External validation and evaluation of an intermediate proficiency-based knot-tying and suturing curriculum

Area of Science:

• Surgical Education
• Medical Simulation
• Proficiency-Based Training

Background:

• A proficiency-based knot-tying and suturing curriculum was previously developed.
• External validation and educational effectiveness needed assessment for advanced surgical techniques.

Purpose of the Study:

• To externally validate the intermediate-level, proficiency-based knot-tying and suturing curriculum.
• To assess the curriculum's educational effectiveness in preparing residents for advanced open surgical techniques.
• To confirm the construct validity of the curriculum.

Main Methods:

• 47 postgraduate year-1 (PGY-1) surgery residents completed 6 intermediate-level knot-tying and suturing exercises.
• Baseline performance of PGY-1 residents was compared with PGY-3/PGY-4 residents and expert faculty.
• Performance was assessed before and after curriculum completion.

Main Results:

• PGY-1 resident proficiency increased from 21.1% to 92.1% (p < 0.001).
• Post-curriculum PGY-1 residents matched or surpassed PGY-3/PGY-4 residents in 3 of 6 exercises.
• Post-curriculum PGY-1 residents' scores were equivalent or superior to expert faculty performance.

Conclusions:

• The curriculum demonstrated external validity and educational effectiveness.
• First-year surgical residents achieved performance levels matching or exceeding senior residents and experienced surgeons.
• The curriculum successfully prepared residents for advanced open surgical techniques within 4 weeks.