title: Tensiometry as a measure of improvement in knot quality in undergraduate medical students.
abstract: BACKGROUND
  This study examined the validity of tensiometry as an objective method of assessing the improvements in the quality of knots and technical performance due to practice on suturing and knot-tying skills.
  
  
  METHODS
  We evaluated the quality of 1,830 knots produced by undergraduate medical students before training (pre-test), after (post-test), and after a week retention (retention-test) using tensiometry. These results were compared to expert-based assessments of products and performance.
  
  
  RESULTS
  Tensiometry, as well as expert-based assessments can detect changes in the quality of knots and technical performance from pre to post and retention-test ( p<0.05). However, these three methods may assess different dimensions of the same products and actions.
  
  
  CONCLUSIONS
  The development of trainee evaluation criteria for the acquisition of surgical skills is a crucial element in surgical education. Based on our patterns of results it is hypothesized that tensiometry can serve as an economic first approximation of the quality of knots and suturing performance.
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Kyle Leming
authors.forename: Katie
authors.initials: K
authors.lastname: Dorman
authors.forename: Ryan
authors.initials: R
authors.lastname: Brydges
authors.forename: Heather
authors.initials: H
authors.lastname: Carnahan
authors.forename: Adam
authors.initials: A
authors.lastname: Dubrowski
mesh_terms: D000704:Analysis of Variance; D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000592:standards; D004521:Educational Measurement / Q000379:methods*; D013502:General Surgery / Q000193:education*; D006801:Humans; D011786:Quality Control; D013337:Students, Medical; D013536:Suture Techniques / Q000193:education* / Q000592:standards; D013537:Sutures / Q000592:standards; D013718:Tensile Strength