title: Teaching the Simple Suture to Medical Students for Long-term Retention of Skill.
abstract: OBJECTIVE
  Instructional methods for the simple suture technique vary widely and are seldom based on educational research. Published data indicate that video primers and structured instruction and evaluation decrease learning time and improve skill acquisition.
  
  
  OBJECTIVE
  To determine the amount of practice needed to attain simple suture proficiency and to identify the optimal teaching schedule for retention of skill.
  
  
  METHODS
  First-year and second-year medical students at the Icahn School of Medicine at Mount Sinai with little to no suturing experience were randomly divided into 2 equal groups, with one being taught on day 1 and tested for proficiency on day 30 (control group) and the other being taught on day 1 and tested for proficiency on days 10, 20, and 30 (experimental group). Students were evaluated using the objective structured assessment of technical skills method and a checklist. Those initially not proficient on a given day were immediately prompted to practice and retest. This cycle continued until proficiency was achieved for that day. The study was conducted from April 7, 2014, to June 30, 2014.
  
  
  METHODS
  Simple suture proficiency at 30 days and the mean number of practice sutures needed for proficiency on day 1.
  
  
  RESULTS
  All students ultimately achieved proficiency. The mean (SD) number of practice sutures required to achieve proficiency at the initial training was 41 (15). Students in the control group had a 0% pass rate at the 30-day initial proficiency test, while students in the experimental group had a 91.7% pass rate at day 30 (P < .001). There were no differences in instructional time, cumulative number of sutures, or objective structured assessment of technical skills scores at proficiency between groups across the study.
  
  
  CONCLUSIONS
  Single instructional sessions may not be sufficient to maintain simple suture proficiency over the course of a 30-day elective. We propose the use of preparatory instructional videos, followed by instructor demonstration to introduce the technique. Independent practice with intermittent evaluation and critique allows for skill acquisition and time efficiency at the initial training. Students should view instructional videos and practice at least 10 repetitions every 10 days to maintain their skill.
authors.affiliation: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York2currently a medical student at The University of Hawaii at Manoa.
authors.forename: Ethan
authors.initials: E
authors.lastname: Routt
authors.affiliation: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Yasaman
authors.initials: Y
authors.lastname: Mansouri
authors.affiliation: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York3currently a medical student at the University of Connecticut, Storrs.
authors.forename: Ellen H
authors.initials: EH
authors.lastname: de Moll
authors.affiliation: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Bernstein
authors.affiliation: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Sebastian G
authors.initials: SG
authors.lastname: Bernardo
authors.affiliation: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Jacob
authors.initials: J
authors.lastname: Levitt
mesh_terms: D002983:Clinical Competence; D004501:Education, Medical; D006801:Humans; D059032:Learning Curve; D011214:Practice, Psychological; D012054:Reinforcement, Psychology; D012153:Retention, Psychology; D013337:Students, Medical; D013536:Suture Techniques / Q000193:education*; D013663:Teaching / Q000379:methods*; D014741:Video Recording