Clinical ScienceAll for knots: evaluating the effectiveness of a proficiency-driven, simulation-based knot tying and suturing curriculum for medical students during their third-year surgery clerkship

BackgroundWe evaluated the effectiveness of implementing a proficiency-driven, simulation-based knot tying and suturing curriculum for medical students during their 3rd-year surgery clerkship.MethodsMedical students on the 3rd-year surgical clerkship completed a proficiency-driven, simulation-based knot tying and suturing curriculum consisting of 6 tasks. The effectiveness was evaluated by comparing the initial presession scores to the final postsession scores on an 8-item self-efficacy scale and evaluating pass rates on end of clerkship skills testing. A paired t test was used to analyze data.ResultsSixty-five students had matched preintervention and postintervention questionnaires for analysis. Pass rates approached 100% by the 3rd attempt on all tasks. Significant gains on all 8 items of the self-efficacy questionnaire from pretraining to post-training were noted. Timing of the general surgery rotation did not impact results.ConclusionsImplementation of a simulation-based training, proficiency-driven knot tying and suturing curriculum for 3rd-year medical students during the surgery clerkship is feasible and effective in improving student self-efficacy and objective proficiency toward performance of the tasks taught.