Development and validation of a new assessment tool for suturing skills in medical students

Abstract

Background: In recent years, emphasis has been put on that medical student should demonstrate pre-practice/pre-registration core procedural skills to ensure patient safety. Nonetheless, the formal teaching and training of basic suturing skills to medical students have received relatively little attention and there is no standard for what should be tested and how. The aim of this study was to develop and validate, using scientific methods, a tool for assessment of medical students' suturing skills, measuring both micro- and macrosurgical qualities.

Methods: A tool was constructed and content, construct, concurrent validity, and inter-rater, inter-item, inter-test reliability were tested. Three groups were included: students with no training in suturing skills, students who have had training, plastic surgery.

Results: The results show promising reliability and validity when assessing novice medical students' suturing skills.

Conclusions: Further studies are needed on implementation of the instrument. Moreover, how the instrument can be used to give formative feedback, evaluate if a required standard is met and for curriculum development needs further investigation.Level of Evidence: Not ratable.

Keywords: Assessment tool; Microsurgery; Plastic surgery; Surgical education; Suturing skills; Technical skills assessment; Undergraduate training.

Fig. 1

Data distribution of in-house scores by all assessors in the different groups

Fig. 2

Subjects time distribution in time to complete task. The 67% cutoff is marked as the dashed line at 378 s

Fig. 3

Differences in in-house scores between different groups. Individual scores from all three assessors are plotted

Fig. 4

Matched improvement of pre- and post-course performance as measured by the in-house scoring tool

Fig. 5

Correlation of subjects’ in-house scores with their OSATS and UWOMSA scores. O—pre- and post-course subjects, X—expert controls

Fig. 6

Relationship of in-house scores given by the three assessors plotted against the average score

Fig. 7

Repeatability of the in-house score. Single assessor scores plotted against the average score by the three assessors. Arrows represent scores of the same subject by the same assessor at two different time points. The starting point of the arrow is the score given at the first assessment and the arrowhead represents the second assessment score. Large differences in the first and second scores by the same assessor can be spotted as elongated arrows. Only arrowheads are shown when the two scores are equal. The average score is indicated as a numeric value on the graph