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Old versus new: which is better? A comparison of 2 training methods for suturing and knot tying in the Obstetrics and Gynecology clerkship

Purpose: The purpose of this study was to compare 30 min instructor guided suture training vs independent video-based instruction on student satisfaction and competency in suturing and knot tying skills.


Background: Simulation is becoming more common as medical school class sizes increase and clinical time is limited. The COVID-19 pandemic presented an additional challenge for in-person learning and forced innovation in teaching of technical skills.Prior to this study, students received no formal training in suture and knot tying skills.  Excellent quality suturing and instructional videos are available online without charge. Additionally, today’s learners are increasingly comfortable using self-paced and online learning platforms.We hypothesized that short instructor-led simulated practice of suturing and knot tying would improve proficiency on suture and knot tying skills compared to self-guided practice.


Methods: A prospective case control study design was used, alternating intervention (30-minute faculty-guided practice sessions) and control groups between November 2020 and June 2021. After four weeks of independent practice, both groups submitted videos of running suture and two-handed knot tying. Videos were scored by two faculty using a modified Objective Structured Assessment of Technical Skills (OSATS). Outcome measures were pre and post student self-assessment via survey and technical proficiency measured by OSATS.


Results: Instructor guided groups demonstrated a statistically significant improvement in 5 OSAT areas: correct needle loading (p=0.011), needle driver technique (p=0.002), alternating knot tie throws with fluid motion (p=0.003), global rating (p=0.035) and mean suture time (p=0.006) compared to control group.


Discussions: Faculty coaching improved performance of technical skills compared to self-guided simulated practice.

Topics: CREOG & APGO Annual Meeting, 2022, Faculty, Clerkship Director, Osteopathic Faculty, Patient Care, Practice-Based Learning & Improvement, UME, Assessment, Simulation, General Ob-Gyn,

General Information

Faculty,Clerkship Director,Osteopathic Faculty,
Patient Care,Practice-Based Learning & Improvement,
Clinical Focus
General Ob-Gyn,

Author Information

Erin Nelson, MD, University of Texas School of Medicine at San Antonio; Gabe Medrano, MD; Anne Porter, MD; Katrina De Leon, MS

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