An education theory-based method to teach a procedural skill

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 in: struction (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.