Improved Confidence and Clinical Application: The Effects of a Longitudinal Suture Curriculum for Medical Students

The ability to competently suture is an expected skill for graduating medical students, but many graduates report feeling unprepared to perform this skill. This study aimed to improve student confidence and clinical readiness for third-year clerkships by implementing a novel, mandatory 7.5-hour longitudinal suturing skills curriculum across the first 3 years of medical school.

The required suturing skills curriculum was implemented for all medical students throughout the first 3 years of medical school at a large academic health center in the mid-South United States. Precurriculum (n = 167) and postcourse (n = 148) surveys were administered to first-year students in the first year of the curriculum (2017-2018), and a parallel follow-up survey was administered to this cohort in 2020 after students completed their clinical clerkship year (n = 82). Aggregate changes in students' survey responses were analyzed for proper instrument position, simple interrupted sutures, and instrument ties using independent groups Mann-Whitney U tests and Rosenthal correlation coefficients for effect sizes.

Statistically significant improvement from pre to post was observed in student comfort in performing three basic skills: proper instrument position (P < 0.001), simple interrupted suture (P < 0.001), and instrument ties (P < 0.001). These pre-post gains were sustained at 2-year follow-up (P < 0.001). Also, the majority of students (66%) reported they were very or completely prepared to suture wounds during their clerkships. Most (83%) also reported they had successfully sutured patient wounds during third-year clerkships without needing significant direction or guidance.

We found that a longitudinal suture curriculum with dedicated faculty involvement can improve student confidence in suturing and overall preparedness for third-year clerkships. Although the study is limited to ratings of student comfort and self-reported performance as well as some attrition of responses at postcourse survey and postclerkship survey, the findings highlight the importance of a focused curriculum dedicated to teaching basic suturing skills. Our findings also contribute to the limited body of work examining longitudinal surgical skills development for medical students.