key surgical skill for novices, and repetition over several training sessions improves knot tying. This study examined the effects of repetition within a single training session on quality of knotted loops and compared results of novice trainees and experienced surgeons. Methods Using 0.55 mm nylon monofilament fishing line, novices and surgeons each hand-tied 20 knotted loops, using a 2=1=1=1 configuration (surgeon’s throw and three square throws). Loops were mechanically tested with a single load to failure. Results All loops tolerated five newtons (N) preload. More than 70% of novice and surgeon knots failed by slipping or untying, and 8.8% of novice knots and 2.5% of surgeon’s knots were considered dangerous. Surgeons’ loops had less extension at preload, indicating better loop security. However, during single test to failure, there was no difference in mean extension or maximum load between surgeons and novices. There was no significant difference in results of mechanical testing or modes of failure for the first and last ten knotted loops, or the first, second, third, and fourth sets of knotted loops. Discussion With appropriate training, novices can construct knots as strong and secure as experienced surgeons. A large percentage of knotted loops are insecure under testing conditions; extra throws may be required when using large diameter monofilament nylon. Novices may require extra training in maintenance of loop security when constructing square knots. Tying more than five or 10 knotted loops within a single training session does not provide added benefits for novices.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does quality of novice hand-tied square knots improve with repetition during a single training session?

Tobias

Mulon

Daniels

et al. 2022

PeerJ

View full text Add to dashboard Cite

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Retention of basic suturing skills with brief or extended practice in veterinary students

2020

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ObjectiveTo evaluate the effect of practice duration on accuracy, retention, and confidence when learning how to tie basic surgical knots.Study designProspective study.Sample populationFifteen first‐year veterinary students.MethodsStudents were randomly assigned to a 2‐week practice (TWP) or an 8‐week practice (EWP) to learn how to tie surgeon's, strangle, and miller's knots. Students' knot‐tying accuracy and confidence were evaluated immediately after training, at an intermediate time point (2‐6 weeks postpractice), and at 12 weeks postpractice.ResultsStudents who had been trained during an extended period tied the strangle knot correctly more often at all assessments (P = .025). The ability of students trained for 2 weeks to tie the strangle knot correctly decreased over time (P = .028). These students lost some confidence (P = .03) and repositioned suture more frequently (P = .03) while constructing the strangle knot at the final time point compared with students trained for 8 weeks. Students who completed TWP felt more confident at placing surgeon's knots than friction knots at the final assessment period (P = .0164 miller's knot, P = .0056 strangle knot), whereas confidence did not differ between knot types for students who completed EWP. All students felt less confident with their knot‐tying skills at 12 weeks postpractice.ConclusionTraining for 8 weeks rather than for 2 weeks resulted in superior knot tying skills. Students' confidence decreased 12 weeks after training.Clinical significanceProlonged distributed practice is recommended to train students for more complex tasks such as placement of a strangle knot.

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Evaluation of various hemostatic knot configurations performed by veterinary students

Giusto¹,

Comino²,

Vercelli³

et al. 2018

javma

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OBJECTIVE To determine the most effective hemostatic knot configuration performed by veterinary students following a brief training session with an experienced surgeon and a subsequent deliberate self-training period. DESIGN Experiment. SAMPLE 24 fourth-year veterinary students with no previous surgical knot-tying experience. PROCEDURES In a 1-hour training session, an experienced surgeon showed veterinary students how to perform 5 hemostatic knot configurations (giant, slip, strangle, surgeon's, and transfixing), which they then practiced at home on a hemostasis simulator for 2 weeks. Thereafter, students performed each knot 4 times (twice each with monofilament and multifilament suture) on a hemostasis simulator. An experienced surgeon evaluated the correct execution of knots and measured their effectiveness by use of a manometer to measure vessel pressure distal to the ligature. Each student completed a questionnaire regarding their perceived learning and execution difficulty and sealing security for each knot. Responses were compared among knots and suture materials. RESULTS Overall, students considered the surgeon's knot the easiest to learn and the strangle knot the most difficult. The slipknot was also considered the easiest knot to perform, and the giant knot was considered the most difficult. The strangle knot was deemed the most effective in reducing vessel pressure distal to the ligature. CONCLUSIONS AND CLINICAL RELEVANCE The strangle knot was the most effective hemostatic knot in inexperienced hands, although veterinary students considered it more difficult to learn than other, perhaps more commonly taught, knots. Therefore, teaching of the strangle knot should be encouraged in veterinary schools.

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Comparison of Veterinary Student Ability to Learn 1‐Handed and 2‐Handed Techniques for Surgical Knot Tying

Cited by 3 publications

References 18 publications

Does quality of novice hand-tied square knots improve with repetition during a single training session?

Does quality of novice hand-tied square knots improve with repetition during a single training session?

Retention of basic suturing skills with brief or extended practice in veterinary students

Evaluation of various hemostatic knot configurations performed by veterinary students

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