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Timothy S. Wang, MD; Jennifer L. Schwartz, MD; Darius J. Karimipour, MD; Jeffrey S. Orringer, MD; Ted Hamilton, MS; Timothy M. Johnson, MD

Arch Dermatol. 2004;140:1357-1361.

Objective  To determine the effectiveness of an education theory–based method to teach students to place and tie a simple interrupted stitch.

Design  A teaching intervention before-after trial.

Setting  Dermatology department, academic university.

Participants  Fourth-year medical students and dermatology residents.

Main Outcome Measures  Scores on a 12-criterion grading instrument before and after instruction.

Results  The scores for medical students and residents in each class showed significant improvement. The mean score for all participants (N = 23) rose by 24% after instruction (P< .001). Scores in 9 of the 12 graded performance areas improved significantly after instruction, including scores in tissue damage/teeth marks (P<.001), needle dulled/bent (P< .001), needle loaded properly and knots square (P = .01), throws done correctly (P = .01), stitch tension and needle entry/exit angle (P = .02), amount of suture used (P = .03), and correct number of throws (P = .04). In addition, participants’ confidence increased significantly after instruction (P<.001). No difference was noted between men and women in preinstruction vs postinstruction score improvement.

Conclusions  This teaching method can be effectively used to teach students to place and tie a simple interrupted stitch. Once validated and expanded, it may prove useful in shortening and standardizing procedural skill training and in objectively documenting competency.

Author Affiliations: Departments of Dermatology (Drs Wang, Schwartz, Karimipour, Orringer, and Johnson and Mr Hamilton), Otolaryngology (Dr Johnson), and Surgery, Division of Plastic Surgery (Dr Johnson), University of Michigan Medical School, Ann Arbor.

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