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

作者：Huang Emily^*; Chern Hueylan; O'Sullivan Patricia; Cook Brian; McDonald Erik; Palmer Barnard; Liu Terrence; Kim Edward

来源：American Journal of Surgery, 2014, 208(4): 690-694.

DOI：10.1016/j.amjsurg.2014.05.028

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

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.

• 出版日期2014-10