Anatomy Lab Suturing Workshops: Another Gift to Students from Donors

Anatomy Lab Suturing Workshop

Abstract

PURPOSE

Early, regular practice of clinical skills like history-taking and physical examination are fundamental to Physician Assistant (PA) education.   Procedures training, however, is often delayed until students are approaching their clinical year, oftentimes without the opportunity for students to achieve competency.  Studies have shown that pre-clinical year training in suturing increased medical students’ confidence in their suturing ability.  However, there are no data that demonstrate whether students’ suturing skills during rotations were improved as a result of this training.   This study was undertaken to determine whether regular suturing practice in the Anatomy lab during didactic (first) year would correlate to improved suturing competencies during students’ clinical rotations (second year).

MATERIALS / METHODS

The authors piloted a novel suturing curriculum and compared the perceived suturing competency of that cohort with those of a control cohort.  The control group, the PA Class of 2017 (CO2017) undertook the existing suture training during the Transition between their didactic and clinical years (one pig’s foot suturing practicum and one animal lab workshop).  The PA Class of 2018 (CO2018) undertook the new curriculum of ten workshops in the Anatomy lab over 3 months during the didactic year.  Students were given repeated opportunities to practice various suturing techniques on the cadavers over the course of the semester, as well as the pig's foot practicum.  Data were collected from preceptor evaluations, measuring preceptors’ assessment of competency in basic suturing and bladder catheterization (as a skill competency control).

RESULTS

Clinical preceptor evaluation data for rotations 1-4 showed CO2017 control cohort (n=141 rotations) were deemed competent at suturing by their preceptors in 26.24% of their rotations vs. 41.22% of CO2018 pilot cohort (n= 131 rotations).  Two proportion Z-test verified that the 14.98% increase in preceptor-reported suturing competence was significant (p = 0.05).  There was no significant difference in preceptor-reported bladder catheterization competency.

DISCUSSION

A longitudinal curriculum that incorporates pre-clinical suture workshops with an Anatomy lab may improve suturing competence.  Integrating suturing workshops into Anatomy lab was cost-effective and provided a convenient and effective venue to facilitate multiple sessions throughout the didactic year in a low-stress environment.

REFERENCES

Sharma V, Surek C, Stewart H, Stephens R, Wright B, et al. (2016) Integrating Surgical Skills into Pre-Clinical Years of Medical School. J Surg Open Access 2(3) 

https://sciforschenonline.org/journals/surgery-open-access/JSOA-2-121.php

Esterl, R Jr., Henzi, D, Cohn, S. Senior medical student “Boot Camp”: can result in increased self-confidence before starting surgery internships. Curr Surg. 2006;63:264. 

https://www.ncbi.nlm.nih.gov/pubmed/16843778

Zaid H, Ward D, Sammann A, Tendick F, Topp K, Maa J. Integrating Surgical Skills Education into the Anatomy Laboratory. Journal of Surgical Research. 2010; 158:36-42 

https://www.journalofsurgicalresearch.com/article/S0022-4804(08)00539-8/abstract

    
Dimaggio, P, Waer, A, Desmarais, et al. The use of a lightly preserved cadaver and full-thickness pigskin to teach technical skills on the surgery clerkship - A response to the economic pressures facing academic medicine today. Am J Surg. 2010 Jul;200(1):162-6. 

https://www.sciencedirect.com/science/article/pii/S0002961009006473?via%3Dihub

PREVIOUSLY EXHIBITED

May 2018        Yale School of Medicine, Medical Education Day Poster Session, New Haven, CT

October 2019  Physician Assistant Educator’s Association Education Forum Poster Session, Washington, DC.