Format

Send to

Choose Destination
Am J Surg. 2014 Oct;208(4):690-4. doi: 10.1016/j.amjsurg.2014.05.028. Epub 2014 Aug 10.

A better way to teach knot tying: a randomized controlled trial comparing the kinesthetic and traditional methods.

Author information

1
Department of Surgery, University of California San Francisco, San Francisco, 513 Parnassus Avenue, S-321, San Francisco, CA 94143-0470, USA. Electronic address: emily.huang2@ucsfmedctr.org.
2
Department of Surgery, University of California San Francisco, San Francisco, 513 Parnassus Avenue, S-321, San Francisco, CA 94143-0470, USA.
3
Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
4
School of Medicine, University of California San Francisco, San Francisco, CA, USA.
5
Department of Surgery, University of California, San Francisco-East Bay, Oakland, CA, USA.

Abstract

BACKGROUND:

Knot tying is a fundamental and crucial surgical skill. We developed a kinesthetic pedagogical approach that increases precision and economy of motion by explicitly teaching suture-handling maneuvers and studied its effects on novice performance.

METHODS:

Seventy-four first-year medical students were randomized to learn knot tying via either the traditional or the novel "kinesthetic" method. After 1 week of independent practice, students were videotaped performing 4 tying tasks. Three raters scored deidentified videos using a validated visual analog scale. The groups were compared using analysis of covariance with practice knots as a covariate and visual analog scale score (range, 0 to 100) as the dependent variable. Partial eta-square was calculated to indicate effect size.

RESULTS:

Overall rater reliability was .92. The kinesthetic group scored significantly higher than the traditional group for individual tasks and overall, controlling for practice (all P < .004). The kinesthetic overall mean was 64.15 (standard deviation = 16.72) vs traditional 46.31 (standard deviation = 16.20; P < .001; effect size = .28).

CONCLUSIONS:

For novices, emphasizing kinesthetic suture handling substantively improved performance on knot tying. We believe this effect can be extrapolated to more complex surgical skills.

KEYWORDS:

Basic skills; Kinesthetic; Knot tying; Skill; Surgical education; Technical

PMID:
25241957
DOI:
10.1016/j.amjsurg.2014.05.028
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center