Implementation, construct validity, and benefit of a proficiency-based knot-tying and suturing curriculum.
OBJECTIVE
The aim of this proficiency-based, open knot-tying and suturing study was to evaluate the feasibility of implementing this curriculum within a residency program, and to assess construct validity and educational benefit.


METHODS
PGY1 residents (n = 37) were enrolled in an Institutional Review Board (IRB)-approved prospective study that was conducted over a 12-week period. Trainees viewed a video tutorial during orientation and as needed; they self-practiced to proficiency for 12 standardized knot-tying, practiced suturing tasks; performed 1 repetition of each task at baseline and posttesting; and completed questionnaires.


RESULTS
Curriculum implementation required 376 person-hours, and material costs were $776. All trainees achieved proficiency within allotted 12 weeks. Overall, trainees completed 141 +/- 80 repetitions over 12.7 +/- 5.3 hours in addition to performing 13.4 +/- 12.4 operations. Baseline trainee and expert performance were significantly different for all 12 tasks and composite score (732 +/- 294 vs 1488 +/- 26, p < 0.001), which supported construct validity. Baseline trainees demonstrated significant improvement at posttesting according to composite scores (732 +/- 294 vs 1503 +/- 131, p < 0.001), which validates skill acquisition.


CONCLUSIONS
Implementation of this proficiency-based curriculum within the constraints of a residency program is feasible. This curriculum is educationally beneficial and cost effective; our data support construct validity. Evaluation of transferability to the operating room and more widespread adoption of this curriculum are warranted.
Goova
Mouza T
MT
Southwestern Center for Minimally Invasive Surgery, UT Southwestern Medical Center, Dallas, Texas 75390-9156, USA.
Hollett
Lisa A
LA
Tesfay
Seifu T
ST
Gala
Rajiv B
RB
Puzziferri
Nancy
N
Kehdy
Farid J
FJ
Scott
Daniel J
DJ
D016009:Chi-Square Distribution; D002983:Clinical Competence; D015331:Cohort Studies; D003162:Competency-Based Education; D003479:Curriculum; D005240:Feasibility Studies; D005260:Female; D013502:General Surgery / Q000193:education; D006801:Humans; D007396:Internship and Residency; D008297:Male; D017145:Models, Educational; D009048:Motor Skills / Q000502:physiology; D011336:Probability; D011446:Prospective Studies; D015203:Reproducibility of Results; D013536:Suture Techniques / Q000193:education*; D013647:Task Performance and Analysis; D055815:Young Adult