Student Mentoring to Enhance Suturing Proficiency in a Medical Curriculum

Background: Teaching fundamental skills such as suturing varies between medical teaching institutions. Despite great expectations from medical students, they are often left on their own for learning these skills, which sometimes takes place during a clerkship. We aimed to evaluate the efficiency of a suture curriculum based on simulation teaching considering the potential effect of role modelling during clinical practice. Methods: All third-year medical students at our university were enrolled in a suture curriculum that comprised two simulation sessions. Proficiency was evaluated using a purposefully devised suture Objective Structured Assessment of Technical Skills (OSATS) score. After randomization, some participants were selected to perform sutures on patients with mentoring between the two sessions during a clerkship, and they constituted the clinical group. Results: A total of 254 participants met the inclusion criteria. The overall performance in the second session was statistically better compared with the first session. The clinical group (78 students) performed significantly better in terms of OSATS scores (32.3 [30-33] vs. 30.2 [21-33]; P 0.001) and the completion time (64 [25-131] vs. 96 [29-360] seconds; P=0.006) compared with the control group. We found a significant association between perception of positive role model and performance (P=0.012). Conclusion: This study demonstrated the effectiveness of a simulation curriculum for suture proficiency with the reinforcing effect of mentoring during a clerkship. Simulation as part of the medical curriculum is only effective if it is integrated in clinical practice to achieve situated learning.