Cross-Suturing is Effective for Teaching Suturing Skills: A Randomized, Controlled Trial

Introduction: Basic suturing is a skill expected from graduating medical students. A pro-posed concept to increase suturing competency is to integrate art by mixing cross-stitching with suturing. We hypothesize that students trained with cross-suturing would improve suturing performance.Methods: We performed a randomized controlled trial of preclinical medical students using an art-based cross-stitching method intervention compared with conventional suturing. Both groups were provided with an introductory suturing video. Assessment of simple interrupted suturing were conducted preintervention and postintervention, and at 2-wk follow-up with a video review by blinded expert raters using the American College of Surgeons basic suturing and knot tying performance rating tool. Students completed a self-assessment of proficiency, confidence, and anxiety. Statistical analysis was performed using unpaired t-tests.Results: A total of 16 preclinical medical students participated. Self-assessment and objective suturing performance were comparable in the preintervention measurements. The intervention group showed significant improvement compared to the control group with median (interquartile range) self-assessment scores 9 (8.5-9) compared with 6.5 (6-7.5) (P < 0.01) and objective performance scores of 25.25 (22.75-27) compared with 16.5 (14.5-18.5) (P < 0.01). The intervention group showed retained skills at the 2-wk follow up with no differences in self -assessment or objective suturing scores immediately postintervention compared with two -wk follow-up with self-assessment scores of 9 (8.5-9) versus 9 (8-9) at 2 wk (P = 0.16) and objective performance score of 25.25 (22.75-27) versus 24.75 (23.5-26.5) at 2 wk (P = 0.29).Conclusions: The cross-suturing intervention improved suturing skills in this cohort. This low-cost approach to medical student surgical education should be explored on a larger scale.(c) 2022 Elsevier Inc. All rights reserved.

Automated summary

The integration of cross-stitching with suturing can improve suturing skills in medical students. In a randomized controlled trial comparing an art-based cross-stitching method with conventional suturing, the intervention group showed significant improvement in both self-assessment and objective suturing performance. The skills acquired by the intervention group were retained at the 2-week follow-up, suggesting the potential effectiveness of this low-cost approach in medical student surgical education.