Development of an Interactive Remote Basic Surgical Skills Mini-Curriculum for Medical Students During the COVID-19 Pandemic

Abstract

Introduction. Teaching surgical skills has historically been a hands-on activity, with instructors and learners in close physical proximity. This paradigm was disrupted by the COVID-19 pandemic, requiring innovative solutions to surmount the challenges of teaching surgical skills remotely. In this work, we describe our institution’s path and early results of developing an interactive remote surgical skills course for medical students in the surgical clerkship. Methods. 31 third-year medical students were distributed a set of surgical equipment and 3D printed phone dock. Each participant completed a baseline questionnaire and underwent 3 structured interactive remote sessions on surgical instruments, knot tying, and suturing techniques. Students were instructed on sharing their first-person viewpoint and received real-time feedback on their knot tying and suturing techniques from the course instructor. Pre- and post-session surveys were conducted and analyzed. Results. All students were able to complete the remote surgical skills course successfully, as defined by visually demonstrating successful two-handed knot and simple suture techniques. Students’ aggregate confidence score in their knot tying ability (pretest mean 7.9, SD 0.7 vs posttest mean 9.7, SD 0.9, t-statistic −2.3, P = .03) and suturing ability (pretest mean 8.0, SD 1.3 vs posttest mean 13.8, SD 0.9 t-statistic −5.5, P < .001) significantly improved after the intervention. Qualitative feedback from the students underscored the utility of the first-person perspective for teaching surgical technique. Conclusion. This study demonstrates that remote teaching of knot tying and simple suturing to medical students can be effectively implemented using a remote learning curriculum that was well received by the learners.

Perceptions of medical students towards and effectiveness of online surgical curriculum: a systematic review

“…In this study, it was found that even by online teaching, medical students still could get satisfactory training for basic surgical skills if they were given suture instruments in advance, was taught with video, practiced suturing and knot-tying with suture kits by themselves, and interacted with online platform or expert feedback [11][12][13][14]16]. Although medical students could get confidence in the ability of basic surgical skills by online classes, they eventually have to practice successfully for the real patients to verify their abilities.…”

“…Thereafter, data extraction of included studies was completed by two independent reviewers. Only the searched studies related to surgical training for medical students were analyzed [4][5][6][7][8][9][10][11][12][13][14][15][16]. The articles not specifically to online education Fig.…”

“…Among the clinical surgical training, in addition to lectures and patient encounters, training of surgical basic skills (suturing, knot-tying) is also one of the important things medical students care most. In a study by Quaranto et al [14], medical students could increase their confidence score in suturing (pre-course 8.0 +/− 1.3 vs postcourse 13.8 +/− 0.9, p < 0.001) and knot tying (pre-course 7.9 +/− 0.7 vs post-course 9.7 +/− 0.9, p = 0.03) through online teaching. In a study by Xeroulis et al [11], medical students were asked to learn through online interactive video demonstration and instruction, and then practiced the technique for suturing and knot-tying.…”

Remote Training of Functional Endoscopic Sinus Surgery With Advanced Manufactured 3D Sinus Models and a Telemedicine System

“…Several additional small studies assessing remote training for surgical skills have also been reported. These generally involve the teaching of basic surgical skills using box trainers such as peg transfer, knot tying, and suturing techniques under laparoscopy (25,26). Recently a course utilizing remote guidance of actual endovascular surgery using augmented reality (AR), has also been published (27).…”

A rapid review of the effectiveness of alternative education delivery strategies in medical, dental, nursing and pharmacy education during the COVID-19 pandemic

“…A variety of different online platforms was used to deliver synchronous learning; five used the Zoom video conferencing platform 20,21,24,26,27 three used the University Supported Management Systems: CANVAS 22,29 or Meducator, 30 one used Microsoft teams, 33 another Skype for business, 30 and three did not specify the type of video communication software used. 23,25,28 Other methods included neuroanatomical interactive virtual activities using “Digital Neuroanatomy” software, 29 simulated patient encounters employing online MedEd Case X videos, 33 and structural specimens replaced by photographs.…”