Early and prolonged opportunities to practice suturing increases medical student comfort with suturing during clerkships: Suturing during cadaver dissection

Abstract

Medical students are expected to perform common procedures such as suturing on patients during their third-year clerkships. However, these experiences are often viewed by medical students as stressors rather than opportunities for learning. The source of this stress is the lack of instruction on common procedures prior to being asked to observe or perform the procedure on a patient. First-time exposures to procedures in stressful environments may result in decreased confidence in medical students and decrease the frequency with which they perform these procedures in the future. The authors sought to change this paradigm by: (1) introducing a suturing module to first-year medical students in the context of the anatomy dissection laboratory and (2) measuring its effects on student attitudes and behavior over the course of their third-year clerkships when they encounter patients. The authors found that early and prolonged introduction to suturing was associated with increased student confidence relative to suturing a patient. Participation in the suturing module was associated with increased student confidence in identifying suturing instruments (P < 0.001) and suturing patients (P = 0.013). Further it positively affected their behavior as demonstrated by increased performance of suturing events from students exposed to the suturing module. (P < 0.001) This study demonstrates that early and prolonged opportunities to practice a procedural skill in a low-stress environment increases student confidence during patient interactions and alters student behavior.

Dissection in the Modern Medical Curriculum: An Exploration into Student Perception and Adaptions for the Future

“…The procedure-based dissection protocols can be supplemented by relevant problem-solving type clinical scenarios to facilitate higher order thinking and development of competencies required for handling real world clinical problems. Additionally, the PBP sessions can be used to introduce and practice basic skills such as suturing at an early stage of medical student training (Manning et al, 2018). Based on previous feedback, a few procedure-based dissection protocols were added to Griffith's medical anatomy dissection program (Dissabandara et al, 2015).…”

Cadaveric Dissection in Relation to Problem‐Based Learning Case Sequencing: A Report of Medical Student Musculoskeletal Examination Performances and Self‐Confidence

“…Regardless, there are other benefits associated with dissection laboratory beyond objective examination scores. Manning et al () introduce the idea that cadaver dissections could be used to educate medical students on the suturing techniques required for their third‐year rotations. Anatomy laboratory also assists students in gaining a deeper understanding of human morbidity and mortality, and it allows the students to reflect on life and death (Aziz et al, ; Topp, ; Cho and Hwang, ; Flack and Nicholson, ).…”

Creating a Human Gross Anatomy Laboratory: The Experience at a Primarily Undergraduate Institution

“…• Affords the opportunity to teach four-dimensional concepts (e.g., performing ligament stress testing before and after incision of ligaments) (Krause et al, 2011). • Trains students in the use of instruments and methods (e.g., suturing) that are utilized in surgery and develop manual dexterity, hand-eye coordination, and confidence (Moore, 1998;Parker, 2002;Granger, 2004;Manning et al, 2018). • Aids in the development of palpation skills (Kinirons et al, 2019).…”