Blau Jared A, Shammas Ronnie L, Anolik Rachel A, Avashia Yash J, Krucoff Kate B, Zenn Michael R
Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Hospital, Durham, N.C.
Zenn Plastic Surgery, Raleigh, N.C.
Plast Reconstr Surg Glob Open. 2020 Apr 22;8(4):e2738. doi: 10.1097/GOX.0000000000002738. eCollection 2020 Apr.
We hypothesized that medical students trained in suturing using high-fidelity models (cadaveric tissue) would demonstrate greater proficiency when compared with those trained using low-fidelity models (synthetic tissue).
Forty-three medical students were randomized into 2 groups. Group 1 consisted of students taught to perform simple interrupted sutures using synthetic tissue, and group 2 consisted of those taught using human cadaveric tissue. Suturing proficiency was measured pre- and postinstruction using the Global Rating Scale and by measuring suture accuracy. Perceived confidence in suturing was measured on a scale of 0-100.
Perceived confidence was measured as an average of 8.26 out of 100 pretraining and significantly improved after training (56.91 out of 100); however, there was no significant difference when comparing confidence between groups posttraining (57.65 cadaveric versus 56.05 synthetic; = 0.78), nor in the measured confidence change pre- and posttraining ( = 0.53). Posttraining, participants displayed a significant improvement in the number of adequately placed sutures; however, there was no significant difference posttraining when comparing groups (2.43 cadaveric versus 2.75 synthetic; = 0.48). The change in adequate suture placement pre- and posttraining did not reach statistical significance between groups ( = 0.27). After instruction, participants demonstrated a significant improvement in total suture performance scores; however, there was no significant difference when comparing groups (30.04 cadaveric versus 29.80 synthetic; = 0.90), nor in the total change pre- and posttraining ( = 0.74).
Training medium fidelity (tissue versus synthetic) does not significantly influence a student's overall suturing performance. However, formal instruction significantly improves objective competence and perceived confidence. Regardless of the model, surgical departments should emphasize medical student exposure to basic surgical skills education.
我们假设，与使用低保真模型（合成组织）训练的医学生相比，使用高保真模型（尸体组织）训练的医学生在缝合操作上会表现出更高的熟练度。
43名医学生被随机分为两组。第1组学生学习使用合成组织进行单纯间断缝合，第2组学生学习使用人体尸体组织进行缝合。在教学前后，使用全球评分量表并通过测量缝合准确性来评估缝合熟练度。使用0至100分的量表来衡量对缝合的感知信心。
训练前感知信心的平均得分为100分中的8.26分，训练后显著提高（100分中的56.91分）；然而，训练后两组之间的信心比较没有显著差异（尸体组织组为57.65分，合成组织组为56.05分；P = 0.78），训练前后测量的信心变化也没有显著差异（P = 0.53）。训练后，参与者在放置合适的缝合线数量上有显著改善；然而，训练后两组之间比较没有显著差异（尸体组织组为2.43，合成组织组为2.75；P = 0.48）。训练前后合适缝合线放置的变化在两组之间未达到统计学显著性（P = 0.27）。教学后，参与者在总缝合表现分数上有显著改善；然而，两组之间比较没有显著差异（尸体组织组为30.04，合成组织组为29.80；P = 0.90），训练前后的总变化也没有显著差异（P = 0.74）。
训练媒介的保真度（组织与合成组织）对学生的整体缝合表现没有显著影响。然而，正规教学显著提高了客观能力和感知信心。无论使用何种模型，外科科室都应强调让医学生接受基本外科技能教育。
